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Elizabeth Anderson RD

Pre Op
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Everything posted by Elizabeth Anderson RD

  1. Elizabeth Anderson RD

    Coffee Controversy: to Drink or Not to Drink

    "Elizabeth, regular coffee after surgery or decaf for life? Let's keep this simple. If you can drink a cup of regular coffee every day without trouble, go for it. This isn't my opinion folks and that's why it's so magically delicious. There is a ground-swell movement among bariatric dietitians to fact-check some of the standard nutrition no-no's we've been sharing with clients. If there's no science to back up the recommendation, we're not going to keep promoting it. The latest worn-out bariatric rules without evidence? No straws, no gum, no soda. Today I'm dispelling the no coffee/caffeine rule. A recent review of the scientific literature reveals no evidence supporting the avoidance of caffeinated drinks to prevent dehydration or stomach lining damage. “Here I come quad espresso over ice???” Whoa, Nelly. Sane caffeine consumption after WLS means: 1. waiting six weeks post op or until you are fully healed from surgery 2. aiming to limit regular coffee to one cup per day 3. groping with the painful truth that a medium pumpkin spice latte with whip = 420 calories Dietitians are working hard to create nutrition plans individually based on client’s unique needs and wants. The next time you hear one of those bariatric no no’s, ask the provider if the current science is still robustly supporting that recommendation. It might take them aback a bit but a good provider will thank you for your smart thoughtfulness and self-advocacy.
  2. Elizabeth Anderson RD

    The Secrets of the Slim at All You Can Eat Buffets

    Now here is a researcher I like. He’s down to earth, funny, non-judgmental and driven to understand what we eat and why. I recently saw Dr. Brian Wansink speak at the Obesity Action Coalition’s Your Weight Matters 2016 annual convention. Wansink is Professor and Director of the Cornell University Food and Brand Lab. He’s also the author of the books Mindless Eating and Slim by Design. Wansink describes his work at the lab this way: “Using new tools of behavioral science, we invent healthy eating solutions for consumers, companies, and communities. We invent, redesign, and empower.” Wansink tells great stories about his unique research and I wanted to share one that I thought you might find interesting. Wansink and his team of researchers were curious how people with ‘normal’ BMIs could frequent all you can eat buffets and not gain weight. First, he flat-out asked them, “What’s your secret?” Know what? They honestly didn’t know what they did differently, at all. Wansink decided to set up cameras and monitor the behaviors of the slim diners at the buffet as well as what people with obesity did. Every. Single. Thing. After hours and hours of video recording and analysis, Wansink came up with a list of 8 differences between the groups. The slim diners… 1. Sat an average of 16 ft. away from the salad bar. 2. Sat with their backs to the buffet. 3. Used chopsticks instead of silverware. 4. Put their napkins in their laps. 5. Chewed their food more times. 6. Sat at booths, not tables. 7. Scouted the buffet completely before putting anything on their plates. 8. Used smaller plates. I think one of the coolest things about this list of behaviors is that the ‘healthy’ weight people unknowingly limited their exposure to food, chose their food with careful consideration and didn’t rush the experience. Wansink told us the owner of a large chain of buffet restaurants employed some of the slim diners’ habits to subtly influence his customers to eat less. Thus, increase his profit margin. After just a year, the restauranteur had saved tens of thousands of dollars. My take-away from Dr. Wansink’s talk is that the food and foodservice industries use science to influence our buying and eating habits. Usually, without our knowledge. Wansink’s work changes that. It does empower us to be more mindful of the many influences on our food environment and make deliberate choices in light of that. Until next time, I’ll see you at the buffet, look for me in the booth in the back. J
  3. Elizabeth Anderson RD

    Is Eating Fruit Like Eating Candy?

    Is Eating Fruit Like Eating Candy? In my opinion as a bariatric dietitian, no. Is fruit nature’s candy? Well, I don’t know about you, but I haven’t yet confused blueberries with blue jellybeans. Many of my post-op WLS clients are nonetheless extremely nervous to incorporate fruit back into their diets. Some have even been told ‘fruit is dirty’ by their providers. Most feel they ought to avoid fruit-- like mosquitoes in Florida. Now I think I know where this is coming from. Many folks with the best intentions believe the sweetness of fruit can prime the appetite-pump for MORE sweets—the high fructose kind. If you feel fruit might lead you to return to sweets with wild abandon then you are better off skipping it. But for those of you post op gastric sleeve and bypass clients, fully healed from surgery, and hankering for a small piece of watermelon to beat the heat or a tiny bowl of pineapple while vacationing in Hawaii, I say, enjoy. When I became a dietitian I took a solemn vow that I would always encourage well-balanced nutrition. To me, that means recommending to my WLS clients: lean proteins, whole grains, fruits and vegetables. I understand and encourage my clients to limit carbohydrates. I follow the bariatric plate guidelines and suggest 2 tablespoons of starch at lunch and dinner or, about 10 % of these meals. It’s late summer. This is your opportunity to enjoy the starchy vegetables of the season like sweet potato, fresh summer corn or green peas. And the delicious fruits of summer like Maine blueberries, Georgia peaches and succulent summer melon—in WLS portions. Fruits and vegetables, especially the deeply colored varieties like beets, raspberries, kiwi and tomatoes, are packed with disease-fighting antioxidants and nutrients that are so vital to good health. Plus, the loads of vitamins and minerals in fruits and vegetables are much better absorbed by our bodies than the version we get in supplements. I know many pre-surgery eating habits need to change after surgery. I sincerely hope that doesn’t mean you have to avoid some of nature’s tastiest treats of the season.
  4. Elizabeth Anderson RD

    Protein 101

    Which foods have protein? Protein is found in meat, fish and chicken. For vegetarians and those less keen on meat, there’s protein in cottage cheese, eggs, Greek yogurt, tofu, cheese sticks all the beans you might put in chili—except green beans. There’s also protein in meat alternatives like products from Morningstar Farms and Boca. You can usually find these products in the frozen food section. Protein amounts vary so check the labels. How much protein do I need? I tell my clients aim for 60-80 grams per day. Anyone with kidney issues might need to be much lower so it’s important to work with a dietitian specializing in bariatrics and kidney disease to get the protein prescription right for you. Can you get too much protein? If you’re drinking more than a two protein drinks per day along with multiple servings of protein, it’s easy to get up to 90 grams per day or more. There IS such a thing as too much protein and greater than 95-100 grams per day is starting to push healthy levels. p.s. Did you know the body simply cannot absorb more than 30 grams of protein per meal? If any of your protein drinks or bars are promising more than this per serving, don’t be fooled into thinking you are giving your body that full amount. Is protein really that important, anyway? Oh yes my friends, it is. Here’s why. Your body needs protein for its daily operations—cell building, transportation and repair work-- just to name a few. If you don’t feed it enough protein it will use the protein it has in storage (your muscles!!!) while stopping all fat burning activity. It does this because it senses that this is a crisis situation and perhaps a famine is ahead. Any body fat on hand has become more precious than a winning Powerball ticket and will be protected appropriately. It’s a common myth that after WLS you can eat whatever you want because you can’t ‘overeat.’ My advice? For optimal weight loss, that you can sustain, pull a Goldilocks and strive to get the amount that’s not too low and not too high but just right.
  5. If you'd rather vacation in a desert greenhouse this summer than get your bloodwork done, you're obviously not a fan of WLS labs. Are all those labs really necessary? Bariatric Dietitian Elizabeth Anderson helps you decide if it's time to fast or pack the sunscreen. “Do you think I should keep taking my sublingual B12, Elizabeth?” Roxanne* is 3 years post op from her gastric sleeve and is wondering if the expense of the meltable supplement is worth it. “I’m not sure, what does your latest B12 lab show?” I respond. “Uh…..I haven’t had labs done in, well...years,” Roxanne admits. And she’s not alone. Scores and scores of WLS clients intend to keep up with the required post op labs but life gets in the way. People, I am here to tell you, if it has been a long, LONG since you’ve had your specific bariatric lab work done, run, don’t walk, to your nearest phlebotomist. Every few years, the Obesity Society (TOS), the American Society of Metabolic and Bariatric Surgery (ASMBS) and the American Association of Clinical Endocrinologists (AACE) update medical guidelines for bariatric surgery patients. They have a list of labs that need to be done at 3 and 6 months and those that need to be done annually. Yes, every-single-year, after surgery. Why? Believe it or not, vitamin and mineral deficiencies increase over time—regardless of your WLS procedure. I know many PCPs push back against ordering these regular labs--whether it’s the cost to their practice, the patient or both, many providers don’t understand the necessity for the work-up. What concerns me the most is that the damage from some vitamin and mineral deficiencies cannot be undone or corrected. The damage is permanent. A psychiatrist speaker at a recent convention I attended, talked about patients he’s seen that were 6-10 years post op that were suffering from mental health issues--sometimes incapacitating problems. When he looked at their lab work, he was shocked to see that for some patients, vitamin and mineral deficiencies were the sole cause. If your provider pushes back against these labs, I’m happy to provide you with the link to the scientific paper citing which labs need to be done and when. You can share this with your provider and insurer. Roxanne is off having her B12 checked as we speak. Armed with those results, we’ll be able to determine the most affordable and healthful path forward, specifically for her. You deserve the same so make that appointment today. I thank you. *names of clients have been changed
  6. Elizabeth Anderson RD

    WLS and Labs....(not the four-legged kind.)

    Here's the link for you: https://asmbs.org/wp/uploads/2014/05/AACE_TOS_ASMBS_Clinical_Practice_Guidlines_3.2013.pdf
  7. Elizabeth Anderson RD

    WLS and Labs....(not the four-legged kind.)

    “Do you think I should keep taking my sublingual B12, Elizabeth?” Roxanne* is 3 years post op from her gastric sleeve and is wondering if the expense of the meltable supplement is worth it. “I’m not sure, what does your latest B12 lab show?” I respond. “Uh…..I haven’t had labs done in, well...years,” Roxanne admits. And she’s not alone. Scores and scores of WLS clients intend to keep up with the required post op labs but life gets in the way. People, I am here to tell you, if it has been a long, LONG since you’ve had your specific bariatric lab work done, run, don’t walk, to your nearest phlebotomist. Every few years, the Obesity Society (TOS), the American Society of Metabolic and Bariatric Surgery (ASMBS) and the American Association of Clinical Endocrinologists (AACE) update medical guidelines for bariatric surgery patients. They have a list of labs that need to be done at 3 and 6 months and those that need to be done annually. Yes, every-single-year, after surgery. Why? Believe it or not, vitamin and mineral deficiencies increase over time—regardless of your WLS procedure. I know many PCPs push back against ordering these regular labs--whether it’s the cost to their practice, the patient or both, many providers don’t understand the necessity for the work-up. What concerns me the most is that the damage from some vitamin and mineral deficiencies cannot be undone or corrected. The damage is permanent. A psychiatrist speaker at a recent convention I attended, talked about patients he’s seen that were 6-10 years post op that were suffering from mental health issues--sometimes incapacitating problems. When he looked at their lab work, he was shocked to see that for some patients, vitamin and mineral deficiencies were the sole cause. If your provider pushes back against these labs, I’m happy to provide you with the link to the scientific paper citing which labs need to be done and when. You can share this with your provider and insurer. Roxanne is off having her B12 checked as we speak. Armed with those results, we’ll be able to determine the most affordable and healthful path forward, specifically for her. You deserve the same so make that appointment today. I thank you. *names of clients have been changed
  8. Are you a prisoner of your own making? Bariatric Dietitian Elizabeth Anderson explains how our thoughts can lead us to success or the drive-thru. Shari* is one of my clients. She’s six months out from wls. She’s lost 55 lbs. and has hit her first significant roadblock. “I’m a failure. I went back to sugar. I’m an addict. I’ll never be able to stop. I know I’m going to regain all the weight I’ve lost. I can’t believe this [surgery] didn’t work for me.” Sound familiar? As a bariatric dietitian I hear these worries every day. Totally disheartened clients are confident they cannot maintain their post op weight loss, that the honeymoon is over and their bad luck/life-long battle with weight has returned. When I tell them their own abusive thoughts are doing more damage than the donuts they’re eating, they’re shocked. I’m not making this stuff up people. Research continues to show over and over that cognitive structuring or what we think about what we eat, who we are and what we’re capable of is one of the most crucial factors in weight management. I’m reading Ph.D. therapist, Joyce Nash’s fabulous book “Now That You’ve Lost It, How to Maintain Your Best Weight.” Nash shares research identifying thought patterns in those who struggle with obesity. Here are some examples: Obese thoughts: ”Why do I have to work so hard at this when other people get to eat whatever they want and not gain weight?”….”I guess I’m just meant to be fat.”…..”I shouldn’t feel angry.”…..”If I don’t do it, no one else will.” Researchers summarize those not very successful at long-term weight loss tend to…”not want to set limits, doubt their ability to change, reject the right to speak up for their needs, avoid interpersonal conflict, set up unrealistic expectations for themselves and judge themselves and others harshly.” The researchers conclude that weight loss plans cannot have a long-term effect if such beliefs exist because they totally undermine success. But how in the world can someone turn that frown upside down when they’re in a period of full court press relapse? Here’s what Nash suggests. “[The client]…must decide that something is different this time, something has changed. Whereas in the past something was missing, now that ingredient is present. [The client] now understands she must THINK differently and DO things differently to succeed. She must take charge, not only of her behavior but of her thinking.” If it seems all too happy and Pollyanna-ish, it doesn’t have to be. With Shari, I helped her reframe how she was thinking about her swings through Dunkin’ Donuts. Shari is struggling with some of those Top 10 Most Stressful Life Events right now and she’s turning to sweets as a reward/treat/distraction. When we devised a plan to reset boundaries, seek grief counseling and think more flexibly about her eating, she was able to regain her footing. Have your regained some of your weight? Whether it’s 5, 10, 50 pounds or more, the fastest way to stop the runaway train is to do a 180 degree turn in your thinking. We usually can’t do this alone. Find someone from your bariatric team or a supportive counselor or dietitian who can help you see the error possibilities of your beliefs. *names are changed to protect client identity
  9. Elizabeth Anderson RD

    The Brain Drain: Are You Your Own Worst Enemy?

    Ms. Becky, never, ever forget you are a ROCKSTAR!! Talk about having a few issues on the 10 Biggest Life Stressors list! I'm going to say what you already know, you must take care of yourself FIRST to offer the world a massive dose of love. And, the fastest way to hopelessness and despair is flogging yourself mentally. Self-compassion isn't an excuse, it's a necessity for long-term weight management. xoxxo Elizabeth
  10. Elizabeth Anderson RD

    The Brain Drain: Are You Your Own Worst Enemy?

    It sounds like you've found a sustainable way to coexist in the world with sugar. Congratulations on your continued healthy success!
  11. Elizabeth Anderson RD

    The Brain Drain: Are You Your Own Worst Enemy?

    Shari* is one of my clients. She’s six months out from wls. She’s lost 55 lbs. and has hit her first significant roadblock. “I’m a failure. I went back to sugar. I’m an addict. I’ll never be able to stop. I know I’m going to regain all the weight I’ve lost. I can’t believe this [surgery] didn’t work for me.” Sound familiar? As a bariatric dietitian I hear these worries every day. Totally disheartened clients are confident they cannot maintain their post op weight loss, that the honeymoon is over and their bad luck/life-long battle with weight has returned. When I tell them their own abusive thoughts are doing more damage than the donuts they’re eating, they’re shocked. I’m not making this stuff up people. Research continues to show over and over that cognitive structuring or what we think about what we eat, who we are and what we’re capable of is one of the most crucial factors in weight management. I’m reading Ph.D. therapist, Joyce Nash’s fabulous book “Now That You’ve Lost It, How to Maintain Your Best Weight.” Nash shares research identifying thought patterns in those who struggle with obesity. Here are some examples: Obese thoughts: ”Why do I have to work so hard at this when other people get to eat whatever they want and not gain weight?”….”I guess I’m just meant to be fat.”…..”I shouldn’t feel angry.”…..”If I don’t do it, no one else will.” Researchers summarize those not very successful at long-term weight loss tend to…”not want to set limits, doubt their ability to change, reject the right to speak up for their needs, avoid interpersonal conflict, set up unrealistic expectations for themselves and judge themselves and others harshly.” The researchers conclude that weight loss plans cannot have a long-term effect if such beliefs exist because they totally undermine success. But how in the world can someone turn that frown upside down when they’re in a period of full court press relapse? Here’s what Nash suggests. “[The client]…must decide that something is different this time, something has changed. Whereas in the past something was missing, now that ingredient is present. [The client] now understands she must THINK differently and DO things differently to succeed. She must take charge, not only of her behavior but of her thinking.” If it seems all too happy and Pollyanna-ish, it doesn’t have to be. With Shari, I helped her reframe how she was thinking about her swings through Dunkin’ Donuts. Shari is struggling with some of those Top 10 Most Stressful Life Events right now and she’s turning to sweets as a reward/treat/distraction. When we devised a plan to reset boundaries, seek grief counseling and think more flexibly about her eating, she was able to regain her footing. Have your regained some of your weight? Whether it’s 5, 10, 50 pounds or more, the fastest way to stop the runaway train is to do a 180 degree turn in your thinking. We usually can’t do this alone. Find someone from your bariatric team or a supportive counselor or dietitian who can help you see the error possibilities of your beliefs. *names are changed to protect client identity
  12. Elizabeth Anderson RD

    Dangerous Diet Myth #2

    Bariatric Dietitian Elizabeth Anderson unveils 5 common but Dangerous Diet Myths. Today, myth #2--low calorie food don't count. Let’s start with pure, innocent popcorn. Popcorn is a great, high volume, low calorie, whole grain snack-- if prepared in a healthful way. Dieters love air-popped popcorn! It provides a BIG feeling of fullness for very few calories. It can be a great tool for managing late night snacking when you’re watching your weight … if you aren’t a bariatric surgery patient. For weight loss surgery patients, it’s that feeling of fullness that’s the concern. After WLS, you’ve got to be very careful about high volume foods—even if they’re ‘healthy’ or low calorie. Those neat little bags of baby carrots are a classic example. In many diet plans, these low calorie veggies are the perfect ‘free food’ because they’re high in nutrition. I’ve had many clients tell me this is their go-to snack because ‘they really don’t count.’ Don’t get me wrong, we all need vegetables and carrots ARE super healthy. But WLS surgery intentionally left you with precious little capacity in your pouch or sleeve. For the very best and most healthy weight loss/maintenance, you need to fill that tiny space very strategically. Protein, vegetables, whole grains—in that order. Be careful not to override your surgical tool with very low calorie vegetables or…popcorn. Yes, they’re healthy but standard dieting advice is just one more of things that don’t fit after WLS. Tomorrow dangerous diet tip #3: Fooling Your Stomach with Fluid.
  13. Elizabeth Anderson RD

    Dangerous Diet Myth #3: Fooling Your Stomach with Fluid.

    Remember this old diet trick? 'Drink a BIG glass of water or a diet drink before a meal; you won’t be hungry and you’ll eat less.’ Clearly this isn’t the most delicious diet tip but nevertheless, it’s one that many dieters still follow. WLS patients should not try this for three reasons: 1. Filling your pouch or sleeve with a large amount of fluid at one time will cause great discomfort. 2. Emptying your stomach quickly after a meal counteracts the satiety benefit of your surgery. Meaning, the faster your stomach empties—the sooner you’ll be hungry again. 3. Using fluids or drinks to replace food could lead to less total weight loss. Wait, less weight loss?? How’s that possible? Fluid pushes food through the pouch/sleeve more quickly. Food moving through your ‘stomach’ faster means important vitamin, mineral and nutrient digestion might not happen. Without these important nutrients and micronutrients, your metabolism will not run efficiently. A sluggish metabolism leads to less weight loss, if any at all—despite reduced caloric intake. Tomorrow dangerous diet tip #4: Salads: Your Weight Loss Staple.
  14. Years of diet plans, programs and books make most WLS patients nutrition gurus. Much of that information is great to have but it's important to separate out the unofficial diet 'rules' that might be unsafe to practice after bariatric surgery. Today, bariatric dietitian Elizabeth Anderson continues her series on 5 of the most dangerous dieting myths for weight loss surgery patients. Salad. The food most synonymous with the word ’diet.’ Many people LOVE salad. Others eat it because they feel like they should if they’re on a diet. Nutritionally, the darker the greens, the more brightly colored the vegetables—the healthier the salad. High volume, low calorie salads make a lot of sense for the average dieter. You feel full on very few calories, provided you skip the high calorie dressing. But there’s one ingredient many people forget that prevents salad from being a balanced meal---the protein. I tell my weight management clients if they really enjoy salad, it’s a great meal AS LONG AS there is at least 3 ounces of a lean protein included in, on or with the salad. The protein piece is vital because it helps the meal digest more slowly. This leads to less hunger between meals. The protein is also important to protect lean muscle from being used for fuel when calories are cut. I tell my weight loss surgery clients, the need for protein is more than just a recommendation, it’s an absolute must. At least 3 ounces of lean protein (about 15-20 grams of protein) with your salad. I urge you to actually measure out the chicken, cottage cheese, beans....to ensure you are hitting the mark. A bariatric salad ‘meal’ should look like protein with a little salad on the side rather than a huge bowl of greens with a sprinkle of cheese or half an egg. As we’ve seen with the other diet myths, standard operating procedures for dieting do not translate after WLS. Tomorrow, dangerous diet tip #5: It’s all about the calories.
  15. Elizabeth Anderson RD

    Dangerous Diet Tip #4: Salads: Your Weight Loss Staple.

    In case you didn't see my response to VSGAnn2014, anything over 90 grams of protein per day would make me concerned. Check with your bariatric team to see what they recommend for you personally.
  16. Elizabeth Anderson RD

    Dangerous Diet Tip #4: Salads: Your Weight Loss Staple.

    Good question--I wonder that, too. My understanding is that too much protein can cause kidney damage, but I don't have a sense of how much that is, and over what kind of time frame.
  17. Elizabeth Anderson RD

    Dangerous Diet Tip #4: Salads: Your Weight Loss Staple.

    The standard protein recommendation is 60-80 grams of high quality protein daily. I don't know your individual circumstances so I can't say what's wisest for you. You absolutely CAN have too much protein however. Check in with your bariatric team or dietitian and see if they can make a personalized recommendation. All things being normal, anything over 90 grams per day for a healthy female would make me ask some questions. Good luck!
  18. Elizabeth Anderson RD

    Dangerous Diet Tip #4: Salads: Your Weight Loss Staple.

    You are the expert on you so always listen to what your body says. Now this can be confusing in your case because on the one hand it's saying, 'Must. Eat. salad.' On the other hand, your stomach is saying, 'Ouch.' Also, timelines on when you can tolerate what, are very individual. I think you're wise to wait a bit longer. When you do try again, go slowly, like you've been doing and remember, Protein first. Let me know how it goes!
  19. Elizabeth Anderson RD

    Dangerous Diet Tip #5: Calories are all that Count.

    I enjoy this community so much. Thanks for the feedback Alex.
  20. Many diet plans tell us it's all about the calories. But is that true after weight loss surgery? Can you really keep eating everything you love just limit the portions? Bariatric Dietitian Elizabeth Anderson provides her take on this question in the final installment of her dangerous diet tips series. Imagine me, 16 years old at the neighbor’s pool, feeling pretty sassy in my new one piece bathing suit with the buttons down each side. My grandmother’s friend edges up to the side of the pool and motions me over conspiratorially. “Elizabeth, I see you’ve lost some weight, tell me, what’s your secret?” “It’s easy, just eat 1000 calories a day. You can eat whatever you want just don't go over 1000." Ladies and gentlemen, why did I ever pay for a nutrition degree when I clearly had all the information at age 16???? Clearly, I jest. 1000 calories of hot dogs, English muffins, fat free cookies and pancakes does not a diet make—let alone a healthy weight loss plan. But it’s soooo tempting to follow this advice. It’s simple, clear cut and junk food is totally fine--as long as you keep the total consumption under the specified number of calories. Some WLS patients have taken the bait—especially after they stop losing weight. Not surprisingly, there are some problems with this type of plan. 1. 1000 calories of potato chips isn’t nutritious but it fits the criteria. 2. If you don’t have enough protein you’ll be compromising your weight loss—regardless of calories. 3. Individual calorie needs depend on sex, age and activity level to name a few. One size does not fit all. There’s a better way. Stop counting calories. Don’t let a number determine how much you’re going to eat today. Rely instead on your surgical tool and natural hunger. This can be scary—flying without a net. The temptation to use total calories as a guide is real. But ignore it. You are ready for something else, something more effective and natural. Here’s how to start: 1. Eat three bariatric-sized meals and two portioned snacks each day. 2. Sit down to eat, eliminate distractions: TV, computer, magazines or books. 3. Pay attention to the deliciousness of the food. Savor it. 4. Try to take at least 15 minutes to finish a meal, 30 is better. 5. When you are full, stop eating. Notice if there is still food on the plate. If there is, does that make you uneasy? There are a lot of members in the Clean Plate Club. Cancelling your membership IS possible, but first you have to realize you are a member. It isn’t easy shaking old diet thinking and behaviors—the first step is realizing you are following them. With some self-compassion and support, you can find your way back to healthy and sustainable weight management.
  21. Elizabeth Anderson RD

    Dangerous Diet Tip #5: Calories are all that Count.

    So very glad!

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