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  • Paige Smathers

71: A Radically Respectful Approach to Nutrition & Health


All too often, visits with health care providers leave you feeling like you're a total failure and it can be so discouraging to feel like your questions weren't really answered because you were being judged or not really heard/seen.

This is what I chatted with Katherine Zavodni, MPH, RDN about on the podcast. She is a registered dietitian nutritionist who believes wholeheartedly in a radically respectful approach to nutrition and health. In this episode, she outlines what exactly that means and why she approaches her clients in that way.

In this episode, Katherine and I talk about what it means to be radically respectful in your own journey with health and nutrition and what it means to receive radically respectful care from providers. We also outline why it's pretty "radical" to be respectful to yourself in a world that values dieting and certain body types above all others. Katherine also dives into her own story of dealing with a chronic illness that changed the way she approached food and her body.

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Full Transcript:

Hi everyone. welcome back to another episode of Nutrition Matters podcast. As you know, my name is Paige and I'm your host. As always I’m super excited to share this conversation with you. Today i’m speaking with my good friend names Katherine Zavodni who is a registered dietitian in Salt Lake City in private practice. Today we’re talking about this idea of radically respecting your body and a radically respectful approach to nutrition and health. Before we get into that and explaining who she is and what she does I want to take a minute to make sure that you know about a few things that are available to you. One is the Facebook group for Nutrition Matters Podcast listeners. You just type Nutrition Matters Podcast into Facebook and request to join the group. We would love to have you there to have you be part of the discussion. As always, I would always love an online review from you if you have a few minutes on iTunes. I did want to tell you about my online course which is called Educate Embrace Empower: How to Unlock Your Inner Wisdom and Become Your Own Eating Expert. This is a ten week online eating course that is taught by me. I walk you through how to, instead of taking one giant leap of faith so to speak into intuitive eating, I take you through those stepping stones to each step feeling comfortable and feeling like it makes sense based on the step before it and building on the knowledge that you have and also the experiences that you’ve had to eventually move toward this really healthy happy relationship with food and your body. The best part is, you get lifetime access to the course. Plus the online Facebook group that we do in association with the course where i pop in each week and do a lot of discussion and question and answers. So, progress doesn't need to stop after the course ends. So if you're at all interested in that check it out at PagesmathersRD.com/course.

With that let me just tell you a little bit about Katherine. Katherine is a registered dietitian nutritionist who specializes in eating disorder treatment, intuitive eating, weight concerns and also family and childhood feeding dynamics her counseling approach is very consistent with the models of intuitive eating and also the health at every size model. The reason I'm really having Katherine on the podcast is because one of the things that she talks about on her website is she just has this radical respect for the body’s innate mechanisms for being able to sustain life and maintaining balance. She comes at health and nutrition from this perspective that's very similar to mine where we both really strongly believe that our bodies are very good at communicating their needs to us as long as we learn to pay attention and learn to get rid of all that dieting noise that’s in our minds from past attempts at dieting or even just being socialized in our culture that's so size obsessed. She’s just a phenomenal person to talk to about this issues. I love getting together with her and talking about some of the hard issues within our world or nutrition and intuitive eating and health at every size. She’s such a strong advocate for the idea that all bodies are worthy of love and compassion and self care regardless of size, shape or ability. All of us can start where we are to be the best ppl we can be. So with that, one thing i also wanted to tell you is that this is my very first interview I've ever done for the podcast that was done in person. That was a lot of fun. A little bit of a different dynamic. Let’s get on into the interview

PAIGE: Hey Katherine. I’m so excited to have you on NMP this is the very first time I’ve been in person with someone while I interviewed them. This is a bit different for the recording process not different for the listeners. But, this is fun

KATHERINE: Well, thanks so much for having me.

PAIGE: So, for the listeners. Katherine is a registered dietitian in private practice in Salt Lake City. Some of you might know that’s where I am too. So we’re friends in real life and colleagues and we love to talk about all these nutrition issues together and we wrestle over them together and she’s just one of my favorite people to get together with and talk about work and talk about family and all kinds of different things. So, this is fun to have a formal conversation where we’re going to be sharing it with a larger audience today. But yeah. So, Katherine thanks so much for being here. And welcome. Let’s get on into talking about the topic for the day. When you asked me to kind of take a look at your website when you were getting things up and running one of the big things that stood out to me in the words on your website was this phrase “radically respectful nutrition therapy” and I gave you the feedback like I’m just obsessed with that I love that I think that’s such a great idea. Let’s start there. Let’s talk about why that’s your way of describing the way you approach nutrition therapy. Tell me about that.

KATHERINE: Sure. So, when I think about radically respectful approach I'm talking about two different things the first being that I just have this immense respect and admiration for the human body and how sophisticated it is in its ways of keeping us alive. There are just thousands and thousands of physiological mechanisms that we are not even aware of on a daily basis that just do this spectacular job of maintaining homeostasis in our body. That includes keeping our heart beating and our breathing rates and maintain the proper pH in our blood within a really tight range and all these incredible things that our body is doing all the time to keep us alive and thriving and that also includes as dietitians we see folks who are concerned about their weight and I also believe that our body works really hard to maintain what is an ideal optimal body weight for our bodies and that we don’t get to decide that. So in my nutrition therapy approach it’s really very much based on respecting what the body decides it needs as opposed to me as the nutrition professional deciding how much a particular body should weigh or what a particular person should be eating. I really prefer to take my cues from the body. So I see my job as more of helping the client interpret the signals that the body is sending so that we can really best determine how to meet the needs of the body.

PAIGE: So, I know you’re going to get to your second reason for the radically respectful, but I want to hit on that one before we talk about the next because I love love love that approach. Where any potential client of yours knows that that’s the fundamental way you’re going to approach any questions about shoulds and shouldn’ts and good and bad and right and wrong with food and really put that on the total back burner or even not talk about that but really talk about how do we come at all of the questions about our bodies and about feeding them and taking care of them from this angle of “let’s respect our body and have awe for it.” I think there’s areas of self care that are easier than others to be radically respectful about. Such as this is going to sound really stupid, but you know, maybe not radically respectful about this, but maybe just the idea that we never even think twice about one day we might go pee ten times and another day we might only go pee four times and we never think that that’s just so weird or we’re never mad at ourselves for or our bodies like “why did you make me go so many times today” or “why did you make me only go four times today” it’s just this non issue. There’s areas of life, I guess what I'm thinking is, there’s areas of health and self-care and wellness that are sort of easer to respect and or not give a second thought to. Food tends to be so wrapped up in body image which is wrapped up in your sense of self-worth and your sense of your place in this world and all of these other really messy entangled issues. I think that’s why it becomes so difficult to be respectful of your body’s cues of hunger and fullness and what sounds good and what seems appetizing and all of that. But really we’re born with that kind of innate in us which I think is so cool to be able to try to not really relearn something new but maybe uncover something you already know, right?

KATHERINE: Absolutely. It involves a lot of unlearning.

PAIGE: Yeah, that’s so true

KATHERINE: there are things that we’ve picked up along the way.

PAIGE: Maybe less learning more unlearning.

KATHERINE: Absolutely. You know it’s a very counter-cultural idea that we can really trust the signals that our body is sending us. Rather there is this hugely strong cultural message from folks that we should be able to trust. Folks who are so called experts in public health and medicine and healthcare who basically set up this embattled relationship with our bodies that we can’t trust them and that everything about what we do in terms of our health behaviors and our quote self care is really about overcoming what our body is. You know, if we’re hungry then we figure out ways to trick ourselves into not being hungry if we've already eaten quote too much or if we've already eaten the amount that we’re quote supposed to eat in a particular day. When, my belief, again, just getting back to respecting the body’s wisdom about these things. Our needs in terms of energy intake or calorie intake might be wildly different from day to day and there’s no way that we can apply this kind of external, rules based, system of determining of how much we’re supposed to eat or how much we're going to eat that actually adequately or accurately meets the body’s needs that might be changing so frequently. There's no way to apply those external rules to meet those needs when they’re changing so rapidly.

PAIGE: Ugh. Yes. that’s so true. And I think that’s kind of what I was getting at with the peeing example. I know that’s weird

KATHERINE: Exactly. For sure

PAIGE: But, it’s like, some days you go a lot and some days you don’t a lot and some of that has to do with how much water your drink. Sometimes that has to do with absolutely not how much water you drank but other factors, right? Maybe you sweat a bunch that day. And you never think twice about it and you’re never mad at yourself. I guarantee Katherine that if there was a bunch of guilt and shame around peeing we would all have peeing disorders. You know what I mean? I feel like it’s not out of the realm of possibility for anything to become super disordered when there’s when your whole entire sense of where you belong and how you can connect with people and how you can love people is wrapped up in this particular area of self-care. Some just happen to be super automatic and intuitive. Others should be intuitive and connecting but aren’t and that’s sort of, I think we see things very similarly. That’s sort of what we’re just trying to do is go with the cues of the body and allow it to be wise and in charge but sort of alongside some knowledge and some wisdom too that’s gentle about nutrition principles. So, tell us about that second reason why you relate to this idea of radical respect.

KATHERINE: So, the second way that I think about this is that I really strongly believe that each individual is the expert in his or her own life and as such anytime a client walks in my office. Well, I guess as dietitians we have this reputation as being the food police or being these know it all judgey I'm going to size up how you're eating and make my judgements about what you’re doing wrong and what you’re doing right and a lot of that can also be tied up in a person’s weight and when a person is living in a larger body or even if a person is living in a much slimmer body there’s a lot of judgment that gets flung around in helping professions and in health professions and in the media and just in our social circles that people think they can really judge or criticize why a person is struggling with certain medical conditions or why a person is weighs what he or she weighs. We think that we can just “oh well, clearly this person eats too much” or by the same token looking at a person in a much slimmer body and say “hey, come on. eat a sandwich” we hear those same sorts of judgments when in reality we really have no idea what is going on in a person’s life. There are hundreds of factors that might be playing into whatever factor or feature it is that we’re making this snap judgment about. As a nutrition professional, I feel very strongly that when a client comes into my office with whatever complaints or concerns or issues that they’re struggling with. Whether or not they are weight related. It’s my job, it’s my ethical obligation to have utmost respect for that person’s lived experience and what is going on in that person’s life that is leading to these concerns so that rather than making this “well, clearly here are the things that you’re doing wrong that are contributing to this concern that you’re having” I really try and partner with the client to better understand that lived experience and to have respect for that lived experience. As well as the values that that person is coming in the door with and allowing those values to be that person’s own values and priorities and those are not always going to be the same thing. I think that there’s, whether it’s kind of one on one provider patient or provider client relationship or just in the larger social landscape, that there’s just so much judgment getting flung around. Especially in the age of the internet where people can hide behind their screens and say really nasty things. We’re really lacking this basic respect for other human beings and other individual experiences.

PAIGE: So, to summarize the two reasons for radically respectful nutrition therapy. One is the radical respect for the body and the second is respect for the person’s lived experiences their values and their own particular situation. Right?

KATHERINE: Yeah.

PAIGE: Something that I love about that is that I can really relate to going and seeing a doctor and saying “here’s my issue. Help me with this. It’s taking over my life”. And what comes to mind is my oldest child, she just did not sleep well. She would wake up 10, 15, 20 times a night and you can handle that. You can handle the newborn phase for the newborn phase but you can’t really handle it when they’re, like, two. You know? When you’ve been doing that every night you start to go insane. So, I remember that two-year-old checkup I was like so desperate I probably had crazy eyes. You know? Like, “Help me. why won’t this child sleep? Give me some answers here”. And his response, like I know he meant well, but his response was so over simplified. And you know he had to get out the door. And he didn’t really take time to hear what I had tried or what was going on or really learn the situation. He was just like “Well, x y and z do these things”. And it’s just like GAH that’s not going to help. Or, just tell me there’s nothing I can do. But don’t give me a dumb answer that you haven’t taken the time to really learn my situation. The reason I bring that up I that’s so often what well intentioned health professionals in general do is “oh ok I see you walk in. You’re in a larger body. Oh, ok I make assumptions about why that is and then I prescribe x, y, and z.” Some over simplified nutrition prescription basically without taking the time to get to know, well what about your culture what about your values what about how much time you have or your cooking skills. Or, what about your other areas of self-care. How do you sleep? How do you manage stress? Let’s talk about all those other things before we even start to talk or nitpick what you’re eating. I think that’s awesome. I that’s a really really important approach but it does require a lot of time.

KATHERINE: It does. It does.

PAIGE: And not provider has time. We’re lucky we do, right?

KATHERINE: Well, and I think it’s a discipline on our part. AS the providers in those scenarios to really keep in check our own tendencies to judge. Even as someone who is aware and thoughtful and intentional about this. You still catch yourself drawing conclusions about somebody’s story that you really, you don’t have that. You don’t have that background and you don’t have that, again you don’t have that person’s lived experience and you’re so right to bring up parenthood about it. Because that opens up a whole huge can of worms in terms of judgment and people watching what you’re doing. And seeing what your kids are doing. Whether it’s how they’re sleeping or how they’re eating or how they behave. Every kid is so different and it’s such a humbling experience to be a parent. You know, they say “I was a really great parent until I had kids.”

PAIGE: I’ve never heard that. That is true.

KATHERINE: That’s so true, right? Because every kid is so unique and brings his or her own challenges and I really think that we have to respect that. And give each other the benefit of the doubt that your struggles are different than mine. I don’t know your struggles because they are absolutely, fundamentally unique. I can’t presume that I would do something different or I would do something better than anybody else if I were in her shoes because that’s taking that respectful piece out of it. It’s me just taking. Looking at a snapshot of your situation and sizing you up and criticizing and making those judgements.

PAIGE: Yeah. I want to ask. Why did you use the word radical and what does that mean to you? Radical will catch attention that’s for sure. But, why is it radical to respect those two things you talked about?

KATHERINE: I think it comes back to that culture of judgement. Especially around, I guess this is what I do, so I'm more attuned to this than I might be to other realms in which this is relevant. When it comes to health and nutrition and weight and appearance and all of these things there’s such this culture of judgment. Read any comment section on a Huff Post article about this sort of stuff and you see the claws really come out. It’s kind of the norm for people to draw these really fast simple conclusions about “well, it’s not that”, looking at folks in larger bodies “it’s not that hard. You eat less and exercise more. It’s not rocket science.” This really nasty, hateful, judgmental rhetoric around these things. I think both in the sense of, ok first of all let’s give this individual or this, kind of, prototype, this respect that. “ok, wait a minute. It’s clearly not that simple for this person.” Probably this person has considered what sorts of things might go into a person’s body size. Maybe that person living in this world wishes that he were in a different size body. More than likely, that’s the case. More than likely, there have been attempts to manipulate body size. If you’re a person who is in a naturally smaller body it’s very easy for you to say that it’s not rocket science in this critical way. Clearly, if you look at our population of folks and the rate of attempted weight loss versus actual sustained weight loss it’s not that simple. People spend their entire lives trying to manipulate their body size. And our bodies just don’t like to be manipulated. They don’t’ like to be forced to be something that they’re not meant to be. It’s a radical act to show that individual the respect that, “ok this is your experience. I’m not going to draw conclusions about how you even feel about your body. I’m not going to draw conclusions about what you have or have not done. Or want to do or want to engage in in terms of lifestyle. I'm not going to impose my own agenda on your life because you’re an individual and you’re entitled to your own values and priorities. And to your own lived experience and I’m not going to come in and just make a snap judgment or criticism about that.” I think it’s also a radical act to allow my body to be what it’s meant to be. To not have an agenda to manipulate my body to look how the world thinks it’s supposed to look. On that same token to impose that agenda on my clients. TO say “Ok. Yes. This is what you want your weight to be let’s make that happen. Let’s calculate x number of calories to cut. Or even if it’s not that blatant. Let’s manipulate your eating in this way so that we can naturally with a lifestyle approach bring your weight down to what we arbitrarily decide it’s supposed to be.” In our culture that’s a radical act.

PAIGE: I call it swimming upstream. I often feel like I'm swimming upstream when I. You know, I’m lucky I have a lot of really good friends who understand who I am and how I approach this and they aren’t that typical “Let’s all get together and talk about how much we hate our bodies and how much we feel so guilty for eating these foods.” I don’t really have those friends. I don’t know if I’d do well if I did. Even just existing in this world with really amazing friends and family who get me, I still feel like I'm swimming upstream. I do recognize that if I were in a different sized body it would be even more difficult to exist in this world with that radical respect because people would automatically assume “oh, you must be dissatisfied. You must be intentionally trying to manipulate.” When you used that word manipulate in your last little comment, it made me think back. Sorry I'm doing this pee example. We’re just going to bring this analogy all the way through. When you manipulate a natural body function like going to the bathroom, you can think about the consequences. Like, you will get a bladder infection. You might get a UTI. You might get a full-blown kidney infection. Your body does not appreciate manipulation. Your body appreciates heeding cues and doing what you need to do to take care of it. Again, it’s so easy to see how any type of efforts to manipulate sleep or to manipulate breathing in oxygen or to manipulate any form of what we need to do to stay alive, it doesn’t work out so well for us. So, why do we think we can manipulate our body size with food? You know what? I think it’s just important to say. Some people’s body sizes might shift or do shift throughout their life one way or another. We’re not saying that your body is a permanent, fixed thing that never changes. Both of us will recognize that even on a cellular level your body is changing every single minute. There’s nothing wrong with that. But, at the same time it’s not assuming or saying, “ok well, I'm going to look at a chart and say this is how much gravitational pull your body should have.” That’s just totally bogus. And similar to trying to manipulate something as natural as going to the bathroom.

KATHERINE: Yet, there’s this cultural expectation that we all should be trying to manipulate our body size. And that no matter where you fall on the spectrum, the BMI spectrum or the size spectrum however you think of it. We’re always supposed to be working on improving something or changing or toning or fitting into whatever size. It’s just absolutely the conventional wisdom. The assumption like you’re talking about this theoretical group of friends that I don’t really associate with either thankfully. I don’t have too much of that in my life although it’s so ubiquitous it’s hard to entirely avoid this assumption that we’re all unhappy and that we’re all just fighting the tide of making our bodies something that is just always just a little bit out of reach. And when you orient this way. When you orient with this acceptance that our bodies are what they are and they do what they do and they have this wisdom that we can’t impose on them it’s kind of maddening to hear this rhetoric that surrounds us all the time that makes this assumption that we’re always supposed to be fighting our bodies and that we’re supposed to be apologizing for having an appetite and for eating a cheeseburger at lunch if that’s what we want. There’s this expectation of us in this culture that we should all be engaging in this battle with our bodies. As someone who really rejects that it’s really kind of maddening to hear that all the time.

PAIGE: That’s actually one of the biggest pieces of feedback I get from podcast listeners. A lot of people say it’s great to learn these things and to become aware and sensitized but it’s also sort of a burden because you get freaking annoyed with everyone in your life. You’re like, “why is everyone so clueless and annoying?” I think most of the time when we come to some type of radical conclusion. Or we do something radical in our life, we’re not bored with that knowledge. It’s usually an epiphany or a realization or something you come to in this miraculous, beautiful way. I want to hear, as much as you want to share, how did you, I think all dietitians who practice in this area: therapists, doctors, whoever, clinicians who practice from a weight neutral, gentle approach to all of this. We don’t come out of school this way usually. It’s not really in most programs to even speak of this one time. So, tell us about that. How did you come to this radical respect idea?

KATHERINE: Ok well. So, I came into dietetics as, well not really a second career, it just sort of took me a while to find my first career. In my twenties, early in my twenties, I was diagnosed with a chronic illness and I struggled with that for several years and I experienced something that’s very similar I think to what we were discussing earlier. About how people address very critically and dismissively folks with weight concerns or folks in larger bodies. That is, in the sense that people. You see, if you’re sensitized to it, which I am. You really do see a lot of that same judgement and criticism when folks aren’t classically healthy. In other words, if you’re struggling with some sort of chronic health issue that I was that was really difficult to get under control medically. I was interested in, along with that whole health struggle, my weight actually fluctuated quite a bit. That was sort of where my interest in nutrition came from, originally. I started to become aware of health professionals or my own health care providers. I was starting to get sort of interested in some of the alternative health and integrative health practices. When conventional, western medicine wasn’t really seeming to do the trick for me I did seek out some of those alternative modalities for treating chronic issues like this. I was really fascinated by it but I always felt this frustration with not really ever quite knowing what was real and what was helpful. At the end of the day none of those modalities that I really did give an honest good long term try really ended up helping me either. In that circle, I really felt this judgement that “oh, well, I must just not have eliminated the right foods. Or, oh I must have not have tried the right alternative therapy. Or oh I must have not really believed in what I was engaging in or else it would have worked for me.”

PAIGE: So, in other words, there was like “oh, if our recommendations aren’t working you’re doing something wrong.” The blame is on you. You’re being lazy or you’re not putting the effort in. Or you’re clearly not eliminating the right food. And it just sort of starts to feel like, I'm sure, pretty exhausting and also frustrating that. And you internalize “oh there’s something wrong with me. Not only do I have this chronic condition, but I'm also a total loser.” I mean, I'm not calling you a loser, but that must have been how it felt.

KATHERINE: Yeah, I mean. The phrase that sticks in my head that is kind of applicable in this kind of realm as well as what we do as dietitians. There’s this whole concept of a lifestyle change and it’s just way too easy and convenient to us to just say “oh well, if you’re just willing to make the lifestyle change then everything would change and everything would be great and we would all be in perfect health.” It’s that same sort of dismissive judgement of a person who’s suffering with whatever concern that really gets the provider off the hook. If some provider is gonna say, and it’s the same thing if we’re going to be the type of dietitians who assign meal plans or assign calorie goals or whatever it is. Then It’s so easy for us, and it’s the same thing with the whole entire diet industry. If we can blame our customers or clients or the folks who are receiving this whatever it is that we’re doling out, if we can take responsibility for the successes but dish out blame for the failure then that’s a pretty sweet spot for a provider to be in. But, it really leaves those of us who are consuming health care feeling really frustrated. And I did struggle with that for a long time. I think it has informed the way that I treat my own clients. I really don’t ever want to be in a position to say “well, if this isn’t working for you then it’s because you did or didn’t fill in the blank.”

PAIGE: Isn’t that the great thing about a non-diet approach though? There really is no one right way to do it. If someone’s feeling like man things aren’t functioning well for me. I'm feeling chaotic. I'm feeling off. You don’t blame the “diet” it’s like OK well we clearly haven’t settled into a really great routine or, an approach, or thought, self-talk around these things that we potentially can. So, let’s keep exploring. Let’s keep learning. That’s what I love about when someone comes to me and says, “I’ve totally failed” or “this isn’t working” or “I'm so discouraged” it’s like ok great it’s good to know that that particular way isn’t going to work for you. Maybe we can revisit that idea later because maybe it might with a little bit of tweaks with your self-talk or a few tweaks with when you go to bed at night. Or your job. Maybe your jobs just too stressful where you just can’t handle grocery shopping every week. Or something along those lines, you know?

KATHERINE: Right. And I like to use the phrase let’s see what happens. Let’s try x, y, or z and let’s see what happens. Encouraging this curiosity as opposed to judgment about what the body is trying to tell us and what the body is doing with what we give it. I think that that’s a really important component of, for me, a successful therapeutic relationship.

PAIGE: Do you wish that there was more of that with your own experience? Is that part of why you approach things the way you do?

KATHERINE: Well, sure. There are all kinds of things, parts of my story, that I still find little whispers and messages here and here. Well, if you’d only tried this or if you’d only done this and it’s still. I mean, I ended up having multiple major surgeries to address this issue. And I’ve lost a lot of time and I've endured a great deal of pain and time literally flat on my back. It was a setback in my career because I couldn’t work for a lot of that time. I’ve lost a lot. It really gets under my skin to hear these messages of this kind of dismissive, and not even necessarily towards me, but to other people who are having similar experience “oh well, if you’d only tried this” or “oh well, this diet changed my life” or “I cured myself with whatever.”

PAIGE: Yeah.

KATHERINE: It’s really triggering for me, personally, to hear those messages. I really get my back up on behalf of people who are hearing those messages. The people who are sending those messages literally have no idea what that lived experience is like and what, like somebody in my situation, what I wouldn’t have given to avoid all of that pretty intense pain and suffering. And to have someone just come along and dismissive it and walk away.

PAIGE: Say, “oh, why didn’t you think of this?”

KATHERINE: Right. Exactly.

PAIGE: That’s such an important parallel to what we’re talking about here. That’s the way that people in larger bodies often feel whenever they seek health care. Right?

KATHERINE: Absolutely.

PAIGE: In every encounter.

KATHERINE: It makes me so angry.

PAIGE: At the ER, at the PCP visit. With the nurse. With the dietitian. I mean, how exhausting to live your life that way you know? That just gets me riled up big time. That needs to end. WE need to check our weight stigma, or biases. I love this idea of radical respect because it does inform, or un-informs you of any type of assumptions about who a person is and why they appear the way that they do. On both ends of the spectrum. Someone in a smaller body too. You don’t know what they had to do to get there. That’s one of the advantages of having my job. I tell a lot of clients this. I have sat across my table in my office with so many people in thinner bodies who go to some extreme lengths to be there. They appear to everyone else that they have everything together and they’re happy and they’re functional. But then they tell me in their quiet moments “I'm bingeing. I'm struggling in this way. I'm struggling in that way.” And in that sense, it just helps me as an individual, as a regular person to suspend any judgement. When I look at a person I don’t know if their life is great or if it’s hard, what they’re doing to have that body. Whether it’s one end of the spectrum or another or right smack dab in the middle. We just don’t know. We do so much damage when we try to look at people and assume that we understand anything about them. We do damage to ourselves because maybe we don’t make friend with amazing people who we could have if we didn’t do that. We do so much damage to each other because we all absorb that narrative from age two on. When you were talking about all this time and energy and effort that people do to maintain these certain bodies. It just keeps us so small and it keeps us from doing the things that we should be doing with our time. Like, being creative and making discoveries, and working hard, and learning. It occupies so much of our brain space that it keeps us from accomplishing what we could have otherwise. That really gets me riled up too. I don’t know where I’m going with this. What are you thinking?

KATHERINE: No, absolutely. I’m actually thinking that I want to make the point that I am very much in favor of allowing experts their expertise and for respecting the extensive education and training and mentorship and practice that health care providers go through to be where they are. And that includes dietitians and physicians. I'm not in favor of marching into the doctor’s office with your degree from Google University and telling him all the things that you’re not an expert on that you can teach your doctor about. Certainly, and this is a huge part of my own story that I can’t fully get into right now, you absolutely have to be an advocate for yourself. Long story short, I had a particular doctor who was a dead end for me and I had to seek out a new doctor pretty far out of town for me. I’ve had to travel a great deal to see the right provider. So, I am a walking example of being an advocate for yourself and finding the provider that’s right for you. I do think it needs to be said that we need to have respect once we’ve found that right provider, to not think that there’s some simple substitute for the years and years and thousands and thousands of hours of training and education that these folks have completed to get where they are. But, I think as health care professionals and providers we have to take responsibility for this ethical obligation that we have to not let that expertise trump the respect that we owe our clients and our patients. And the attention that has to be afforded to the lived experience of our patients and clients.

PAIGE: People first, right?

KATHERINE: Absolutely.

PAIGE: I think that’s a really important distinction. That’s super interesting to hear about how your own lived experience has informed your professional work. Tell us about some of the good things you’ve seen come from that approach. My listeners will probably be familiar with a lot of these idea because we do talk about this quite a bit on the podcast. But I always love hearing why this is beneficial. And maybe if this is someone’s first time being exposed to these ideas, help connect what this does on a practical level for people. And you can talk in general or you could talk specifically if you wanted to. Let’s just hear why. Why do it this way?

KATHERINE: One of my favorite experiences that I have with clients, and this has come up a number of times, is if I'm having a conversation with someone who maybe has been a chronic dieter her whole life or she’s just, for years and years, has felt a lot of shame about her body and is maybe just looking for that next answer about, ok, I’ve tried all these different things but now I really want the right answer. And tell me what to do, and I really want to finally just, fill in the blank. Lose the weight or whatever it is that that person is seeking. I gently challenge some of those assumptions that we’re supposed to want to manipulate our bodies like we were talking about before. And kind of a how would it be if we just focused on how you’re feeling and if we could move into a place where you just allow your body to be what it is and make the choices you make based on how to care for the body that you have instead of trying to change it into something else. That can be really wild and mind blowing for some people. But, what I really love to hear is this relief that people finally feel permission to let go of all that because it’s, for so many of the people that we see, it’s literally been years or decades even of this feeling of an obligation hate our bodies, and to try and manipulate them, and to keep fighting and trying to finally conquer this enemy that we have in our body. It just continues to be a losing battle and people just get more and more unhappy and they lose more and more time. That they could have been focusing on things that really matter and things that bring them joy. And when people get to that point where I, as kind of a voice with some authority, give them permission to just stop. and start pursuing a life! And that they have permission to start pursuing a life right now. Given whatever limitations that they might have in their lives, from any number of factors. Let’s figure this out. And let’s figure out how you can start living a life that is meaningful to you right now. As opposed to, once I’ve lost the weight, or once I’ve finally, successfully manipulated things the way that I feel this obligation to do. There can be such relief in that permission to let that go. I see the same thing when I’m talking with families with young kids who are concerned about their kids eating. That’s one of my areas of specialty and there’s so much pressure, going back to the whole parenting thing, to have our kids eat perfectly and do all the things that they’re supposed to be doing if we’re going to be considered successful parents. Not to say that I'm not really passionate about child nutrition. I think feeding our kids well is very important. But I think that a lot of the minutia that we worry about when it comes to feeding our kids is not worth the anxiety that we devote to it. So, when I give parents that permission to back off a little bit, relax, let’s figure out how we can introduce some structure and some order into this whole dynamic with feeding a family that will allow you to really relax into a pattern that’s functional for the family. The relief that I hear from clients is so sweet.

PAIGE: That’s another example of radical respect. Where you’re radically respecting your child, your child’s own autonomy. Like, you’re in charge. Like the Ellyn Sater Division of Responsibility, right? You know that you have some responsibilities, and that the child has some responsibilities, and the feeding relationship and giving parents permission to back off on the things that are the kid’s jobs can be a huge source of relief, for sure. And when you were talking earlier about some of the benefits and positive things you’ve seen, I had this visual pop into my head. Where I think a lot of people see dieting as synonymous with healthy eating, right? And I think we need to bash that. They’re totally not the same. For so many reasons. And we should probably have an entire podcast about that. A lot of people see it in this way. Where dieting is on one end of the spectrum dieting/healthy eating. And on the other end is free for all, I've given up on my diet so get everything in that I haven’t been eating and eat it in large quantities. And screw it all. Don’t think about it at all, right? People are often just bouncing in between those extremes. So, when they hear someone like us say “Hey guys, don’t diet” they’re like whoa. What? You don’t want me to eat healthy? I think what we’re trying to get across here. And what I'm trying to get across in this entire body of work in the podcast is “No, healthy eating exists somewhere in the middle.” It’s maybe a little bit different than your healthy eating, Katherine. And that’s ok. We all have a different where we fall. And we all fall in different places on different days. But it’s not a choice between healthy eating and crazy eating. It’s just functional appropriate mindful aware of what your body is experiencing, heeding and honoring those cues with a gentle knowledge of “hey, how do I get some balance in here so things function best and I feel my best and so that I have energy.” But also, how do I enjoy that fun day out with my family and not stress about food the entire time. One of my last questions for you is. I know sometimes we try to avoid specifics because it tends to put things in a box and has the potential for people to glom onto this like oh Katherine said this is what I should be doing. I think the benefits of talking specifically and practically outweigh the negative things if we do it in a responsible way. So, what does a day, a general outline of what radically respectful approach to nutrition and food and body, what does that look like? Could you give us an outline? And I know I'm kind of putting you on the spot here.

KATHERINE: Gosh, I mean I think you kind of nailed it when you said that it really depends on the person. I think that some combination of hunger and appetite awareness, which I think of those as two different things, right? I mean, if you are hungry, if you’re a person who is starving in a food insecure sort of way you might find some cans of condensed soup and if you consume a few cans of condensed soup you’re not going to be hungry anymore. But, as a person who has adequate access to food, if you eat a can of condensed soup, unless that happens to be what you’re really hankering for, your appetite is not going to be satisfied from that. I think being aware and respectful of your own hunger and appetite cues. So, both how hungry are you and what are you hungry for and what will, with the knowledge of yourself and how your body works, what is going to be the most actually satisfying for you. Combining those sensitivities with some gentle knowledge about nutrition. Which can be as simple as: I know that if I only eat carbohydrate for breakfast I'm going to be hungry an hour later and I don’t want to be hungry in an hour so I…

PAIGE: So, I eat an egg with this.

KATHERINE: Right. Exactly. Just making those decisions about. And you know another one for me, which, you know, kind of coming full circle with the peeing example.

PAIGE: I’m so glad that’s run through this whole conversation.

KATHERINE: So, I'm a coffee drinker. And I love my morning coffee it’s one of my favorite things about my day. But I know that as I get older and having had two children that if I drink a second cup of coffee I'm going to be peeing every twenty minutes like halfway through the afternoon. And as much as I might enjoy that second cup of coffee, and as much as I may want to drink a second cup of coffee, if I'm dragging or if I just feel like having another one, I have to have that awareness. Like, ok I know that if I drink this I'm going to be peeing every fifteen minutes for the next three hours. Sometimes, that may mean still making the decision…

PAIGE: Doin’ it!

KATHERINE: Like if I really just want it I’ll just going into that decision with that knowledge and just go for it and deal with the consequences. Or, maybe, I've got a lot of work to do today or I'm taking my kids to the zoo or whatever it is and I really can’t be peeing every fifteen minutes, so I'm going to hold off on this other cup of coffee. I think it really comes down to allowing yourself, if you know your body well, to respect and have that sensitivity in making those decisions. If you’re in a place where you don’t feel very well acquainted with your body in that way to proceed in a way that you free yourself to become acquainted with your body about those things. To pay attention…

PAIGE: You do that through curiosity, right?

KATHERINE: Curiosity. Absolutely. Curiosity, rather than judgement. Notice what happens when you choose this versus that or when you eat when you. Right when you wake up in the morning versus a couple hours later. Whatever it is.

PAIGE: That’s what I was going to say. Your example of the two cups of coffee and the consequences that you experience and weighing that. And sometimes it’s worth it and sometimes it’s not. I think that’s exactly how food is too. I love Chipotle, you guys. I always have. Sometimes it’s worth it to eat the entire burrito even though I know it makes me a little too full. I just love the end of the burrito. It’s the best part. It’s all juicy and sour cream-y and delicious. Then other times it’s like, you know what, I know I have dinner plans tonight. I want to make sure I'm hungry for that, so I’ll order this instead. Or maybe I’ll cut it in half or maybe I’ll, whatever. And I think that there’s the ability to practice that decision making where you’re kind of doing what’s in your own best interest. Sort of like you would in any other situation with someone you care about. You try to come up with a way to make it work the best for everybody involved. I think there’s a way to do that with food that doesn’t involve rules about, like, oh this is good and this is bad and this is right and this is wrong. It’s sort of like all food can be good and bad and right and wrong in different situations and in different amounts and for different reasons and intentions, right? So, it’s sort of elevating above these really over simplified rules and just saying, “what’s right for me in this moment?” and thinking ahead, “Hey, what’s this going to feel like in my body? What’s this going to do for me?” and sometimes it’s worth it to kind of like, eh who cares, whatever. Entire Burrito. Other times it’s worth it to just say, “you know what? I'm going to make a different choice today because of, lots of different reasons.”

KATHERINE: And I think parenting is another really good metaphor for exactly that. I'm think about how my kids have a bedtime and I try to get them in bed by whatever hour at night most nights. But this past weekend there was this super amazing outdoor festival with all these cool activities and there was an outdoor movie, and we all ended up staying out a lot later than we normally would. I was really kind of fine with letting bedtime fly out the window because we made a really fun memory together, and had a really good time, and sometimes it’s just worth it. I think that we can feel some flexibility and some freedom to take those individual circumstances and to account when we’re making those decisions. And the same applies when we’re talking about how we care about our bodies. It’s the same as any sort of activity, physical activity regimen. Our body’s going to feel like doing different things on different days and if we allow space for that that’s where we can really learn how to care for our bodies responsively and respectfully as opposed to like, “this is what I do every day. And this is what I'm going to do, and I don’t care if I'm tired and I don’t care if I didn’t get enough sleep last night this is what I do because it’s no pain no gain and I'm just gonna impose this agenda and these rules on myself and on my body and on my life. No matter what.” And that’s how I show that I'm committed. Well, that’s not really how life works.

PAIGE: Right. That is so true. What you’re saying about the example of the bedtime thing I think it was in everyone’s best interest for you to just let that go out the window because, gosh, sometimes you just have to have fun! And its summertime, and it’s all that stuff. But it’s also usually in everyone’s best interest to have that bedtime. Otherwise, people are grumpy. Including you and you don’t get time alone and all of that. So, it’s sort of like, this delicate dance, or balance that I think it’s easier to see in some areas, like with parenting, and a little bit harder to see sometimes with food. Especially because we’re surrounded by this culture of good and bad and right and wrong and should and shouldn’t. It’s really just not that way. You end up driving yourself crazy if you really attempt to follow that perfectly. It’s just not the way it works. It’s not realistic and it’s not respectful.

KATHERINE: Right. And with that perspective I think it’s kind of essential to understand that that balance is going to look different for every single person. And that those decisions on a daily basis are going to play out differently for different people and we have to allow people the space to balance those decisions in whatever way feels authentic and functional for them. Without coming in “well, I would have made this decision here” or “I would have chosen differently that day” or “I would have taken my kids home because that’s irresponsible to keep them out late” to follow that metaphor. But I think one of the most important parts of our jobs are to empower people to feel the freedom to make those decision and make those judgment calls and feel confident in them.

PAIGE: Right. And also, like you said. I liked when you said with the voice of a little bit of authority that sort of how I feel my credentials as a registered dietitian really are helpful in these conversations because I'm not just some wishy-washy therapist who’s like “whatever you want. It’s all good.” We do. We have these credentials and there’s science to back it up and it’s not wishy washy it’s not out there it’s not woo woo. It really is just a great way to live life and a good way to find that freedom around food and around areas of self-care. I think there is an advantage to hearing this message from two registered dietitians who feel strongly that nutrition is an important thing but also health. WE want to zoom out on the big picture of health and there’s so many other areas that deserve time and attention and effort and nurturing. Not just nutrition. As you’re navigating that that’s just an important thing to keep in mind. Let nutrition be a slice of the pie, wink wink. And have other slices of the pie so that you have this whole circle of what’s important to you and what makes you feel whole and well. Don’t let anything take up too much space otherwise, ironically, you don’t end up very healthy or well. Katherine, last question for you. If you could just tell your prototype that you talked about earlier, if you could just sit down and talk to someone and just be like “this is what I wish you would know about nutrition” or about health or about self-care or body image. Any of those areas that we talked about on this podcast. What would be your message to sum it up?

KATHERINE: Ugh I love that question. I think what I would say is that your body is a good body. All bodies are good bodies and all bodies have a wisdom that we don’t possess in our conscious minds. Every single thing that your body does. Every way that your body responds to all of the input that it’s given what you eat, what you do, how you sleep, the climate that you live in, the relationships that you engage in. Like every little bit of input that your body receives it responds to. And it responds in a way that cares for you and that loves you and that wants you to thrive and stay alive. Your body absolutely has your best interest at heart. As cheesy as that sounds. We as a human species, we’re in the business of survival and every response that your body issues it has that agenda. It has that bottom line that it wants you to survive and it wants to create a system in your body that supports survival. I think we talk a lot about body image and that can be this hazy concept about self-love but my favorite way to talk about body image is to really think about your body as this machine that really wants to work hard for you. If we are yo-yo dieting or whatever it is that we’re doing in our lives that we think are supposed to make us “healthier” or make some meaningful change that we have decided we want to make in our lives. If our body responds in the way that’s the opposite of how we want it to respond, which is what we see in a lot of folks who are doing dieting, trying to lose weight a lot of times they end up trying to gain weight. Well, that’s your body trying to…

PAIGE: They end up gaining weight, not trying to gain weight.

KATHERINE: Oh, sorry. Gaining weight. They end up gaining weight. Yeah, my fault. That’s your body trying to take care of you. If your body perceives that there’s this threat of famine or starvation, it’s going to really build up the resources because it wants to make sure it’s using this really sophisticated wisdom to try and keep you alive and take care of you. When we start to really think about, even when we get sick, when we get a high fever. That’s our body trying to fight infection. All of these mechanisms that our body has are meant to protect us. When you start really thinking of your body in that way. I find it to be easier to help clients relate to this idea that your body is not the enemy. That your body can actually be a really really powerful ally. It offers a bridge to that more positive body image that I think can be a hazy concept for people. That’s the message that I would want to impart to people. That your body is not an enemy. It’s a partner.

PAIGE: Yes. I love that. That is such a great way to sum up what we’ve talked about today and also such an important message for people listening to hear that all bodies are good bodies and that you’ve been fed this lie your whole life of “ignore bodily cues, ignore what your body is saying, ignore appetites and guess what? That’s not right. That’s not true.

KATHERINE: And it harms us.

PAIGE: And it harms us! Yeah. And it’s so easy to see how it harms us in other ways. It’s hard to see it with food because we’re so steeped in this culture. But, if you’re ever a little bit confused about these concepts, think about any other natural mechanism of your body and think about what happens when you manipulate it, or when you try to change how you do things from a natural perspective.

KATHERINE: Denying basic needs, yeah.

PAIGE: It harms you. If you deny basic needs, exactly. Thank you for helping me with that. So, I think everyone listening can see why I'm friends with you Katherine because you’re freakin’ awesome! Don’t you guys love her? She's so great. So, thanks so much for being here. Just take a minute and tell the listeners how they can keep in touch with you and how they can contact you if they’d like to.

KATHERINE: Absolutely. All my contact information can be found at my website which is www.kznutrition.com. K Z for Katherine Zavodni. You can email me from there or, yeah. Contact me.

PAIGE: Follow you on social media. From there right?

KATHERINE: Oh. Yep. I’m on Facebook at Katherine Zavodni MPH RDN. SO, come see me there too.

PAIGE: Ok. Awesome. Well, thanks so much Katherine for this awesome conversation about radically respectful nutrition and health. I've loved it and I hope people got a lot out of it. I'm sure they did.

KATHERINE: Aww it was really fun to talk with you. Thanks so much for having me.

PAIGE: Well, I sincerely hope you’ve enjoyed this conversation If you haven't already please go ahead and leave a review on iTunes. Thanks again so much for listening and I’ll see you soon for another episode.

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