DeliveryRank meets Kate Sweeney, a Registered Dietitian Nutritionist and Certified Intuitive Eating Counselor. She recounts her holistic and weight-inclusive approach to food and nutrition.
The Association for Size Diversity and Health states that “Health exists on a continuum that varies with time and circumstance for each individual. Health should be conceived as a resource or capacity available to all regardless of health condition or ability level, not as an outcome or objective of living.”
As a dietitian, this really means that I respect body size and do not pathologize it. I do not make clinical suggestions or decisions based solely on body size or weight. I believe strongly that eating is for wellbeing and nourishment and is flexible based on physical needs, pleasure, medical considerations, sleep, stress and more. This is where the holistic work comes in. It includes considering all influences of food, such as emotional wellbeing, culture, lived experience, stress levels, food history etc…
In my process with clients, we bring all of this to the table so that when we discuss goals and strategies, they fit with their individual needs and profile, and the process is holistic in nature. As a professional and from my own personal experience, we need to affirm and validate our bodies and our experiences. This is, in my mind, a weight-inclusive, holistic approach.
This is a big question and I am by no means an expert in food heritage. However, I have some thoughts and research to back them up. We all have memories of food if we think back to our childhood, that are tied to culture, family, friends or religion…Over the last 80 years we have seen a radical change in a number of areas which has led to a decrease in food heritage and culture; how and where food is produced, consumption patterns have changed, homogenization of diets, food access (food deserts for example), lack of time, the nuclear family setup and a decline in family and consumer sciences in schools.
As a dietitian, and in an attempt to restore these values, we need to stop medicalizing food so it is only based on nutrients and encourage people to explore their own heritage around food - this includes helping them find the time and access to food.
It really depends on the client. I see clients who have disordered eating and eating disorders. If they are coming out of a high level of care, I may work with them for a year or more, depending on where they are at. If someone comes to me with a gastrointestinal issue, this may include finding a diagnosis with their doctor, going through symptom management and this could only take a few sessions, or a couple of months.
Whoever I work with, my work is humanistic and relational and I try to build trust with the client, have clear goals, and meet them where they are at. For eating disorder work, I make sure my clients are eating enough and work on regular meals and snacks to make sure their brains are functioning. Of course, there is no one size fits all.
Intuitive eating is a large part of my practice. I use many resources and counseling strategies., This includes workbooks, cooking and prepping meals together, eating together, and overall, building capacity for embodiment through learning about hunger, fullness, satisfaction and more. Whatever it is, I really try my best to make it as individually based as possible, meet the clients where they are at and walk with them (hand in hand) during this process.
I would say that overall, the most rewarding part of my work is seeing when individuals (whatever their concerns) find a place with food where they really feel free, comfortable and nourished. To be honest, this usually happens when they let go of other societal norms and embrace themselves.
Seeing clients unlearning the rules of what society has told them about their body size or what they should be eating, or what they should be doing in terms of exercise is wonderful. Clients are able to listen to themselves and do what is best for them. Seeing people feel better overall, and seeing them suffer less is incredible. Seeing people simply enjoying food is empowering in itself. Food is something to be celebrated.
What a big question! There are so many fascinating things going on in nutrition science right now. First, we know that dieting (restrictive eating) does not make someone healthy or lose weight. And, weight is not an indicator of health. Just because some people are small doesn’t mean they are healthy and vice versa. I am hopeful that the future of nutrition will involve focusing less on weight-based outcomes and more on the desperately needed policy changes surrounding food access, food production, environmental health, and supporting families through affording them the time to cook or experience food in a way which is best for them. And, that we look at and research the issues of ‘obesity’ and ‘health’ through a socio-cultural, social justice lens, ultimately creating more equity for people.
Second, the dieting industry is an about 75 billion dollar industry annually in the US and it will simply adapt to changes. It is not going anyway anytime soon. The industry needs to be ahead of the science, and always has, to sell products. Now, the science is shifting to more personalized nutrition that aims to use genetic testing for intervention as well as science focused on the microbiome. The diet industry will simply repackage dieting in those forms; for instance, selling (probiotics as a weight loss tool when no conclusive evidence is yet available on the effect of the microbiome on weight.)
Training ALL dietitians on eating disorders is ultra important moving forward, as is dietitians learning about different food cultures and heritages so they can provide inclusive care. Knowledge on sustainability and climate change are also critical for dietitians, so they can guide clients in making choices according to the client’s environmental values. I know when I was a student, the above topics were not covered in much detail, if at all!
If you would like to know more about Kathryn Sweeney, visit https://www.katesweeneynutrition.com/ or email [email protected]