Maintain Boundaries Re: Food and Family
Welcome to week #4 of my series, A Yuletide Guide to Staying Safe and Sane.
So far we’ve discussed tips to cope with:
This week is about how to talk with loved ones about food, weight and bodies — and how not to. It is inspired by two readers, both mothers, who wrote to me in response to my recent newsletter series on myths about weight loss.
One newsletter reader connected with how difficult it is to talk to doctors about weight:
I wanted to reach out because this [newsletter] resonated in particular. My son has been struggling with his weight almost his entire life and I have yet to find a single medical professional whose advice isn’t along the lines of “eat more carrots and exercise.” As with each person, his story is more complicated than something that can be fixed by that advice. This newsletter is the first time I’ve ever read advice that I think could resonate with him.
And then this second reader gave me an idea:
Thank you for this installation of your newsletter! I would LOVE to see a follow up on ways to talk about eating with our kids, especially as the holidays approach. Perhaps something we can forward on to family members who still have really outdated and harmful opinions about dieting and fat bodies. I’d love to see you address the harm of fat-phobia and weight stigma as those are catastrophic for our health.
Let’s do it!
But first, I will LET YOU IN ON A LITTLE SECRET: starting this Wednesday, I’ll be offering more fun ways for you, dear readers, to ask me questions, pose your medical mysteries, suggest topics of conversation, and engage more dynamically with my content and with me. The comment above is a perfect example of what I’m talking about. So stay tuned!!
(Note to my patients: not to worry! As always, I am available for patient care five days a week and rotate with my medical partners to cover nights and weekends too! You — and my family — are my first priority, always.)
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I don’t think I’ve met a single patient struggling with obesity or overweight who hasn’t at some point been shamed — overtly or subtly — by a medical professional. I try with my own patients to appropriately frame obesity not as a personal failure (because it’s not), but rather as a symptom of complex societal, cultural, behavioral, hormonal, and biochemical factors (because it is). I then try to address weight issues with sensitivity and concern for the root cause(s). But I find that my patients who struggle with weight also carry a hefty burden of shame.
How do I know this? They tell me.
When they see an orthopedist for knee pain, they get a lecture about weight. When they see a gastroenterologist for abdominal pain, they get a lecture about weight. When they see a cardiologist for chest pain, they get a lecture about weight. Don’t get me wrong: obesity and overweight are clearly associated with skeletal, gastrointestinal, and myriad other medical problems — yes. But my job is to help patients treat these complex problems with multi-pronged solutions. It is to treat the whole patient and not just the number on the scale.
The real rub? These patients already know they need to lose weight. They aren’t unaware about the benefits of broccoli and the potential harms of obesity. They have been flooded with messages that conflate thinness with virtuousness. Sometimes for them, the biggest barrier is finding a provider to see them as a person — and not just a number on the scale.
Indeed, only by understanding the totality of people’s health — physical, social-emotional, behavioral, and otherwise — can we begin to help people with complex issues like weight.
So, if the doctor’s office is this tough, imagine what it’s like for people struggling with weight during the holidays when they get together with family and friends. Temptations and family-to-family examinations abound. Well-intended loved ones may feel freer to scrutinize and comment on other people’s bodies and food choices. Alcohol can unleash unhelpful — and even harmful — opinions at the very moments when we most need and deserve unconditional love.
There are the not-so-subtle comments:
Honey, are you sure you want to eat that? Don’t you think that’s more than enough on your plate, sweetie? Maybe you should exercise more in college if you’re going to eat like that, pumpkin?
And the general food/body talk that can permeate the air:
Oof I just ate so much food — I don’t deserve any dessert! I’ve been so bad this season I need to exercise to work off everything I’ve eaten! I can’t wait to eat “clean” again after the holidays!
The meta-messages in these seemingly innocuous comments are that:
Eating for the joy of eating is shameful.
Delicious treats must be earned.
Pleasure must be accompanied by guilt.
Exercise is punishment for eating.
Foods are either “clean” or “dirty.”
Thinness is a moral virtue.
Guess what? All of the above statements are dead wrong. Yet they are at the core of American diet culture and can easily permeate our consciousness.
So here are my suggestions for holiday harmony when it comes to eating and food:
For those of you who struggle with weight, body image, and/or your relationship with food:
Give yourself permission to enjoy delicious foods and drinks this season. No one should have to earn the right to seek and experience pleasure. Moreover, eating is a required activity for all human beings, regardless of size!
Recognize the pervasiveness of diet culture-related thoughts, feelings and behaviors in other people — and gently correct them if you’re comfortable. For example: “Grandma, I know you love me so much, so I hope you understand that my [body/weight/eating habits] are not for public consumption.” Or “Mom, I know you just want me to be healthy, but the regular talk about dieting and weight is a little overwhelming to me. I wonder if we could talk about something else?” Or “Granddad, I love everything about you and I hope you feel the same way about me, regardless of [my body/weight].”
Focus on meeting your needs — physically, mentally, emotionally — this season. That may or may not include your personal weight loss journey. Either way, prioritizing your needs and establishing healthy boundaries with family is the best gift you can give yourself this season!
For those of you who are genuinely worried about a loved one’s weight and naturally want to do anything you can to help them:
Even if you have the purest intentions to help someone you love to be healthy, you must accept that 1) stating something that is already obvious to the other person can be extremely hurtful, especially given the pervasiveness of diet culture, 2) you cannot change other people simply by telling them what to do, and 3) shame is never a healthy or productive way to motivate other people — or ourselves.
You are more likely to help your loved one overcome obstacles to healthy and sustainable weight loss (if that is what they want) if 1) you model a healthy relationship with food yourself, removing any language that moralizes food, exercise, or body size, 2) you provide your family member with unconditional love and a safe, supportive space to celebrate the totality of their being.
Remember that we truly cannot tell what’s going on in other people’s lives, bodies, and minds by looking at them — even if we are blood relatives! Assuming things about other people is never appropriate. If you are seriously concerned about someone else's health — weight or otherwise — you should always lead with empathy over assumptions. Example: I love you so much. Please know I am here to listen and support you and never to judge you.
Treat yourself to skipping the emotional labor of worrying about other people this holiday. You will open up fresh brain space for joy and invite new opportunities for emotional intimacy, which is the glue of healthy relationships.
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On the subject of food as medicine, check out this week’s podcast!
Dr. Glynis Albright, fondly known as The Waffle Queen, has built an empire off of her pies, cookies and pound cakes. As CEO of the world renowned Glynis’ Kitchen, her treats have been tasted and loved by the likes of Bill Clinton and John Legend.
But cooking isn’t just Dr. Albright’s passion, it’s been her lifeline. On this episode of Beyond the Prescription, she and I discuss our often complex relationship with food, how to reject diet culture, and how to appropriately nourish our bodies and minds. We talk about the baker’s journey of self-discovery as she moved away from skipping meals toward preparing delicious ones for herself and others. As the inventor of the “Just Sweet Enough” line of treats for people undergoing cancer treatment, Dr. Albright herself is food for the soul.
A holiday favor! Please take a moment to rate and review the show by clicking here and scrolling down to the review section.
Most of all, I hope you give today’s episode a listen now on Apple, Spotify, or wherever you find podcasts!
Expect to hear from me again on Wednesday! Until then, be well.