Friday Q&A: binge eating; probiotics; talking to teen boys about food; & the Mediterranean diet
You ask the best questions!
It’s Friday Q&A time!
This week is all about nourishing our bodies and minds. (Next week is about gut health!)
Check out this week’s newsletter about what adverse childhood experiences teach us about our relationship with food.
Tune into this week’s podcast with the co-founder of Whole30, Melissa Urban, about recovering from addiction through creating healthy boundaries around food and substances. You can also find it on Spotify and Apple Podcasts.
Don’t miss my recent Q&As on:
The first question today (about restricting and bingeing) is for all subscribers. The remaining questions (about probiotics and gut health, concern about my son’s relationship with food, and the best diet) are for paid subscribers.
Click here to submit your questions (about anything) for future Q&A posts!
Let’s dive in!
I am trying to work on my relationship with food. However, I frequently get urges to binge or restrict. These urges often feel overpowering and I don’t feel like I can control them. How can I manage these urges?
-Stuck in a Cycle
You are not alone. So many people find themselves inadvertently using food to avoid difficult emotions or to get a quick hit of Dopamine, the “pleasure hormone.” It's great that you recognize your urges to binge or restrict. The next steps involve connecting the dots between your thoughts, feelings, and behaviors around food—then carving out agency where able. Here are some strategies that help many of my patients regain control of their relationship with food:
Identify triggers: Is it a certain emotion or situation that makes you want to binge or restrict? For some people, it’s shame, fear, or feeling out of control that triggers them. For other people, it’s a certain place or person that triggers difficult emotions.
Practice mindfulness: Recognizing that this will be difficult (indeed some of our thoughts are the very ones we’re trying to avoid!), try to be more present and aware of your thoughts and emotions in the moment. When you feel an urge to binge or restrict, take a few deep breaths and observe the urge without judgment.
Distract yourself: Remember that no feeling lasts forever. Feelings wash over us like waves on a beach. Sometimes, distracting yourself with a non-food related activity can help you ride out the urge. Try going for a walk, cuddling with a pet, or calling a friend in order to mentally “change the channel.”
Practice self-compassion: Remember that it's okay to slip up sometimes! Be kind to yourself and try not to beat yourself up if you do binge or restrict. Instead, focus on learning from the experience and moving forward.
Seek professional help: If you find that these urges are persistent and interfering with your daily life, consider seeking help from a therapist or healthcare professional who can work with you to develop a personalized plan for managing these urges.
Do probiotics work to restore gut health?
Great question! I will address this in more depth next week. The short answer is: it depends. For example, when one of my patients had COVID, she decided to be extremely intentional about what she ate and drank. No sugar. No alcohol. No Fritos with her chili. A banana if bored, an apple in the late afternoon as a distraction from processing emails. She also started drinking kombucha and eating more yogurt.
She emerged from COVID retaining these habits and found that she was sleeping better, lost four pounds, and was no longer bloated. Why? Because the changes in her diet boosted her consumption of probiotics. Products like yogurt, kefir, kombucha and other fermented foods contain “good” microbes like Lactobacillaceae and Bifidobacterium which are the actual living bugs your body needs to take up residence.
Think of the good guys in your gut as small pets. They want to eat well. Try taking really good care of them for a month and see where you end up. You may find you crave an entirely different range of foods. My advice?
Consume more probiotics: yogurt, kefir, kombucha.
Feed your microbes with good prebiotics (the nutrients that probiotics need to thrive): whole grains, nuts, seeds, oats, barley and apples.
Avoid taking antibiotics. They kill the good microbes and can cause dysbiosis (which is an imbalance between “good” and “bad” bacteria).
Cut out as many processed foods as you can. Swap out the box of Cheezits for almonds, trade the the sugar cereal for an apple with peanut butter.
Cut out as much sugar as you can. For example, add honey to tea at night instead of having a cocktail or wine!
None of this is easy, so give yourself a few weeks to change a habit—and be sure to take notes on how you’re feeling from the inside out!
My teenage son seems to overeat. How can I talk with him about my concerns with his relationship to food? I’ve heard so much about how teenage girls struggle with this, but rarely hear how to support teenage boys with these struggles. Do you have any advice for how I can express my concerns, without shaming him?
- Molly from Pittsburgh
I wrote a detailed post about this issue right here. It's important to realize that boys, too, can be vulnerable to negative self-image issues that can affect their relationship with food. The combination of diet culture, social media imagery, and the pressures on young people can conspire in myriad ways. So it’s important to approach conversations about food and body image with sensitivity and empathy, particularly with teens! Here is some advice about having that conversation with your son:
Focus on health, not weight: Avoid framing the conversation in terms of weight or appearance. Instead, focus on health and wellbeing. For example, you might say something like, "I've noticed that your appetite seems bigger than usual. I wonder if this might be affecting your health."
Choose the right time and place: Choose a time and place where your son is likely to be receptive to your conversation. Avoid criticizing him while he's eating or in a public place where he may feel embarrassed or ashamed.
Lead with curiosity, not judgement: Make sure to listen to your son's perspective and encourage him to talk about how he feels about himself. Ask open-ended questions like, "What’s on your mind these days?” or “Are there certain foods that help you feel strong and energetic?”
Empathize, and use yourself as an example: Let your son know that it’s perfectly normal to sometimes eat for comfort, pleasure, boredom, etc. Remind him he is not alone by giving an example such as “When I get overwhelmed I gravitate toward ice cream. I wonder if you ever feel like I do?”
Offer support and resources: Let your son know that you're there to support him and offer resources if he needs them. This might include finding a nutritionist or therapist or simply being a listening ear and supportive presence. Sometimes it means grocery shopping together to find healthy and pleasurable foods!
Remember that talking about these issues can be challenging, but it's important to open the conversation and offer support. With sensitivity and empathy, you can help your son develop a healthy relationship with food and his body.
I am 53, and I feel like I eat healthy for the most part and I walk 3-5 times a week. My food pitfall is baked goods and chocolate. I am not eating huge amounts, but I do like something sweet every day. I just want to be healthy and is the Mediterranean diet the best for overall health?
It's great to hear that you are already taking steps to maintain your health by eating healthy foods and getting regular exercise. It's also important to enjoy the foods you love in moderation, like baked goods and chocolate.
The Mediterranean diet is often recommended by doctors and has been associated with various health benefits, including reducing the risk of heart disease, stroke, and certain cancers. It emphasizes consuming plenty of fruits, vegetables, whole grains, legumes, nuts, and seeds, while also incorporating moderate amounts of fish, poultry, and dairy products. It also limits the intake of red meat and processed foods, while incorporating healthy fats such as olive oil and avocado.
That said, there is no one-size-fits-all approach to nutrition. What works for one person may not work for another. My podcast guest founded Whole30 to help find balance in her diet!
In general, I recommend to my patients that they get three decent meals a day, ideally each with protein, fiber, whole grains, and healthy fats—and to pay close attention to hunger and satiety cues. Mindfulness around eating is almost as important as the things we eat!
Disclaimer: The views expressed here are entirely my own. They do not reflect those of my employer, nor are they a substitute for advice from your personal physician.