WEBVTT - When Weight Loss Doesn’t Cure Your PCOS ft. Eleni Agresta, MS, RD 0:00:00.400 --> 0:00:04.400 I won't lend my body out be out weigh everything 0:00:04.440 --> 0:00:07.920 that I'm made do. Won't spend my life trying to change. 0:00:08.640 --> 0:00:12.440 I'm learning a love who I am, I get I'm strong, 0:00:12.840 --> 0:00:15.840 I feel free, I know who every part of me 0:00:16.480 --> 0:00:23.920 it is beautiful and I will always out way if 0:00:23.960 --> 0:00:26.560 you feel it with your hands in the air, She'll 0:00:26.640 --> 0:00:29.840 some love to the boy. Get there, say good day 0:00:29.920 --> 0:00:36.040 and time did you and die out? Welcome back to Outweigh. 0:00:36.240 --> 0:00:39.560 We're joined again by a Lenny, the amazing weight inclusive 0:00:39.600 --> 0:00:42.760 dietitian that we had on two weeks ago talking about 0:00:43.000 --> 0:00:46.960 what a weight inclusive dietitian is, um how eating disorders 0:00:47.120 --> 0:00:51.800 can exist within larger bodies, and so many other amazing 0:00:51.800 --> 0:00:55.920 conversations about how people in bigger bodies can take their 0:00:55.960 --> 0:01:01.120 power back by unlearning so much of what has been ingrained. So, 0:01:01.520 --> 0:01:03.760 like I said in that episode, we are really excited 0:01:03.760 --> 0:01:05.720 to have a Lenny back because she has a really 0:01:05.880 --> 0:01:10.800 interesting story that involves PCOS and even her own weight 0:01:10.840 --> 0:01:15.720 loss journey and then pivoting into becoming a weight inclusive dietitian. 0:01:16.000 --> 0:01:18.800 That being said, we want to put a trigger warning 0:01:18.840 --> 0:01:20.920 out there now that we are going to be talking 0:01:20.959 --> 0:01:24.080 about her weight lost journey in the context of what 0:01:24.200 --> 0:01:26.840 doctors told her to do and what happened. If that 0:01:27.160 --> 0:01:29.280 doesn't feel good for you at this time, go ahead 0:01:29.319 --> 0:01:32.280 and skip this episode, but we just want to let 0:01:32.280 --> 0:01:35.080 you know, so welcome back to Lenny. We're so excited 0:01:35.120 --> 0:01:37.200 to have you. Thank you so much for having me back. 0:01:37.240 --> 0:01:41.160 I'm so excited to have this conversation because PCOS is 0:01:41.200 --> 0:01:43.520 something that a lot of people don't really know a 0:01:43.520 --> 0:01:46.399 lot about. A lot of healthcare practitioners don't really know about, 0:01:46.400 --> 0:01:48.440 a lot of dietitians don't know a lot about. And 0:01:48.440 --> 0:01:53.160 there's a lot of misinformation and not such good information 0:01:53.200 --> 0:01:57.040 being perpetuated on social media. Um, there are very large 0:01:57.080 --> 0:02:03.240 accounts pushing narratives just that are not healthy mentally or 0:02:03.280 --> 0:02:06.760 physically for women or girls with PCOS, and so I 0:02:06.800 --> 0:02:09.440 think that this is really important, especially in the context 0:02:09.480 --> 0:02:12.280 of disordered eating and eating disorders, which it is very 0:02:12.280 --> 0:02:15.600 prevalent in this population. So let's kind of start from 0:02:15.600 --> 0:02:19.000 the basics of what PCOS is. When you were diagnosed, 0:02:19.040 --> 0:02:23.120 who diagnosed you? PCs is polycystic ovary syndrome. And what 0:02:23.280 --> 0:02:28.120 makes it difficult is that there are no definite, concrete symptoms. 0:02:28.240 --> 0:02:30.680 Everyone is kind of different. UM. I call it kind 0:02:30.720 --> 0:02:33.239 of like a spectrum. Some people have it not so 0:02:33.320 --> 0:02:36.800 seriously and other people haven't much more seriously. Some of 0:02:36.840 --> 0:02:41.560 the symptoms include elevated androgen levels in your lab values, 0:02:41.919 --> 0:02:46.160 So women with pcos who have this symptom um have 0:02:46.400 --> 0:02:50.120 a lot of excess hair growth, male pattern baldness, things 0:02:50.200 --> 0:02:54.960 like that. Another kinds of tell tale is really bad. 0:02:55.040 --> 0:02:59.360 Acne is another symptom. High body weight is considered a 0:02:59.400 --> 0:03:02.920 symptom as a result of the insulin resistance, which is 0:03:03.360 --> 0:03:07.760 something that is experienced with women with PCOS and most 0:03:07.840 --> 0:03:11.760 characteristically is not having your mental cycle or not having 0:03:11.800 --> 0:03:15.120 it frequently enough. So what were your symptoms specifically at 0:03:15.160 --> 0:03:18.000 the beginning. UM, I basically have had PCs my whole life, 0:03:18.040 --> 0:03:22.240 but I was not diagnosed until I was twenty by 0:03:22.280 --> 0:03:25.560 the dietitian that I started to see. She kind of 0:03:25.600 --> 0:03:28.200 took down all my symptoms and everything, and at that 0:03:28.280 --> 0:03:33.359 point I was over three hundred pounds and I had 0:03:33.400 --> 0:03:36.240 been essentially dieting my whole life since I was in 0:03:36.320 --> 0:03:38.880 third grade, and that's as young as I could remember. 0:03:38.920 --> 0:03:41.760 I had done like every single diet possible, and so 0:03:41.880 --> 0:03:44.920 my whole life, I was just searching for shrinking myself 0:03:45.400 --> 0:03:47.640 and it just kind of made it worse, Like it 0:03:47.720 --> 0:03:50.360 just kind of compounded, and that's how I ended up 0:03:50.400 --> 0:03:52.960 where I was. And so I would argue that at 0:03:53.000 --> 0:03:55.320 that point I was not in tune with myself. I 0:03:55.400 --> 0:03:57.200 was not in tune with my body. I didn't even 0:03:57.200 --> 0:03:59.160 know how to listen to my body. And so I 0:03:59.160 --> 0:04:02.000 had found this diet titian who inspired me to become 0:04:02.000 --> 0:04:04.720 a dietitian. Um. I was pre med at the time. 0:04:04.880 --> 0:04:07.200 I was in my junior year of college as a 0:04:07.240 --> 0:04:09.840 bio major cam miner. It was just, you know, it's 0:04:09.880 --> 0:04:12.200 difficult time. And so I had met her and I 0:04:12.240 --> 0:04:15.120 had told her I tried everything and like everyone was 0:04:15.160 --> 0:04:16.800 telling me, like you have to lose weight. And she 0:04:16.920 --> 0:04:19.159 was like, I think based on like your symptoms and 0:04:19.240 --> 0:04:21.440 just hearing about like your history, like you have something 0:04:21.440 --> 0:04:23.599 called PCOS And I was like, what is that. I 0:04:23.640 --> 0:04:25.960 had never heard of that before, and so she was 0:04:26.000 --> 0:04:28.280 the first person to tell me about it. And when 0:04:28.279 --> 0:04:30.320 I had gone to the guy in the collegist that 0:04:30.400 --> 0:04:32.680 I was seeing at the time and I told him, 0:04:32.800 --> 0:04:35.360 he was like, oh, no, that's crazy, you don't have it. 0:04:35.440 --> 0:04:37.920 He didn't even test me or anything. And so, like 0:04:37.960 --> 0:04:41.000 I said, it's difficult because certain lab values may or 0:04:41.000 --> 0:04:44.080 may not be within normal range. Some women with pcos 0:04:44.200 --> 0:04:47.400 have cysts on their ovaries, others don't. I personally do 0:04:47.480 --> 0:04:49.760 not have cysts on my ovaries. So it's it's a 0:04:49.760 --> 0:04:53.760 little bit difficult because sometimes it's not really diagnosed. And 0:04:53.800 --> 0:04:57.360 so not having your period is definitely one of those things, um, 0:04:57.400 --> 0:04:59.840 that I experienced. And I was just put on the pill. 0:05:00.200 --> 0:05:03.320 No one even thought like, Okay, what's going on underneath that. 0:05:03.560 --> 0:05:05.960 So you lost your period, that was a symptom. But 0:05:06.120 --> 0:05:07.760 like you said, you were so out of tune with 0:05:07.800 --> 0:05:11.000 your body at that point. The medical professional just said, 0:05:11.080 --> 0:05:14.440 go on the pill. Problem solved, period came back, didn't 0:05:14.440 --> 0:05:17.360 die further correct. And so I had started to see 0:05:17.360 --> 0:05:20.320 this dietitian and I had started to lose weight working 0:05:20.320 --> 0:05:23.200 with her. I never counted calories or anything like that. 0:05:23.240 --> 0:05:26.599 It was just like increasing the fiber that I ate 0:05:26.640 --> 0:05:30.200 throughout the day. But in this process of losing weight, 0:05:30.279 --> 0:05:33.520 because I had probably lost over a hundred pounds, I 0:05:33.520 --> 0:05:36.080 don't count, I don't weigh myself. Um. She would just 0:05:36.120 --> 0:05:38.360 tell me how much I had lost at the time, 0:05:38.960 --> 0:05:42.599 I developed much more severe disordered eating patterns where I 0:05:42.680 --> 0:05:47.240 became afraid of eating carbohydrates. I would restrict carbohydrates and 0:05:47.240 --> 0:05:50.200 then binge on them. And so in the process of 0:05:50.200 --> 0:05:53.160 doing something that I was being congratulated for because you 0:05:53.200 --> 0:05:55.880 have PCOS and now you're losing weight and it's going 0:05:55.920 --> 0:05:59.880 to fix everything, because that's kind of how healthcare practitioners approach. 0:06:00.120 --> 0:06:03.760 I mean, even like research focuses on what's the best 0:06:03.839 --> 0:06:07.760 diet to control weight in PCOS. And so when I 0:06:07.800 --> 0:06:10.159 did my mass just thesis, I focused on this because 0:06:10.200 --> 0:06:12.200 I was like, no one knows what's going on, Like 0:06:12.240 --> 0:06:15.160 all the studies were inconclusive, and that should just tell 0:06:15.279 --> 0:06:18.040 us that there is no one diet that's going to 0:06:18.080 --> 0:06:21.320 help every single person or every single woman with PCOS. 0:06:21.400 --> 0:06:24.080 And so the reason why I wanted to talk about 0:06:24.120 --> 0:06:27.159 my experience as far as weight loss goes, is because 0:06:27.720 --> 0:06:30.320 I did lose the weight. And when I finally did 0:06:30.360 --> 0:06:33.800 get diagnosed by like an actual great kind ofcologists, my 0:06:33.880 --> 0:06:36.600 hormone levels were all over the place, and you know, 0:06:36.680 --> 0:06:38.400 I was still on the pill, so I didn't even 0:06:38.440 --> 0:06:41.160 know if my cycles were regular, but I didn't know 0:06:41.240 --> 0:06:43.320 that I felt like, Okay, well I lost all this weight, 0:06:43.320 --> 0:06:45.320 like I should be finding now, you know, that's kind 0:06:45.320 --> 0:06:48.440 of how I thought it was supposed to be UM, 0:06:48.640 --> 0:06:51.320 and it just wasn't the case. And you know, I 0:06:51.320 --> 0:06:54.400 think it's important to highlight that if someone comes to 0:06:54.440 --> 0:06:57.080 me and they're pre diabetic and they are of a 0:06:57.160 --> 0:07:01.560 normal sized body or a larger sete body, recommendations are 0:07:01.600 --> 0:07:04.680 the same. So I do have specific recommendations for PCUS, 0:07:04.800 --> 0:07:07.880 generally depending on the client. UM. I do find that 0:07:07.960 --> 0:07:10.320 including more fiber rich foods are good, but also I 0:07:10.360 --> 0:07:13.560 find that for most individuals in general. But it just 0:07:13.920 --> 0:07:18.040 monitoring what your symptoms are and trying to address them 0:07:18.320 --> 0:07:21.800 is really more important than focusing on weight loss, which 0:07:21.800 --> 0:07:25.760 is why I don't encourage it. Our promote intentional weight loss. 0:07:26.160 --> 0:07:29.080 So to back up for a second, you started seeing 0:07:29.080 --> 0:07:33.239 a registered dietitian, you were losing weight, you were being 0:07:33.320 --> 0:07:38.040 congratulated by people. You assumed that you must be improving 0:07:38.040 --> 0:07:41.800 your health because all the doctors and medical professionals said 0:07:41.920 --> 0:07:45.480 to improve symptoms of PCOS, lose weight. That will just, 0:07:45.600 --> 0:07:47.840 you know, blanket take care of all of your problems. 0:07:48.000 --> 0:07:50.200 At the same time, we kind of left off our 0:07:50.280 --> 0:07:53.920 last episode kind of talking about this. You were binging 0:07:53.920 --> 0:07:58.600 and restricting. You had a messed up relationship to carbohydrates 0:07:58.680 --> 0:08:02.720 because PCOS is a disorder that messes with ability to 0:08:02.760 --> 0:08:07.360 manage blood sugar, So your relationship to food, specifically carbohydrates 0:08:07.480 --> 0:08:09.960 is kind of messed up. You're binging, you're restricting, you're 0:08:10.000 --> 0:08:12.840 thinking about food all the time. But you're getting applauded 0:08:13.280 --> 0:08:16.720 and you assume that you're improving your health. Yeah, a 0:08:16.800 --> 0:08:21.240 hundred percent. That's confusing. Yeah, And like the thing is 0:08:21.240 --> 0:08:24.680 is that even though sciencests so advanced, especially when it 0:08:24.680 --> 0:08:28.160 comes to PCOS, there is just so much about the 0:08:28.240 --> 0:08:32.080 hormonal levels and how it influences so many different things 0:08:32.120 --> 0:08:35.120 that we just don't really know yet. And that's why 0:08:35.400 --> 0:08:39.160 women with PCs are more likely to have depression and 0:08:39.240 --> 0:08:43.320 anxiety and then disordered eating and eating disorders because a 0:08:43.320 --> 0:08:46.280 lot of the times you see women that lost a 0:08:46.320 --> 0:08:49.839 lot of weight made and instagram to talk about it, 0:08:50.280 --> 0:08:53.320 and then they're doing keto and low carbon all these things, 0:08:53.320 --> 0:08:56.320 and at the end of the day, disordered eating like 0:08:56.440 --> 0:08:59.160 kind of overtakes it, and then these women just end 0:08:59.240 --> 0:09:02.400 up in worse positions than they were before. So it 0:09:02.440 --> 0:09:05.280 could be very dangerous because this is a medical condition 0:09:05.360 --> 0:09:09.160 that impacts your insulin and your you know, blood sugar 0:09:09.240 --> 0:09:11.800 levels and all sorts of things like that. So yeah, 0:09:11.880 --> 0:09:14.079 so I thought that that's what I was supposed to do. 0:09:14.240 --> 0:09:16.720 And you know, I had already not had a great 0:09:16.720 --> 0:09:20.760 relationship with food. But when you received the literal praise 0:09:20.800 --> 0:09:23.640 that I was receiving on a daily basis from everyone 0:09:23.679 --> 0:09:26.199 in my life, people that I worked with, my professors 0:09:26.200 --> 0:09:29.719 in college, like, it's very overwhelming. And so to get 0:09:29.760 --> 0:09:32.559 to a point where I started to gain weight back 0:09:33.040 --> 0:09:36.959 because I was over restricting and then overeating, and just 0:09:37.200 --> 0:09:38.920 I didn't know how to listen to my body. I 0:09:38.960 --> 0:09:42.120 didn't think that my body could be trusted because look 0:09:42.120 --> 0:09:44.560 at how it made me over three hundred pounds. Like 0:09:44.640 --> 0:09:48.520 I vilified myself because that's what society and health professionals 0:09:48.520 --> 0:09:51.200 told me. You know, obese is bad. It means that 0:09:51.280 --> 0:09:55.679 you're not in control. But me trying to put myself 0:09:55.760 --> 0:09:58.000 under control was what had got me there in the 0:09:58.080 --> 0:10:00.920 first place. For you, it just must be such a 0:10:00.960 --> 0:10:03.560 tumultuous journey from being on a diet when you're in 0:10:03.679 --> 0:10:06.839 third grade to dealing with this your entire life, to 0:10:07.600 --> 0:10:12.719 finally losing a significant amount of weight to arriving at 0:10:12.760 --> 0:10:14.800 this point where all of your I'm going to call 0:10:14.840 --> 0:10:17.079 it hard work. I don't know if that's how I 0:10:17.120 --> 0:10:19.440 feel about that word, or if that's how you describe it, 0:10:19.920 --> 0:10:22.439 but I'm sure at the time it felt like an accomplishment, 0:10:22.480 --> 0:10:25.720 whether it was or was not, because everybody was congratulating you, 0:10:26.520 --> 0:10:28.760 only to then, you know, find out that your health 0:10:28.800 --> 0:10:32.400 markers still haven't improved, you still have to learn how 0:10:32.400 --> 0:10:36.000 to manage PCOS. Is a little bit of a mind fork, 0:10:36.120 --> 0:10:41.000 I'll call it, for sure. And the crazy part is 0:10:41.000 --> 0:10:43.640 is that I was just so desperate to lose weight 0:10:44.200 --> 0:10:46.840 that like it wasn't even I mean I was, you know, 0:10:47.040 --> 0:10:49.680 much younger at the time. This was about ten years ago, 0:10:49.760 --> 0:10:53.040 but you know, I was just still so hung up 0:10:53.080 --> 0:10:55.240 on the fact that, like I had to lose weight 0:10:55.360 --> 0:10:58.640 because that's all people would talk about, and that's what 0:10:58.880 --> 0:11:02.240 people would concert and me asked me, like, what's your goal? 0:11:02.440 --> 0:11:04.240 Like how much do you more do you want to lose? 0:11:04.280 --> 0:11:05.960 And I was just like, I don't know, Like I 0:11:06.040 --> 0:11:08.280 did have a part of me that was like, well, 0:11:08.320 --> 0:11:10.880 whatever it is, is what it will be, and I 0:11:10.920 --> 0:11:13.160 don't have a plan, but I just kept chasing this 0:11:13.280 --> 0:11:16.760 idea and so in the pursuit of health, I made 0:11:16.840 --> 0:11:20.520 my relationship with food even worse and my hormones didn't 0:11:20.520 --> 0:11:23.400 even get better. So I was kind of like, oh no, 0:11:23.679 --> 0:11:26.200 like what was the point of all of this, you know. 0:11:26.400 --> 0:11:29.400 And to explain this to people who are who have 0:11:29.520 --> 0:11:32.319 pcdos or just in general who are in larger sized 0:11:32.360 --> 0:11:35.480 bodies who are being told like you have to lose 0:11:35.520 --> 0:11:37.920 weight for your health, I mean, it's just such a 0:11:38.080 --> 0:11:42.160 negative way that people look at themselves because of this, 0:11:42.280 --> 0:11:45.720 and it's so ingrained that I didn't even realize how 0:11:45.920 --> 0:11:49.640 much it impacted me. And to get to a point, 0:11:49.679 --> 0:11:52.240 like I said last episode, to say like I had 0:11:52.280 --> 0:11:54.800 gained weight back, and I don't know how much it was, 0:11:54.880 --> 0:11:58.839 but I was just so like I just felt like something, 0:11:58.840 --> 0:12:01.080 I mean, was like I can't keep doing this anymore, 0:12:01.120 --> 0:12:03.160 Like I have to do something else. And one of 0:12:03.160 --> 0:12:05.320 the fear foods that I had was oatmeal. I know 0:12:05.400 --> 0:12:08.600 that sounds crazy, but oatmeal is just carves, it's and 0:12:08.640 --> 0:12:10.800 it's not even high in fiber. Like I just remember 0:12:10.840 --> 0:12:14.280 hearing myself in my head saying that, and I ended 0:12:14.400 --> 0:12:17.080 up starting to eat oatmeal in the morning every single 0:12:17.160 --> 0:12:19.920 day for breakfast because I enjoyed it. It was convenient, 0:12:20.120 --> 0:12:22.960 and I like added things like ground flax seed and 0:12:23.000 --> 0:12:26.679 peanut butter and cocoun nibs and strawberries, and it was, like, 0:12:26.920 --> 0:12:29.360 you know, it was slowly how I healed my relationship 0:12:29.400 --> 0:12:32.760 with food, reintroducing foods that I was afraid of. In 0:12:32.800 --> 0:12:35.320 the process, my weight has come down. I don't know 0:12:35.559 --> 0:12:37.680 how much or whatever, but I could tell by how 0:12:37.720 --> 0:12:41.840 things were fitting me, and essentially, like my body has 0:12:41.920 --> 0:12:46.080 maintained where I am with working out and everything. Maybe 0:12:46.080 --> 0:12:48.120 it continues to go down a little bit more or 0:12:48.160 --> 0:12:50.600 maybe it goes up. I'm not sure, but like I 0:12:50.679 --> 0:12:53.800 go to the gynecologists every six months, I look at 0:12:53.840 --> 0:12:57.520 my labs um one of the telltale signs of knowing 0:12:57.600 --> 0:13:01.119 that what I've been eating and act being more intuitive 0:13:01.160 --> 0:13:04.160 with what I'm eating and listening to my body. I 0:13:04.200 --> 0:13:07.760 didn't have cysts on my ovaries. I had enlarged ovaries, 0:13:08.320 --> 0:13:12.160 and over the years and over time, my ovaries actually 0:13:12.400 --> 0:13:15.560 came back down to like a normal size range. So 0:13:15.640 --> 0:13:18.240 like that was a way of me knowing that this 0:13:18.360 --> 0:13:21.560 was something that was good and so something that I 0:13:21.559 --> 0:13:24.480 think is important to highlight is just because I don't 0:13:24.480 --> 0:13:27.920 promote intentional weight loss and I don't promote diets doesn't 0:13:27.920 --> 0:13:31.679 mean that I can't use like gentle nutrition and like 0:13:31.760 --> 0:13:35.480 principles that we know that do impact like lab values. 0:13:35.559 --> 0:13:38.040 For example, So if you have you know, a high 0:13:38.320 --> 0:13:40.679 your your blood sugar control isn't good and you have 0:13:40.760 --> 0:13:43.880 PCUS or if you're pre diabetic or diabetic, there are 0:13:43.920 --> 0:13:45.880 things that we could do that can like kind of 0:13:45.920 --> 0:13:49.240 help balance out your blood sugar that still can eat intuitively. 0:13:49.360 --> 0:13:51.280 And there are studies that are being done that to 0:13:51.880 --> 0:13:55.120 not look at PCUS, but diabetics in general and looking 0:13:55.160 --> 0:13:58.560 at blood sugar control while intuitive eating, and it has 0:13:58.600 --> 0:14:01.800 been shown that there are some benefits to it. I mean, 0:14:01.880 --> 0:14:04.320 these studies are not very in depth, and you know, 0:14:04.360 --> 0:14:06.920 as with most studies, you know, more studies need to 0:14:06.960 --> 0:14:09.520 be done. But there is a way to help heal 0:14:09.760 --> 0:14:13.480 your pcos or whatever it may be while still healing 0:14:13.520 --> 0:14:17.000 your relationship with food. And like you said, your relationship 0:14:17.040 --> 0:14:20.440 to food and your lab values started to improve when 0:14:20.440 --> 0:14:22.960 you brought the things in that you couldn't eat, when 0:14:22.960 --> 0:14:26.080 you made food fun. Adding peanut butter accounted like what 0:14:26.160 --> 0:14:31.120 a positive approach to nutrition essentially, which is I think 0:14:31.200 --> 0:14:33.480 is kind of like what you're about. And I just 0:14:33.560 --> 0:14:35.800 want to touch on one thing you said earlier, which 0:14:36.080 --> 0:14:39.800 you said science is advanced, and it is, but the 0:14:39.840 --> 0:14:42.840 most humbling thing that I always returned to is that 0:14:42.920 --> 0:14:47.280 nutrition and science is actually young. No matter how advanced 0:14:47.320 --> 0:14:49.520 it is, it's always going to be young, and we 0:14:49.600 --> 0:14:54.560 need to stay humble and recognize that everything we know, 0:14:54.880 --> 0:14:58.320 the more we know over time, we still only understand 0:14:58.440 --> 0:15:02.240 a fraction of it all because we're only human beings 0:15:02.280 --> 0:15:05.880 trying to solve the most complex, you know, puzzle of 0:15:05.880 --> 0:15:09.360 all time, many of which the variables are always changing 0:15:09.400 --> 0:15:12.960 as a result of nature and and the life that 0:15:13.040 --> 0:15:15.560 we do live. In a post that you wrote, you said, 0:15:15.880 --> 0:15:20.000 lowering your weight will improve your health outcomes possibly, but 0:15:20.400 --> 0:15:23.560 for healthy long term goals to be reached, the behaviors 0:15:23.600 --> 0:15:26.720 need to be suitable for your body. And I love 0:15:26.760 --> 0:15:31.680 that sentence because in medicine we see, or we're trained 0:15:32.000 --> 0:15:35.440 to be told that if we just fix the number, 0:15:35.960 --> 0:15:39.680 the lab values will improve. And I think, like you said, 0:15:39.720 --> 0:15:42.440 that sends a lot of people who don't have that 0:15:42.520 --> 0:15:47.040 wake up call like you did on a lifelong journey 0:15:47.080 --> 0:15:51.520 of painful dieting, because dieting is not just eating a 0:15:51.560 --> 0:15:54.160 certain way, it's living a certain way, it's thinking a 0:15:54.200 --> 0:15:58.600 certain way. It's losing your life to something else externally 0:15:59.080 --> 0:16:02.680 under the guys of health. So I think it's it's 0:16:02.720 --> 0:16:08.040 so interesting to really pay attention to yourself, not just 0:16:08.120 --> 0:16:10.360 at a three month marker of being on a diet 0:16:10.520 --> 0:16:14.480 or a year, but the long term outcomes and lift 0:16:14.560 --> 0:16:16.560 up what's under the hood. So even if your doctor's 0:16:16.600 --> 0:16:19.840 congratulating you and your lab values are improved, there are 0:16:19.840 --> 0:16:21.880 people who are going to lose weight and they're you know, 0:16:21.920 --> 0:16:23.880 their blood sugar is going to improve, or maybe their 0:16:23.880 --> 0:16:27.560 PCOS symptoms will improve. It will be because of a 0:16:27.600 --> 0:16:29.600 lot of other things. But they'll chalk it up to 0:16:29.640 --> 0:16:32.680 the weight. So how can we get people to look 0:16:32.760 --> 0:16:36.120 under the hood and say, am I really okay? Even 0:16:36.120 --> 0:16:39.920 though everyone seems to think I'm okay? Yeah, And that's 0:16:39.920 --> 0:16:43.000 a good point to look under the hood. And for me, 0:16:43.400 --> 0:16:47.360 what I realized just as a practitioner that I had 0:16:47.480 --> 0:16:51.960 clients that improved their lab values. There are weight didn't 0:16:52.000 --> 0:16:55.880 really change, but they started to have their their mind 0:16:55.920 --> 0:16:59.240 still psychle more regular, which means that their hormones were 0:16:59.320 --> 0:17:02.880 kind of balanceding out. So using weight in general just 0:17:03.080 --> 0:17:05.280 isn't my I'm not a fan of. And I've had 0:17:05.280 --> 0:17:10.160 many conversations with physicians of my clients about this, specifically, 0:17:10.240 --> 0:17:13.119 like we're not going to weigh this patient. This patient 0:17:13.119 --> 0:17:15.159 doesn't want to be weighed, Like, please don't weigh this 0:17:15.240 --> 0:17:19.240 patient because then, you know, for some people it's very triggering, 0:17:19.560 --> 0:17:21.960 you know, like I feel great, my lab values are great, 0:17:22.000 --> 0:17:24.760 but like the scale hasn't moved, and you know, so 0:17:25.080 --> 0:17:28.160 I don't weigh my clients. Um, I don't encourage them 0:17:28.160 --> 0:17:30.400 to be weighed. You're looking under the hood. I mean, 0:17:30.480 --> 0:17:33.120 you're asking them how they feel, you're getting the lab values, 0:17:33.400 --> 0:17:36.000 You're making sure that they're good without them being thrown 0:17:36.040 --> 0:17:39.680 off by this external variable. And I think it's important 0:17:39.720 --> 0:17:43.120 to realize, like when you talk about health, what does 0:17:43.160 --> 0:17:46.760 that actually mean? It's different for everyone. So let's say 0:17:46.960 --> 0:17:49.639 you have PCs, and like I said, it's like a spectrum. 0:17:49.960 --> 0:17:52.120 And one of the studies that I looked at in 0:17:52.160 --> 0:17:54.679 my thesis from when I was doing my masters was 0:17:54.720 --> 0:18:00.600 that regardless of weight status, women with pcos experience insulin resistance. 0:18:00.640 --> 0:18:04.000 So even in a normal quote unquote normal weighted women 0:18:04.000 --> 0:18:09.080 with PCUS still exhibited insulin resistance whether they were overweight, obese, 0:18:09.160 --> 0:18:14.160 or regular sized. And so to me, that's like very telling, Like, well, 0:18:14.320 --> 0:18:17.840 so someone comes to they have abnormal lab values but 0:18:17.920 --> 0:18:20.480 they're of a normal weight, what do you recommend? You 0:18:20.480 --> 0:18:23.160 don't recommend weight loss? You like, you know, you figure 0:18:23.160 --> 0:18:25.440 out what depending on what the lab value is and 0:18:25.480 --> 0:18:28.960 what nutritionally we can actually do. But again, it also 0:18:29.040 --> 0:18:31.359 depends on where you are in your relationship with food. 0:18:31.359 --> 0:18:33.320 If you have a poor relationship with food and you've 0:18:33.400 --> 0:18:36.720 been dieting and you're exhibiting disordered eating habits, I don't 0:18:36.720 --> 0:18:39.040 care about anything else. We need to work on that first. 0:18:39.119 --> 0:18:42.240 And so it just really depends on the situation. So 0:18:42.280 --> 0:18:44.960 the last question I have for you is you're obviously 0:18:44.960 --> 0:18:48.080 a weight inclusive dietitian now and you're really helping people 0:18:48.119 --> 0:18:51.840 prioritize their health condition. A lot of us out there 0:18:51.920 --> 0:18:54.960 work with the generalized population of disordered eating, but to 0:18:55.000 --> 0:18:57.680 take it a step further and help people that oftentimes 0:18:58.160 --> 0:19:01.919 need more gentle nutrition shin or maybe less gentle they 0:19:01.960 --> 0:19:04.720 need more coaching on how to I just call it 0:19:04.800 --> 0:19:07.320 nutrition education. Really, like they need to learn how to eat, 0:19:07.359 --> 0:19:10.040 to manage their blood sugar or things like that. It's 0:19:10.080 --> 0:19:12.239 so important that we have people like you in the 0:19:12.280 --> 0:19:15.080 field to do so. So I'd love to kind of 0:19:15.160 --> 0:19:17.040 just I know we're kind of going backwards here, but 0:19:17.440 --> 0:19:22.399 what is a weight inclusive dietitian and what made you 0:19:22.960 --> 0:19:26.359 pivot into becoming one? Like I said on the last episode, 0:19:26.520 --> 0:19:29.720 I was noticing a lot of these disordered habits and 0:19:29.960 --> 0:19:32.400 clients that came to me in a larger body size 0:19:32.960 --> 0:19:35.520 that came to me because they wanted to lose weight. 0:19:35.720 --> 0:19:38.280 And when I explained to them that these habits are 0:19:38.359 --> 0:19:41.359 disordered and this is not a healthy way to live, 0:19:41.840 --> 0:19:44.080 it was kind of like eye opening. But they're like, 0:19:44.119 --> 0:19:46.480 but I'm, you know, overweight, Like how can I have 0:19:46.680 --> 0:19:49.199 disordered eating or you know, and eating disorder? And I 0:19:49.280 --> 0:19:52.480 was like, this is what the habits mean, and you 0:19:52.640 --> 0:19:55.960 deserve to heal your relationship with food before we do 0:19:56.040 --> 0:19:59.400 anything else. And even women in larger sized bodies could 0:19:59.400 --> 0:20:03.240 have very just sort of relationships with movement and exercise. 0:20:03.640 --> 0:20:06.480 And there are patients of mine that are in larger 0:20:06.560 --> 0:20:09.879 sized bodies that we're working on hearing their relationship with food, 0:20:09.880 --> 0:20:13.159 and I don't recommend for them to exercise because they 0:20:13.160 --> 0:20:15.600 have such a disordered relationship, meaning that they try to 0:20:15.800 --> 0:20:18.720 subconsciously burn a certain amount of calories. They have the 0:20:18.760 --> 0:20:21.399 Apple Watch, and now the big thing with the peloton, 0:20:21.640 --> 0:20:25.320 how it like ranks you and you know all these things. 0:20:25.359 --> 0:20:29.120 So I love my peloton. I have no idea how 0:20:29.160 --> 0:20:32.960 to even like know what the rankings are, which I 0:20:32.960 --> 0:20:35.760 guess I don't even know what the numbers mean. So 0:20:35.800 --> 0:20:38.040 it's funny to me that people are getting so roped 0:20:38.119 --> 0:20:41.080 up into this, but especially during the past year when 0:20:41.119 --> 0:20:43.440 it's like the Year of the Peloton, Like I even 0:20:43.520 --> 0:20:45.320 was like, should I get a peloton even though like 0:20:45.400 --> 0:20:49.960 I hate bicycling, Like this's just know everyone's different and 0:20:50.040 --> 0:20:52.120 so but like if that's what you like, and then 0:20:52.280 --> 0:20:55.080 a percent, that's amazing. But I a lot of people 0:20:55.119 --> 0:20:57.000 don't realize, like, just because you're in a large sized 0:20:57.000 --> 0:20:58.960 body doesn't mean you need to force yourself to move 0:20:58.960 --> 0:21:01.720 your move your body needs to lose weight or to 0:21:01.840 --> 0:21:04.280 earn food or to earn off the food that you're 0:21:04.280 --> 0:21:06.920 eating later. And a lot of these thoughts are so 0:21:07.000 --> 0:21:09.479 subconscious that people didn't even realize that this is what 0:21:09.520 --> 0:21:12.120 they were experiencing, so I realized that I was doing 0:21:12.119 --> 0:21:16.479 a disservice to let them. Like, helping someone lose weight, 0:21:16.800 --> 0:21:20.680 for the most part, is really not hard, but the 0:21:20.720 --> 0:21:24.600 idea of what's maintainable and what's actually healthy that's the 0:21:24.680 --> 0:21:27.880 hard part. And so like I explained to my clients, 0:21:27.880 --> 0:21:30.840 when someone first comes to me, their intention maybe to 0:21:30.880 --> 0:21:32.880 lose weight, and I explained him that is not what 0:21:32.960 --> 0:21:35.840