Saturday, November 3, 2007

Regular-size me

I'm feeling a conflict of diet theories these days.

A lot of what I've been thinking about diet lately was crystallized by a blog post I read recently, which talks about the moral value society attaches to foods and how this screws us up:

Teppy wrote a great post yesterday about “demand feeding,” which is a really terrible name for “eating what you want when you’re hungry and stopping when you’re full.”

That’s something I recommend frequently, as it’s a key component of the Health at Every Size strategy. The problem with it, as Teppy points out, is a whole lot of people don’t know when they’re hungry, what they feel like eating, or when they’re full. Ex-dieters, especially, are so used to categorizing foods as “good” and “bad,” and having specific foods and portions dictated to us, the thought of really eating whatever we want — as opposed to the diet version of “eating whatever you want,” which means allowing yourself one bite of ice cream SO YOU DON’T FEEL DEPRIVED (oy) — can be overwhelming and frankly frightening.


But regardless, “We will give you permission — in some limited way — to eat ‘bad’ foods!” is a tremendously effective marketing strategy.

And that’s because so many of us really believe somebody needs to give us permission; simply choosing to eat fatty, sugary food because you feel like it is absolutely not an option. And then somebody also needs to put a limit on that permission, so we won’t go and devour the world. In this culture, most of us never learn to trust our bodies when it comes to eating, and we certainly never learn to trust our desires. Choosing what to eat is a daily battle between good and evil.

I mean, think about it for two seconds. People are selling plans that allow you to “eat what you want,” to the tune of billions. That’s lunacy. Because I love you, I shall offer you the Kate Harding Lifetime Diet Plan — which permits you to eat whatever you want — absolutely free! It goes like this:

DAY 1:

Eat whatever you want. It’s your body. You’re allowed.


Repeat Day 1.

The problem with the Kate Harding Lifetime Diet Plan is exactly what Teppy talks about — figuring out what you’re hungry for and how hungry you are after a lifetime of being told you are always too hungry for the wrong foods. I still struggle with staying on my own plan, for exactly the reasons Teppy and her commenters describe. I have a major fear of deprivation when it comes to food, plus a whole lot of baggage about “good” and “bad” foods, so trying to listen to my body instead of the voices in my head involves a lot of conscious effort — which is exactly what you’re trying to drop by, you know, listening to your body.

I highly recommend the rest of the post. Reading it made a frightening amount of sense to me, especially after I thought about it for a while. It's the way K eats, after all. I control her menu, of course, but within the foods I offer her, she chooses what she wants and how much she eats. And as far as I can tell, she only eats when she's hungry and stops when she's full. Even if it's treat like cake - I've seen her leave half a piece on the plate because she's not hungry any more. And her body seems to tell her what she needs to eat. I don't really worry about her getting enough nutrients any more because I've noticed that over the course of the day she eats a pretty balanced diet. She may eat a lunch of only turkey and cheese, but she ate mostly cheerios for breakfast and grapes at both meals, so it balances out. *

Demand feeding also jibes well with research that shows that deprivation leads to gorging - in a study where children were offered sweets, children who were on very restrictive diets gorged themselves on the sweets, whereas the children who were allowed to eat sweets ate moderate amounts and then stopped.

The more I thought about it, the more I realized that this is pretty much how I've been eating for the past couple years as well. I've made stabs at following diets and "eating better," but mostly I've just eaten what I felt like and stopped when I was full. And you know what? My weight is stable and while it might be a little higher than I would like, it's healthy. My cholesterol and blood pressure are fine. So it seems like the only thing I need to change is give up the guilt, the persistent voice in the back of my head that I should be consuming nothing but spinach salad and sparkling water.

But then there's the other side of the coin, the gigantic But.

I think demand feeding is a great idea. For people with normal metabolism who don't have health conditions that are affected by what they eat. Because the simple fact is that some people absolutely cannot eat whatever they want. People with high blood pressure can't have salt, people with food allergies can't eat the things they're allergic to and diabetics really shouldn't eat foods that cause their blood sugar to swing wildly.

And people with PCOS have a condition that is caused by insulin resistance, and therefore do much better on a diet low in carbs.

So you see the dilemma? I'm all hep to the idea of the Bobby McFerrin-zen approach to eating where restriction is the worst thing you can do to yourself. And I'm seriously considering going on a low carb diet.

The problem is that PCOS is directly affected by how much I weigh and what I eat. It started to get worse after college, when I started eating a mostly vegetarian diet and therefore eating a lot less protein. I started gaining weight, which made PCOS worse. And then I got mono, which stuck around for over a year, and all of that lying around on the couch made me gain more weight and get worse. At that point, the PCOS was making me feel so awful that I couldn't exercise or be active, so it continued on a spiral that just kept feeding itself until I managed to artificially convince my body it had a normal metabolism with metformin. I got back down to a healthy weight and things seemed fine.

But it clearly wasn't enough because I wasn't ovulating. Thus my dilemma: I weigh about what I did before I got pregnant. Low-carb diets are a proven way for women with PCOS to lose weight and improve their fertility. So if I'm serious about trying to conceive, should I go low-carb?

Before anyone starts yelling about how unhealthy low-carb diets are, I will say that any low-carb diet I follow won't be rib-eye steaks with a pork-rind chaser. It will be lean meats and lots of vegetables. Basically, I would replace the starches in my diet with vegetables that have less effect on the blood sugar and give up sugar entirely to start. Then I would get to slowly add carbohydrates back in until I'm on a diet of lean proteins, vegetables, fruits and complex carbohydrates. The way my diet would like in the end is meals that look more or less normal, but with smaller portions of carbohydrates, with Barilla high protein pasta or shirataki noodles instead of regular pasta, beans or pearled barley instead of rice, and no potatoes. Or sugar. Or white bread. And that's where the thought of this makes me groan, because I _like_ potatoes and sugar and white bread (not necessarily together). And the path I would have to take to get to that point would be long and hellish.

One wrinkle is that I've tried low-carb in the past and I think the longest I've made it is two weeks. I have reflux and my stomach doesn't like it when I remove those nice spongy carbohydrates that soak up stomach acid. But I've done a lot more research into alternative foods and recipes, so I think I may be able to deal with that better this time.

So I suppose the essential question is that if the potential improvement for my fertility is worth the deprivation, given that deprivation isn't a very good thing. I guess the thing to do is see what happens when/if my cycle comes back. I don't think it's a good idea to try and give up carbs right before the Thanksgiving-Christmas sugar-fest eating season, so I wouldn't try to start until January. At that point, I may have more of a clue if it wll be necessary.

*Note: I can be zen about how K eats because she eats a decent amount of food and will eat a wide variety, including vegetables. She's also a healthy weight. I understand completely how parents of very picky eaters and children who are very low in the percentile charts get neurotic about their childrens' diets - I was there myself for K's first 18 months.

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