This post is part of my “Know Better, Do Better” series, in which I revisit an old blog post that makes me cringe because my thinking has evolved substantially since I wrote it. The text of the original post is in italics, with my somewhat snarky current notes in plain text.

Note: I wrote the original post in July 2011, when I was two months away from starting graduate school to study nutritional sciences and become a dietitian. Oh, and I was deeply enmeshed in diet culture.

I was doing some research for an article at work the other day and chanced upon this quote from Surgeon General Regina Benjamin:

“Americans will be more likely to change their behavior if they have a meaningful reward–something more than just reaching a certain weight or dress size. The real reward is invigorating, energizing, joyous health. It is a level of health that allows people to embrace each day and live their lives to the fullest without disease or disability.”

I agree that striving for a number on the scale or on a dress label is the wrong way to go. But this statement is to-tal-ly healthist! Not everyone is going to be able to enjoy “invigorating, energizing, joyous health.”

  • Maybe they have a chronic health condition that produces uncomfortable or inconvenient symptoms. Maybe they’re dealing with permanent after effects of major body trauma and injury (such as from a car or cycling accident).
  • Maybe they’re going through cancer treatment.
  • Maybe they’re plagued by all sorts of environmental allergies and the medication options also leave them feeling unwell.

Oh, wait, she’s talking about a level of health “that allows people to embrace each day and life their lives to the fullest WITHOUT DISEASE OR DISABILITY.”

Why did I quote her? Oh, because I believed in that sh*t back then.

But the truth is that some people will never be free of disease or disability. Maybe they were born with a lifelong health condition or a serious birth defect. Maybe something happened to them along the way.

If you are unable to enjoy the “rewards” that Dr. Benjamin describes, does that mean you should just say “f*ck it”? That would be your right as an autonomous human, but most people probably don’t really want to do that.

We need to know that no matter what our level of health or ability, that we can make choices that support our overall health and maybe help us feel better on a daily basis. And we should be supported in our choices by the healthcare system. (I know, I know…what is this utopia of which I write?)

Sanctimonious me

I could not agree more! I know all too well that shooting for a certain number on the scale or trying to fit into a pair of skinny jeans can be awfully motivating in the short term, but staying at that weight or continuing to fit into those jeans is usually less motivating. And that’s when weight regain happens.

Uh, yeah, because weight loss maintenance is only about “motivation.” Never mind the slowed metabolism and constant hunger and the crushing weight of food deprivation (actual or psychological). THAT’S when weight regain happens.

Maintaining a weight loss requires effort for the rest of your life. Part of that effort involves daily choices about what and how much to eat.

True. For those unicorn outliers that lose weight and keep it off, it requires effort for the rest of your life, effort you could be spending on other things like your job, your partner, your kids, your friends, gardening, volunteer work, finding a cure for cancer, creating world peace.

And daily choices? You bet. Every day becomes a constant negotiation of:

  • What foods in what amounts will help hold back the metabolic and hormonal tide of weight regain.
  • Whether you need to eat before you go to that social function next week because there might not be any food there that’s “OK” to eat.
  • How much less you need to eat because your stress fracture or shoulder tendonitis is getting in the way of working out (that second one happened to me).
  • How much more you need to workout because you had an unplanned piece of cake at the office birthday celebration.

So, lots and lots of “choices.”

In which I did not tell the whole truth

From time to time, in the course of discussions with friends or family about what I don’t eat anymore (or don’t eat much of), I’ve frequently heard comments along the lines of, “Well…you need to get at least some enjoyment from your food” or “Oh, I know I should cut back on [name of food], but it’s just so goooooood!”

OK, now I’m cracking myself up, because I totally didn’t mention how these conversations practically sent me into a rage spiral. Was I hangry? Maybe. Did I feel that I wasn’t getting the proper respect for my virtuous food behavior? Probably.

Still, that was nothing compared to an incident a few years prior, when I sat in my healthcare provider’s exam room in my temporarily thin body and mentioned that I would like to lose more weight. She gently asked me, “Why would you want to do that?” and I think I actually wanted to rip her head off.

She was probably concerned that I could be on the road to anorexia. (I’ve said more than once that I’m clearly not genetically predisposed to a restrictive eating disorder, because I sure set the stage for one.) Today, I applaud her concern, but considering how prickly her comment made me, her approach could probably use some work.

Come to think of it, I’d probably been weird about family food events for more than four years by that point, so maybe they were concerned, too. (Just ask my husband about all the drama I conjured up because I didn’t want to do group meals on camping trips with his family because they weren’t “healthy enough.”)

Look at me, acting like the Food Police

The first comment touches on that popular misconception that healthy food isn’t enjoyable. Pardon my French, but that’s bulls–t. (OK, if I were actually speaking French, I would have said “quelle connerie.” Yes, I looked it up.) I enjoy food, and I only eat food I enjoy. About 90 percent of the time, I eat foods I enjoy that also happen to be healthy. It’s a win-win.

Egad, the old 90-10 “rule.” The casualness with which I wrote this belies how rigid I held onto that ratio. Yes, I did enjoy my food, but I may have needed the control more.

The second comment assumes that food is a primary source of pleasure. Here are my feelings on that: If your weight or your health isn’t where you want it to be, and you know you are eating foods that you should be eating less of (whether because of the food itself or the amount in which you consume it), then you need to find other sources of pleasure in your life.

Wow, that’s awfully bossy of me! While I mostly agree with this (except for the weight part, which isn’t my focus for myself or my clients), I take a more gentle approach now.

Yes, if you are eating foods that are making it hard to manage a health condition where your food choices have a direct effect (I’m thinking irritable bowel syndrome, celiac disease, food allergies, GERD/reflux, etc.), and it’s because those foods are the only real source of pleasure in your life, then if you’re my client we’re going to be exploring ways to increase life pleasure so food doesn’t have to do the heavy lifting.

That’s also true if food is a primary source of emotional joy and comfort. I’m here for food pleasure, but I also believe that (when possible) meeting our pleasure needs in a variety of ways is ultimately better for us…and more pleasurable.

Ouch…just, ouch!

Is it worth eating a pint of ice cream every night if it means you develop diabetes and have to start worrying about things like taking insulin and the threat of complications kidney failure, blindness and losing a limb? Ahem.

WTF? I mean, literally what the hell was wrong with me? When I first re-read this, I felt some contempt for my 13-year-ago self, because this statement is so mean and judgy. And it’s not even true, because diabetes is not caused by eating a lot of ice cream.

Yes, once someone develops diabetes, they may worry about needing to take insulin at some point, and the thought of diabetes complications can be scary (especially if they have a family member with diabetes who has experienced complications). But to even imply that there’s a direct ice cream-to-losing-a-limb pipeline is bananas! This is why people who haven’t actually studied nutrition (which at that point included me) should probably zip their lips about these things.

You can tell I was really buying into the idea that health is our personal responsibility and totally within our control — and even that it’s our obligation to pursue health. I believe none of that now, because I know how deeply complex and multi-factorial health is. I also know that many people are just trying to make it through their hard lives. Striving for health may not be something they have bandwidth for, and I will not shame them.

Now, if one of my clients is eating a pint of ice cream every night, and it’s making them feel unwell and/or contributing to a health problem and that is concerning to them, then I will help them untangle from whatever is driving that ice cream habit. But it’s their choice.

On health and pleasure

While I was vacationing last week, I read the next chapter in [redacted]. One of the (many) points made in this excellent chapter was that many healthy foods don’t deliver deep pleasure while we’re eating them, but the fact that we know they will benefit our health is pleasurable in and of itself.

Is it though? I mean, I am fortunate to enjoy good health, and I do enjoy it, especially when I’m temporarily sick or injured and I can clearly see the contrast between health and not health. But pleasurable? I don’t know, that kind of feels like a stretch. I mean, good health can help make it possible to do things that bring real pleasure, but that’s not the same thing.

I do sort of agree that “many healthy foods don’t deliver deep pleasure while we’re eating them,” but some DO, and even when they don’t, they’re usually sufficiently tasty and satisfying. I’m OK with not every meal being a party in my mouth.

On the flip side, many foods that give us immediate pleasure can take away pleasure later by make us feel unwell or actually contributing to poor health.

Yes, this is true. That’s why I talk with my clients about how foods make you feel while you’re eating them but also right after and some hours later. Some people find that foods they love give them heartburn or a stomachache, and it’s worth talking about whether the food is worth it, or if there’s a way to enjoy those foods in a way that produces fewer negative after-effects (eating them earlier in the day, in smaller portions, less often, etc.).

As for whether “many foods that give us immediate pleasure” contribute to poor health, that’s far more nebulous than my original statement suggests. I mean, I ate a peach yesterday that gave me immediate pleasure.

Pulling out my self-compassion tools…

I find a rich, high-quality dark chocolate mousse more pleasurable than a good salad, but I eat a good salad every day, and chocolate mousse about once a year.

OK, duh about the dark chocolate mousse. That would be the dessert I request to go with my last meal. I probably do have it about once a year, because it’s a bit time-consuming to make, unless by happenstance I go to more than one restaurant in a 12-month period that has an excellent dark-chocolate mousse on the dessert menu. But when I originally wrote this, I was totally virtue signaling. Let’s call a spade a spade.

And what did I mean by “good salad”? A big salad? An entrée salad? Probably. I don’t eat one every day, though. I go through phases where that’s all I want for lunch, and then I want other things for a while.

The subtler pleasure of the salad, combined with the pleasure of current and future good health, more than makes up for the more intense pleasure of decadent desserts.

I can’t even, like, stand my 13-years-ago self right now. That sentence practically makes me gag. I need to pause and take a self-compassion break…

…OK, I’m back. I agree that a salad offers a subtler pleasure than a most excellent dark chocolate mousse, but I’ve had some salads, some made by me, some in restaurants (which makes me try to recreate them at home) that were positively divine.

(There’s one I’m looking forward to revisiting this fall, with thinly sliced apple, cubed Manchego cheese, Marcona almonds, and leftover roasted chicken —all over greens — which is a riff on a salad I had at True Food Kitchen in Las Vegas a few years ago…yum!)

What really bothers me about that sentence is the whiff of not just virtue, but morality, ascetism (a lifestyle characterized by abstinence from worldly pleasures), and purity. That’s probably because, in addition to trying to maintain my weight loss, I was also into “clean eating” at that time. For health, of course. (Cue eye roll.)

At least I ended on a high note

There are three exercises in this chapter, which I think about 99 percent of people would benefit from:

  1. Make a list of all foods you think are healthy that you also find pleasurable to eat. Include at least three of these foods in your meals each day and see how you feel.
  2. Make a list of every single food that gives you great pleasure, no matter how “forbidden” it is. In the next week, eat one or two of them and really take the time to savor and enjoy them. See how you feel.
  3. Make a list of every single non-food thing (people, places, things, experiences) that gives you great pleasure. Are you including enough of these things in your life, or are you compensating with food?

OK, I actually think these exercises are not bad! Yay past me!

That’s only scratching the surface, so if the issues surrounding food and pleasure resonate with you, I strongly suggest you get your hands on [book name redacted]. Life’s too short to not be as pleasurable as we can make it, and life will probably be longer if we get most of our pleasure from healthy food and from non-food delights!

Again, I essentially agree with this. I redacted the name of the book because I do think some aspects of it are problematic, so I don’t recommend it wholesale. I do find that many of my clients don’t have enough pleasure in their lives. (I ask all my clients what they do for fun and creativity, and often we end up talking about pleasure, specifically.)

Reading fiction. Painting. Swimming. Listening to live music. Crafting. Cooking classes. Riding a bike. Gardening. Simply sitting in their garden. Watching movies. Having some quiet time in the morning. Those are just a few things that give my clients pleasure.

And for my clients who have lots of pleasurable activities in their lives, food of all kinds is also a pleasure, and to keep food as a pleasure, they’re attuned to how their food makes them feel. They’re also choosy about what they eat (not picky…that’s different), so they’re fully satisfied. And satisfaction is a key element of being an intuitive eater.

Previous “Know Better, Do Better” posts (plus one related post):

Carrie Dennett, MPH, RDN, is a Pacific Northwest-based registered dietitian nutritionist, journalist, intuitive eating counselor, author, and speaker. Her superpowers include busting nutrition myths and empowering women to feel better in their bodies and make food choices that support pleasure, nutrition and health. This post is for informational purposes only and does not constitute individualized nutrition or medical advice.

Seeking 1-on-1 nutrition counseling? Learn more about her Food & Body, IBS management, and nutrition counseling programs, and book a free intro call to see if the program is a good fit, and if we’re a good fit!

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