On today’s episode, we’ll talk about food—for nourishment, for enjoyment, for ourselves and for our families. Dr. Karen Nelson is joined by Alicia Phillips, manager of nutrition services here at Melrose to understand how “all foods fit” in the treatment of eating disorders.
On today’s episode, we’ll talk about food—for nourishment, for enjoyment, for ourselves and for our families. Dr. Karen Nelson is joined by Alicia Phillips, manager of nutrition services here at Melrose to understand how “all foods fit” in the treatment of eating disorders.
Click here for a transcript of this episode.
Dr. Karen Nelson: [00:00:00] Eating disorders thrive in secrecy and shame. It's when we create a safe space for honest conversation that we'll find the opportunity for healing. Hi there, I'm Dr. Karen Nelson, licensed clinical psychologist at Melrose Center, welcoming you to Melrose Heals, a conversation about eating disorders. A podcast designed to explore, discuss, and understand eating disorders and mental health.
On today's episode, we'll talk about food, for nourishment, for enjoyment, for ourselves and for our families. I'm joined by Alicia Phillips, Manager of Nutrition Services here at Melrose, to understand how all foods fit in the treatment of eating disorders. Now, before I begin I invite you to take a deep breath and join me in this space.
Welcome, Alicia!
Alicia Phillips: Thanks for having me, Karen, [00:01:00] I'm super excited to be here.
Dr. Karen Nelson: Well, before we get started, I would love it if you could introduce yourself and tell us about your role here at Melrose.
Alicia Phillips: Sounds good. So I'm Alicia Phillips. I manage our nutrition services, which includes our amazing dieticians and awesome kitchen staff. So I'm super lucky to get to work with them. And I'm also fortunate enough to manage our outpatient programs that, a lot of nutrition stuff happens in all of those programs as well. So, kind of various roles.
Dr. Karen Nelson: Lots of variety. Well, as I mentioned, we're going to start talking about this concept of all foods fit. It's kind of a tagline. We use it a lot. A lot of our therapists use it. Definitely our dieticians use it.
Alicia Phillips: For sure.
Dr. Karen Nelson: Let's maybe kind of start there. Help our listeners know, what do we mean when we say all foods fit?
Alicia Phillips: Exactly that, Karen. Exactly that.
Dr. Karen Nelson: Literally what the word says.
Alicia Phillips: Done. We're done. Yeah. All foods fit. And really, it is part of our nutrition philosophy that we have at Melrose. I really want [00:02:00] our patients to understand that there is no good or bad food. We don't have to eliminate anything in order to achieve something. So really just that concept of understanding that anything and everything can work and let's find its place and we don't need to have judgments about them. So really working through that. And obviously, like you had said, it's a very broad topic. So, you know, as then we explore that, we can narrow that down.
Dr. Karen Nelson: So, wait a minute. So all foods fit. Sure. So like pizza fits.
Alicia Phillips: Like tonight for dinner, yeah.
Dr. Karen Nelson: Cupcakes fit.
Alicia Phillips: Yeah.
KN; Really?
Alicia Phillips: Yeah. For sure.
Dr. Karen Nelson: Like really?
Alicia Phillips: Yes. Absolutely.
Dr. Karen Nelson: I think for our patients, right, that feels like a radical idea and concept. Like, tell me, what have you experienced as you maybe have shared that with patients in the past?
Alicia Phillips: I think we get approached with significant resistance, right? Like, ‘What? No, that's not a thing. Like, have you watched the media? Have you seen anything outside? Like, all foods don't fit. We can't have that.’ Yeah, [00:03:00] like right away, let's debunk that, you know. And let's talk about that and why this is okay. So I think, when you think all foods fit, yes, for sure, pizza has its place. For sure, cup cakes have its place. But, hello, I'm a dietician, like, so do fruits and vegetables, and we will for sure talk about that too.
Dr. Karen Nelson: That’s right.
Alicia Phillips: But it's all about that balance and moderation and why you're eating things and kind of the rationale behind it. Unfortunately, you know, our patients are struggling with eating disorders, and the first thing that happens with just about any eating disorder is an elimination, a judgment of something that then gets labeled as good or bad. It's honestly like words we don't want to use in our practice until we are recognizing, right, or being able to call out, like, ‘Hey, why is that a good food? Or what is the meaning behind that? Tell me more!’ Because I would think a lot of our dieticians, and I guess I know that, myself included, like, just, like, food is food. Here we are. You know? But because there are so much strong judgments around it, we want to [00:04:00] understand why does that feel good? Or what does that mean? Or when did that become a good food versus a bad food?
Dr. Karen Nelson: I think that also kind of identifying this concept that many of our patients might share with us that food almost seems to hold like a moral value. Like, I'm good or better if I eat fruits, vegetables, you know, zucchini and carrots. I'm bad if I eat pizza, chips, and soda.
Alicia Phillips: That's hard, right? Because they do honestly feel that way and working with our patients, you never want to tell them they don't feel that way. But also helping them understand all food has value, right? All food has value, no matter if I'm eating these apples and carrots and zucchini or if I'm going to be having a pizza tonight for dinner. You know?
Dr. Karen Nelson: That’s right.
Alicia Phillips: And really we don't – even us right now using this like opposite ends of the spectrum. I think we're talking about just what we're hearing from our patients. But should we even put that [00:05:00] right on the spectrum versus it just being food is food? All food is going to have nutrients and honestly, every person's body needs nutrients and every food is going to break down the exact same way, because your body doesn't know if you're putting an apple in or that cupcake.
Dr. Karen Nelson: That's right. That's right. Well, what could happen if a person may start struggling with this labeling of food as good or bad? Or, ‘I can't have these foods. I don't want to be adding those into my daily interaction.’ What could happen with that labeling of food as good or bad?
Alicia Phillips: I think it only becomes more heightened. The minute you tell yourself you can't have something, your brain continues to go there, right? And it almost also has part of your brain telling you, like, ‘You do really want them.’ So then you're playing this balance of, ‘I can't have it.’ But then maybe what if you do have it one time and then there's a ton of shame around that, or then maybe you have it excessively versus just not having [00:06:00] judgment, having it when you want it, having it in the amount that you wanted as well, I think is really something we continue to explore as you look at food across the spectrum.
Dr. Karen Nelson: Well I think also, kind of my role as a therapist, you know, I like how you're talking about that, the fancy word that we might use is that dichotomy, right? Two opposite ends.
Alicia Phillips: That's a good word.
Dr. Karen Nelson: It's a big ass word, right? They made me go to school for a long time.
Alicia Phillips: Just to say that word.
Dr. Karen Nelson: Literally, yeah. But I think it like helps when we almost like imagine it as a picture, right? That if I only have two categories of food, good or bad, oh no! And what happens if I don't want to eat a food or I'm not desiring a food in the quote, good category? What do you notice about that?
Alicia Phillips: Well, those are gonna be the only foods that you want, right? And then you really are, you're missing out. No matter what group of foods you're going to desire, you're going to miss out if you don't have this [00:07:00] variety that we always talk about. And people are like, ‘I don't need variety, I like eating the same thing every single day.’ Sure, you might temporarily, and that sounds really good in theory because it's easy, which it probably is if you don't have to think about it. But eventually, your body is going to tell you that it wants something different. That you need fuel from a different food source. That it is going to want a different nutrient. Maybe you've been eating carrots and now we're going to want some apples. Or maybe now we're going to want spaghetti for dinner instead of that turkey sandwich or whatever. So I think, yes, your body does become bored and it will tell you if you listen to it, right? So I think another big piece is figuring out how the heck do we listen to our body and what it needs? And that's really hard for our patient.
Dr. Karen Nelson: It can be, absolutely. I think, too, exploring or maybe elaborating on this idea of good or bad. As a therapist, what I often talk about is the emotion that's attached to food.
Alicia Phillips: Yeah.
Dr. Karen Nelson: And if I'm putting my food into [00:08:00] these two categories, good or bad, if I choose a food or do interact with a food in the bad category, how does that make me feel? And we know, right? Eating disorders are about emotion. And so I think the misconception is they're all about food. If I just can figure out how to not eat the bad list, I'll be golden. This ain't that, right?
Alicia Phillips: No, it's really probably not about the food at all.
Dr. Karen Nelson: You know, it's absolutely about the emotion. Sometimes I'll describe it to patients as like rigidity around food.
Alicia Phillips: Yeah, I think one of my favorite words to use when I'm just talking about like, ‘Well, how should I eat?’ Someone's like, ‘Well, you're a dietitian. Just tell me what to do.’ I think my favorite thing to say is like, let's be flexible. We do not have to have an agenda on what we are going to eat every single day, every single minute. Let's be flexible. And that's hard.
Dr. Karen Nelson: It’s scary, right?
Alicia Phillips: For sure. It can be really scary. Because flexible means we don't know what our body is going to [00:09:00] intake. So if perhaps our patients want control and they don't know what that's going to look like, those two things are really going to butt heads and that's not going to go over well. So I think yes, my favorite word is flexibility, whether it be food, whether it be the time, whether it be someone we're eating with. But how do we get to a place of being able to be flexible and not putting those judgments in that category of the good or bad that we're talking about?
Dr. Karen Nelson: Excellent. I wanted to ask you, Alicia, as we're talking about that flexibility, I love that you bring that up. Kind of thinking about food maybe in a different way, rather than just, good or bad. Might we approach food as like, there's a function to food or what might some of those functions be for people?
Alicia Phillips: For sure. But also the other thing is, food can be fun. Like that is this crazy idea of, why would food be fun? But if we think about it, food is attached to many experiences that we have in [00:10:00] life. Perhaps positive or negative, right? And so you have these judgments and connotations that you tie to different foods that you may have. You know, for example, right? Christmas comes around and my grandma made the best sugar cookies with homemade frosting. And no one can make that same recipe. But I almost have to try everyone's, right? And it's just this, it's a positive connotation to really wanting those cookies and continuing to try that. But I also think, you know, what if then we have the loss of grandma? What emotions then are tied to a certain food? Right? Because that could be very challenging as well.
Dr. Karen Nelson: I think too, kind of connecting that back into the topic that we were talking about, good or bad, what do I do if the cookies are on the bad list? And I really love my grandma and it brings up so many memories, right? I mean, do you think that can show up for people?
Alicia Phillips: Absolutely. Because then that goes to wanting to [00:11:00] have those things, but then you're playing this game in your head. Like I can't, I shouldn't, if I do, I'm going to feel this way. And just trying to figure out how to navigate that. Versus what if we didn't have to put cookies or any food in a category? What if our food was food for us? What if we viewed it as fuel, knowing that we need all of it? And being able to have it when we want it in the quantities that we want it. What would that look like, do you think?
Dr. Karen Nelson: I love that. It can be a pretty radically different way –
Alicia Phillips: Absolutely.
Dr. Karen Nelson: – to conceptualize food. Well, I like it. Maybe you can kind of break it down for us a little bit. I like how you identified kind of having some of that flexibility around food and that we may have different functions to our eating, right? One might be nourishment, right? Like it makes sense. I need vitamins and minerals.
Alicia Phillips: We need food.
Dr. Karen Nelson: Right.
Alicia Phillips: We need it.
Dr. Karen Nelson: Absolutely. And then maybe some other interactions like enjoyment or, [00:12:00] you know, social gatherings or comfort. But if we maybe pause around that concept of nourishment, let's break it down a little bit. How do we nourish our bodies or what does our body need?
Alicia Phillips: Well, if we listen to our body, it'll tell us from the get go, right? Like it is a process and there's no perfect way to explain it. Right? And there's not something that we do wrong, but really, I think when we approach eating, letting it be food. Let's provide a variety of food and allow ourselves to choose what we want. So like with kids, you know, like. The first time they try food, of course we get the yuck faces, right? And of course you remember all those fun memories, but you know, we want to expose people to a variety of foods to test out their taste buds. You might not like something the first time and that's totally okay, but that doesn't mean it's off the table, right? Let's [00:13:00] try it 20 more times before we maybe have a true ‘like or not like’ about it. And I think that's really important to understand, too. All foods can fit, but that doesn't mean you can't have preferences, right? And I think that's really important, too, is to go with what you like.
Don't think you have to like something. Don't think you have to eat that broccoli at dinner every single night if you don't love it. Switch it up. Trying to prepare it a different way could really help enhance those taste buds and offer different nutrients that we're talking about. I think coloring your plate is, it sounds so elementary, but it's my favorite, right?
I think all the handouts that I have, if I have them in color, they are on point just because what that really tells us is we're getting a variety of nutrients in all those different colors that we have. So it's just kind of a game we even play at home. Like, ‘Oh, what color are we missing? Go find something in the fridge. Let's go do that.’ You know, but that really enhances then kind of that positive engagement in eating the food, the [00:14:00] nutrients that we may have as a family.
Dr. Karen Nelson: I love that.
Alicia Phillips: So let's, let's go here a minute. I think the biggest thing that – another big thing, I have lots of big things apparently.
Dr. Karen Nelson: I’m good, I’m glad.
Alicia Phillips: Oh man, here we go. Individualized nutrition: Each of our bodies, Karen, you and I need different nutrients, right? Our activities are different. Our statures are different. And that's the best thing about us. But we also have to listen to our bodies to tell us which nutrients we need, right? So yeah, MyPlate in general, big changes from the pyramid. The pyramid kind of told us exact amounts we needed to have. MyPlate is maybe aligning with like, include all these things, right? It's not trying to take out what someone is having. Which I enjoy about it, but yet it's saying include fruits, include vegetables, include grains, include dairy. It literally wants us to eat that rainbow we're talking about, eat that variety of foods that we have been mentioning. To make sure [00:15:00] we are well rounded in getting those nutrients that we need.
Dr. Karen Nelson: First of all, maybe it might be helpful for our listeners if they're not familiar with what that means or what it might look like. Can you kind of just outline a little bit of food items we're talking about or how is it broken up? Yeah, so it's colorful.
Dr. Karen Nelson: Yes.
Alicia Phillips: That's my favorite, right?
Dr. Karen Nelson: That's right.
Alicia Phillips: But really it's focusing on, you know, what should a plate or a meal look like for you? So just kind of visualize for me a minute. Like your plate sitting in front of you, it's breaking it up. So part of that plate is going to have some source of protein. It could be meat. It could be from legumes. It could be from a plant-based protein, right? But protein of some nature, because all of our bodies do need protein. We need carbohydrates. We need some grains in there, okay? So that's going to be depicted in there as well. And, gosh, there are a lot of grains that we could have, right? So trying to figure out with our patients, like, ‘What do we like? What could we be okay with, you know?’ And the obvious fruits and veggies. Those are going to be in there [00:16:00] too, as well as a source of calcium. And I always like to add in water. I add that in. It's not in there. They didn't ask for my feedback on that, but I think just hydration in general is going to be huge, too. And really exploring, how do we make, when we sit down for a meal, how do we make that? What does that look like? Or why is something missing out of what that looks like?
Dr. Karen Nelson: Really helpful description. Why do you think that the change, kind of from your perception, you know, in the field, why do you think it did shift from a pyramid to a plate?
Alicia Phillips: Like I had said, a big benefit of this that is helpful is perhaps many people did acknowledge that we were encouraging people to restrict intakes to X amounts, and it didn't actually encompass the reality that everyone's needs are different. Yet with MyPlate, if we can encourage everyone to eat all the different food groups in the quantities that fit their body. That's the best way to go about it, and really, that's part of our job, is figuring out what foods in all these [00:17:00] categories, food categories, right, do you like to eat, including sweets and desserts? Do they even need that label? Let's just call it what it is. Is it the Skittles? Purple Skittles, my fave, okay. You know, is it the roasted Brussels sprouts? Okay, you don't know how to roast them? Okay, what else do you like that's green? Let's talk about that, you know. It doesn't have to be perfect. It can be fun. It can be an adventure, versus thinking it needs to be so perfect.
Dr. Karen Nelson: So I think the word that I use a lot with my patients rather than with judgment, looking at that plate with curiosity, is what I'm hearing you talk about, right?
Alicia Phillips: Love it, mmhm.
Dr. Karen Nelson: Like we're just going to explore what comes up, what initially might feel quote safe to put on that plate, what feels really scary. And then we're just going to talk about it. We're not judging it. We're not shaming it, right? We're just being really curious. Absolutely. One thing that I've noticed being an eating disorder therapist is we kind of encourage people to slow [00:18:00] down and maybe reflect on some of those beliefs or interactions that they have with food. Wow, are they surprised at how much emotion or stories or memory? Any comments on that?
Alicia Phillips: I think when you talk about how food does have the emotion behind it, or what is tied to it can lead to some pretty exciting stories, right? Just in terms of what they used to have, and hopefully this kind of leads into this a little bit, but talking about like their journey with food throughout their life. Like when did they enjoy food, or when did they notice that change of feeling like maybe they did need to be more rigid, or they did start judging food and think they needed to make it more specific, if you will, right? So if you can kind of navigate that, sometimes it's great to pull from those times in their life where they did enjoy food, because they do think – we all have at some point, or we can see it, right? But just figuring out how to then tie that into where things got a little [00:19:00]discombobulated.
Dr. Karen Nelson: One thing that I often talk about with my patients is how the eating disorder will start to exclude, eliminate, and take away joyful experiences with food. So food and dinnertime or mealtime becomes a battleground rather than enjoyment, right? And so I love that you're bringing up, maybe with a patient we're exploring, ‘I used to love having spaghetti and meatballs with my family. My grandma would make them. And then the eating disorder took over and I was no longer able to eat carbs and cheese was scary and meat felt overwhelming. And now I'm not participating at all.’
Alicia Phillips: That is a very common story, right? And I think it's not a quick thing, right? Like, but just exploring all those different pieces. When did you notice that you did enjoy family meals? Right? Like when was that important to you as we'll just throw this in there. But family meals are so important [00:20:00] because it allows you that opportunity to not have it be about the food, but about your day, about your reflection. You know, a rose and a thorn at dinner is very common in our household.
Dr. Karen Nelson: That’s right. Highs, lows.
Alicia Phillips: Yes. It's like I work here or something.
Dr. Karen Nelson: That's right. I know.
Alicia Phillips: But I think that's part of this journey with the patient is understanding how they got to that point and why we felt the need to take that out. And do they miss that? Do they have a positive connotation to it? Because I think that's really important too, in terms of just kind of meeting them and their goals of what they're hoping to have. In terms of bettering their relationship with food.
Dr. Karen Nelson: So we were talking about this idea, right? That food serves a nourishing, you know, aspect to our bodies. It serves as enjoyment, right? It also could serve as a way to cope with emotion, right? Or kind of manage overwhelming feelings. [00:21:00] Thoughts on that or what you may notice people do with food when they are feeling overwhelmed and are struggling with an eating disorder?
Alicia Phillips: For sure. I think that's a really good question and I think I do want to just take a little step back to be and say, it's normal to use food to cope.
Dr. Karen Nelson: Oh, thank you.
Alicia Phillips: It is, right? Like what brings you some comfort. If it is a favorite type of food, so be it. Like that is appropriate. And that's the spectrum of eating that we're talking about in what is quote unquote normal. It's normal to use food to cope, right? I think where, in our line of work, when that is your only coping mechanism, is where we could struggle and play a part in your eating disorder. And that's why we really work on multiple coping skills, but I never want to tell someone that's not appropriate. Because it is. We've talked about, yes, food gives us all the fuel we need to live our awesome [00:22:00] life. It has all the positive effects and it's okay to have it also support when we are having maybe more negative emotions or sad. That's all part of it. And that's okay.
Dr. Karen Nelson: I love that you brought up this idea that using food to maybe comfort myself a little bit or to kind of respond to an emotion doesn't inherently have to be problematic or wrong because I think sometimes – now caveat right if that is the only way –
Alicia Phillips: For sure, yeah.
Dr. Karen Nelson: – and if I'm interacting with those foods in maybe a kind of compulsive obsessive binge type way –
Alicia Phillips: Yeah.
Dr. Karen Nelson: – we need to talk about that.
Alicia Phillips: Absolutely.
Dr. Karen Nelson: And having a hard day and coming home and wanting to have a normal amount of grandma's spaghetti and meatballs just might feel really good.
Alicia Phillips: Why not? Why not? I think that's all part of it, right? When we can fuel our body and give it what it needs when it wants it, [00:23:00] it'll tell us when it's done, too. Like, it's crazy, but it will!
Dr. Karen Nelson: That's right.
Alicia Phillips: If we want to listen to it, right?
Dr. Karen Nelson: Yeah.
Alicia Phillips: And I think that just plays into that part of why it is appropriate to have what you want when you want. If we're listening to our body, you know. And that's something that we'll work on with patients, too, is understanding that hunger and fullness, because when that eating disorder comes into play, those hunger and fullness cues definitely can go to the wayside and may not be as readily available for our patients to hear and interpret. And so that's something that we work on right with, regular eating would be like the first thing we would start to work on that. So we can incorporate these variety of foods that we have. All of these foods can fit throughout your day, even those ones that you even have judgments on. But if we can eat regularly, we're not going to necessarily need them in large quantities to cope, potentially, to kind of circle that back through.
Dr. Karen Nelson: I like, Alicia, how you're bringing up this idea of hunger and fullness. [00:24:00] And maybe let's pause there for a second. I think a lot of my patients struggle with this idea of hunger. Like, how do I know I'm hungry? Maybe part of my symptom use has diminished the cue and, and I don't feel it or hear it, or I've become accustomed to ignore it. Tell us a little bit more about that. How our patients may struggle with hunger and fullness cues.
Alicia Phillips: I think you tell them they're right. Their eating disorder has interrupted their ability to do that. And it's a process to understand and bring that back. I was kind of mentioning before, a big part of our role, we want people to be able to have those cues, as that's just part of regular and normal eating. And so as I had kind of mentioned earlier, with that regular eating. That's how we're going to get back there. We might have people say, ‘But I'm definitely not hungry.’ You're right. You may or may [00:25:00] not be because we haven't decided if we can kind of trust our bodies at that moment, because that eating disorder has taken your ability to trust your hunger and fullness away. And through our work together, that's something we're going to bring back. So you can trust if you're hungry, if you're full, because then, fast forward –
Dr. Karen Nelson: So maybe some of the skills that I'm hearing you talk about that dieticians are teaching is literally practicing regular eating.
Alicia Phillips: You're right. Have you worked here for a little while?
Dr. Karen Nelson: I have. Just a little bit. I usually say, ‘Defer to your dietician.’
Alicia Phillips: Solid. No, honestly, I will say that's going to be our foundation and it's hard. We may have patients coming in that are eating once a day. We may have patients coming in that are saying they're eating three times a day, but are they eating enough for their body? And that's what we want to navigate. That goes back to that individualization I was talking about is, it's not black and white. Nutrition is not black and white. But what [00:26:00] is black and white to me, is that we need to fuel your body for what it needs. And that's what I want to explore with you throughout your treatment here at Melrose.
Dr. Karen Nelson: So when I may be starting treatment with a dietitian and they're saying, you know, I need to be listening to my body more, what do I do if my body says I don't think I want to eat breakfast but my dietitian told me I need to?
Alicia Phillips: Your dietitian is right!
Dr. Karen Nelson: Oh yes!
Alicia Phillips: Yes!
Dr. Karen Nelson: Your therapist will tell you your dietitian is right.
Alicia Phillips: Yes! No, I think that is the hardest part because yes, on one hand, we're saying we want you to listen to your body, but that isn't going to come until later in our journey. We really want you to trust your team and listen to their advice. We are so lucky to have professionals that have been in this field a long time, right? So when we're telling you, ‘Hey, I think we really need to eat breakfast, lunch, and dinner, and we need to disperse some snacks in there.’ We need to do it. Because that really is going to help [00:27:00] almost reset that foundation for your relationship with food for that hunger and fullness that we've been talking about to give you that life worth living that you so deserve and not let food interrupt that.
Dr. Karen Nelson: And the expectation isn't radically changing all the things overnight. You and I both know that it's not sustainable. It's scary. It's overwhelming all the things, but. Wow, what a difference. If I went from never eating breakfast to trying to figure out how to add in a yogurt. I mean, it's huge. Those are huge moments.
Alicia Phillips: They are. And I also want our patients to know like we get that's the scariest thing someone can probably ask you to do.
Dr. Karen Nelson: That's right.
Alicia Phillips: Right? We all have fears. And I try to remember eating is one of the biggest fears of our patients, or someone that may come and sit in front of me. So for me to say like, ‘Oh, okay. I hate spiders.’
Dr. Karen Nelson: That’s right.
Alicia Phillips: Like, ‘Hey, can you go put your hand in a bag of spiders?’ Absolutely not. I'm going to peace out and [00:28:00] run the opposite direction as fast as I can. And I always just want to remind myself, like, I'm asking my patient to eat maybe a quantity they haven't eaten, a food they haven't eaten. And that may trigger that same response of like, ‘Absolutely not. I want to b-line it out of this office right now because there's no way I can do that.’ So really letting them know, like, you know, maybe one spider in a bag I could handle, but maybe that one item at breakfast, we can navigate together.
Dr. Karen Nelson: I want to shift a little bit, Alicia, and talk about the role of culture with our perceptions of food, right?
Alicia Phillips: There's a lot of them.
Dr. Karen Nelson: As I know, as we both get like smirks on our face, like, ‘Yeah, we're going to, we're going to walk right into diet culture here. Let's hit it.’ I mean, we've talked about it a little bit. There are so many messages we get around food. And that foods actually don't all fit. I would love to hear your perspective, [00:29:00] you know, as a dietician, having all this wealth of information around what our bodies actually need, and then the messages that are out in the world. What have you noticed or tell us a little bit about your thoughts about what you see kind of out in culture around food?
Alicia Phillips: Karen, this is a big question.
Dr. Karen Nelson: That's it, go.
Alicia Phillips: It's a big question. I think honestly, one of the first things as you were saying that I'm like, ‘Oh man, like, I'm sorry people have to navigate this. I'm sorry there are so many–’ I'm gonna call them lies. There are so many lies about what we are supposed to do for our body, to put in our body, to make it perfect. Like, what is that? That's not a thing. That's not okay. And I clearly feel very strongly about that.
Dr. Karen Nelson: Keep going. My favorite question I've asked.
Alicia Phillips: Oh man. Yeah. And I think [00:30:00] when we see these messages, when we see any messages. Whether it be from young to old, right? Whether it's our young kiddos, Karen, or whether it's grandma and grandpa that you meet, everyone is going to pull something away from what a sign is saying, what social media is saying we need to eat, or how we should behave. Can we just put a pause? Right? Like, can you be curious? Let's just circle back to that. Be curious about like, what, what does that even mean and why? Why? Why would I do that? Can I think about that further? And is that appropriate for me? You know, like, does my body need that? Here we are again. It is individualized. We do not all need the same thing. We do all not respond to the same thing. But we should all be respecting our bodies enough to give it what it needs versus what diet culture is saying that we need, cause it's wrong.
Dr. Karen Nelson: Well, tell us from a dietitian [00:31:00] perspective, what happens when someone may participate in kind of cyclical dieting or kind of yo-yo dieting?
Alicia Phillips: And ultimately, I think one of the first things they say is, ‘Why doesn't it work?’
Dr. Karen Nelson: Yes, exactly.
Alicia Phillips: Because it won't. And I will tell them that until I am blue in the face. And that's when we can explore, like, ‘Well, what does your body want? And why do we want those changes?’ I'll hand that over to you. But we can explore that food piece of typically dieting, right? Let's just go there a minute. Diets want us to restrict something from our diet. It tells us to cut something out. As we've talked about already, Karen, the minute we cut something out, your brain's gonna want that. It just is. That is normal functioning of our brain, which means your brain is working, which is great. But we also then need to respond by giving it what it wants, right? So we don't get into this cyclical cycle of [00:32:00] restricting, then wanting it, and then feeling shame, so then we're going to restrict some more. That's – when we talk about cyclical, that is what's happening. We deprive our bodies of nutrients that it needs, and then we want more of it. And then we feel shame, because maybe we gave into that and we just keep going in this circle.
Dr. Karen Nelson: Well, what do you think about the messages in culture around quote healthy eating? I think often what I notice is my patients are overwhelmed. They are overwhelmed. They're like, ‘Well, this influencer on TikTok says I should–’ Come on. I mean, no wonder. And it looks like legit oftentimes, you know? They're promoting it with pictures or even quote, facts, about dieting and what our bodies need. I don't know. Thoughts on that, of this idea of like, healthy eating in our culture now.
Alicia Phillips: It's completely overwhelming and no one is [00:33:00] alone and it is okay to think that. Because it is. There's too much out there that is not helpful. I think nutrition can be very basic. Healthy eating, you know, like, what is healthy?
Dr. Karen Nelson: Great question. I'm so glad you asked that.
Alicia Phillips: I mean, am I supposed to answer that?
Dr. Karen Nelson: You're the dietician. I ain't going there.
Alicia Phillips: Oh gosh. I think healthy is taking care of your body and giving it what it needs. I do not need to tell you, you need this many fruits, this many vegetables, this many grams of protein. Let's explore who you are. What does your activity look like on a given day? What does your access to food look like? What food brings you pleasure?
Dr. Karen Nelson: Wow.
Alicia Phillips: What does that look like?
Dr. Karen Nelson: So different.
Alicia Phillips: And when we can answer those questions, then we can talk about how to include a variety of food to help you be the healthiest version of yourself. Because it's [00:34:00] not just going to be about that food. Once we put in those variety of foods, you're going to be healthy physically, mentally, and being able to engage in life. And that, to me, is healthy. I always feel like healthy is just prescribed to food, which I don't understand. I don't get it. Healthy to me is really taking care of yourself as a whole and there's so much more to it. That food is just one component, but when we can do that well, it's going to be able to positively impact all areas of your life.
Dr. Karen Nelson: Well, I think also too, sometimes for our patients, this kind of drive to be healthy can actually be a slippery slope into eating disorder behaviors, right? And I'm so glad you said it. You know, healthy isn't a list of foods. Healthy is like this kind of giant concept of just overarching self care.
Alicia Phillips: Absolutely. I think we hear all the time, ‘I did it because I wanted to be healthy.’ Right? And I don't think all – [00:35:00] I don't think the world does a good job of actually depicting what healthy means, right? In all these buckets that we're kind of talking about. A lot of times it's telling someone they need to be perfect. You need to be perfect with what you're eating, with how you're exercising, with how much sleep you're getting. I don't know what that means. Like, that's not normal. I can tell you what normal and regular eating is, but that? None of that's normal, right? A wise friend once told me, I'm never going to serve birthday broccoli.
Dr. Karen Nelson: That's right.
Alicia Phillips: Right?
Dr. Karen Nelson: Wait, even if you're healthy, Alisha?
Alicia Phillips: Right. I would like to think that I want to raise a very healthy family, but I'm not serving birthday broccoli. We're going to have cake at our house.
Dr. Karen Nelson: That's right. Or I'm not coming to your house.
Alicia Phillips: Maybe ice cream cake. I'm not sure yet. And we're going to serve a variety of other things with that. But, let's not overemphasize what we think we have to do to be healthy versus what is real? [00:36:00] What do we want to give our bodies? I am so passionate about the work, as I know you are too Karen, that really remembering we are here to help. And you do not have to be alone, and food does not have to be scary. Let food be fun. Let food be fuel. And let yourself live your life.
Dr. Karen Nelson: Thank you so much for being with me today, Alicia. It's been a joy.
Alicia Phillips: I have really appreciated our conversation and thanks for having me, I appreciate it.
Dr. Karen Nelson: That's it for today. Thanks for joining me. We've covered a lot, so I encourage you to let it settle and filter in. And as I tell my patients at the end of every session: Take notice, pay attention, and we'll take it as it comes. I'll talk to you next time. To learn more about Melrose Center, please visit MelroseHeals.com.
If you or a loved one are suffering from an eating disorder, we're here to help. Call 952 993 [00:37:00] 6200 to schedule an appointment and begin the journey towards healing and recovery. Melrose Heals: A Conversation About Eating Disorders was made possible by generous donations to the Park Nicollet Foundation.