AMY EIGES- Intuitive Weight Loss: Losing 200lbs & Keeping it Off Is a Mental Battle.

So for those who don't know me, my name is Aimee Agassiz and I am a health coach and program director for Tord Health, which is Dr. Tord's practice. But way before that, I was a chronic dieter. Is it working? Yeah. I was a chronic dieter stuck on that never-ending binge game chain cycle that many of us know all too well. I spent, I woke up every day thinking, what am I going to do today and literally dieted my way to over 400 pounds despite trying really hard for many, many years. I went to Weight Watchers 35, 40 times. My parents took me as a child to every single diet doctor, program, nutritionist, dietician in the New York Tri-State area. I took myself as an adult to every diet and influencer and magazine, book, anything you can think of, I tried and I somehow landed over 400 pounds still. So I was, I made the difficult decision to have bariatric surgery despite not knowing that it was going to be the wrong decision for me, but I was desperate to avoid that and I did a two-week challenge and what started as a two-week challenge nine years later has resulted in 220 pounds lost, reversal of pre-diabetes, reversal of lifelong depression and if I tell you that no one is more shocked to be standing on a stage talking about the one topic that was so incredibly, brutally, excruciatingly painful and difficult for me to talk about every day for 50 years and then I am standing on this stage, nobody is more shocked than I am, right. This was, thank you, this was not in the cards for me, this was not the fate that I was destined to live for 50 years, right, and yet here I am. So if I have any superpower whatsoever and that is debatable, it is that it is truly indeed possible to do this after a lifetime of believing that I couldn't. Yeah, it still takes my breath away, right, but I hope it never gets So the advice that I got over and over and over again until I got the right advice was pretty much eat less, move more, right, and then this little piece of gem which is a direct quote from a doctor I saw in my 30s, just take up an extreme sport like mountain climbing, which wasn't all that helpful when I was 400 pounds, but also I lived in Manhattan, so it was a couple hundred miles from the nearest mountain range. So yeah, that's what I got. So the purpose of this presentation is going to explore the concept of intuitive eating and just by a quick show of hands I'm curious who has heard of intuitive eating, like what do you, okay, you've heard of it. So for those who do know about it and I'll go into a little bit more about what it is, you would think that the concept of low carb would be completely antithetical to the principles of intuitive eating and I'm going to show sort of how it we could marry the two into a more peaceful relationship with food. So, okay, how's that? Okay, so the problem, this country has a massive obesity epidemic, not a surprise to anybody here. 42% of us are living with obesity, about 75% of us are overweight, only 12% of us classify as metabolically healthy and these are scary and staggering and pretty much unsustainable numbers, but yet they keep rising. But why and how did we possibly get here when there are so incredibly many resources devoted to helping us lose weight? We want to lose weight, we want to get healthy and there is no end to the amount of predatory diets, doctors, influencers, magazines, books, all the things that there's no end to the amount of resources that are devoted to weight loss and yet we cannot possibly get there, right? So over and over we are told we cannot possibly trust our intuition, we are told that we cannot possibly rely on ourselves, that when we and when we fail at these diets over and over and over again, they're only too happy to sell us their shiny new quick get thin quick plans or these days their GLP-1 medications made in some random compound pharmacy and yeah, $1,200 a month later, here you go. And if we're lucky, like I was, we stumble across a low-carb diet and we find a doorway to that freedom and indeed some people go keto and they live happily ever after, they have no cravings, they have no hunger, everything is resolved and they live happily ever after, the end. And then there's the rest of us who are left wondering why the hell we can't get in on this fairy tale that we see on social media and why is everything looks so easy for everybody else and why are we still struggling? And yeah, when I went low-carb for a little while, anyway, it felt like a fairy tale, like I was no longer hungry, my cravings were reduced, I, you know, but then eventually I left feeling, I was left feeling like this guy, a little battered and bruised and I felt better going low-carb, I lost a fair amount of the weight that I ended up losing on low-carb but I found that it wasn't enough. There is no diet, no matter how well crafted or nutritionally sound, that can outsmart our very crafty brains looking for a loophole, even low-carb. Low-carb gets some things right but it doesn't get the relationship to food right. I have personally broken every single diet I've tried many times over, right? Fat bombs, bulletproof coffee, nuts, nut butters, dairy, keto treat foods, even berries, all low-carb, all our brains have virtually no turn-off switch to. And so when I went low-carb, I was like, what? I got the nutrition part right, but why was I still struggling with overeating food constantly? And then I was left feeling even more disenfranchised, right? Years of disenfranchisement and then, yeah, why couldn't I make this one work either? So you can see it's not about diet but it's not not about diet. So where does that leave us? Where it left me, where it left probably many people in this room feeling like a failure. How many diets have you failed at? How many Mondays have you started over? And who did you blame for that failure? You never blame yourself. You never blame the plan or the program or the doctor or the diet. It's always our fault. We are the failure. Why can't I do this? What is wrong with me? I'm broken. I didn't have enough willpower. I just have to try harder next time. There's got to be a better way. It is exhausting. Enter intuitive eating. Intuitive eating was based on a 1995 book by the same name. It was written by two dieticians, Elise Resch and Evelyn Trebley, disenfranchised and alienated by their own failures and the difficulty in maintaining diets and diet culture. It sprang forth a movement that's gained some popularity in recent years of the same name. It provided a framework for how to handle food relationship issues where nutritional plans and diets fell short. It was called a revolutionary anti-diet approach and aimed to restore our brains and our bodies back to factory settings that had been beaten out of us by toxic diet culture. Eat when you're hungry. Stop when you're full. No food is off limits. At its core, intuitive eating rejected the idea of diets and said that they were unsustainable and aimed, as I said, to get readers back into a relationship with their bodies and their brains in order to heal. The ten principles of intuitive eating are reject the diet mentality, honor your hunger, make peace with food, challenge the food police, discover the satisfaction factor, feel your fullness, cope with emotions without food, respect your body, exercise, and honor your health through gentle nutrition. The intuitive eating author's approach was heavily influenced by a 1945 experiment at the University of Minnesota run by physiologist Ansel Keyes. Yes, the same guy that is responsible for us all getting statins from all of our doctors all these years later. But this experiment was actually quite interesting. It was now called the Minnesota starvation experiment. So there were four phases of the experiment. 36 men volunteered for a 14-month study. The first three months of the study, they ate 3,200 calories a day, which is their baseline calorie intake. Then it was followed by a six-month semi-starvation period of 1,570 calories a day, which I always find incredibly shocking because I try to live about 570 calories less than that a day for 50 years and somehow couldn't make it. Their semi-starvation period was breakfast and lunch, low-fat, high-carb, and the men walked an average of 22 miles a week. So no sort of biggest loser ranch kind of regimen. It was just pretty miles a day of walking. At that period, it was followed by three months of a restricted rehabilitation period of 2,000 to 3,200 calories a day, and then a two-month unrestricted rehabilitation period, no limits on their caloric intake. So what happened? They lost 25% of their body weight, but notably, they became completely obsessed with food. Food and eating became focal points of their conversations, their dreams, their daydreams, their reading. They started to collect recipes. They started to exhibit neurotic behavior around foods where none had previously existed. They became depressed, socially withdrawn, their libidos decreased, and they had significant emotional distress. Some ended up with severe binge-eating issues, again, where none had previously existed. Their resting metabolic rate decreased by 25%, so weight quickly shot up and was regained after the restriction period. Their body fat increased to higher-than-baseline muscle mass was lost and did not return when the weight increased. So I ask you, if six months of eating a 25% calorie deficit did all of that, what do you imagine are the physical and psychological impacts of dieting and failing for 10, 20, 30, 40, and 50 years? Diets and diet culture are toxic. They lead us to food obsession and disordered eating. They ignore our own physiology, they're externally driven by their definition, they're short-term, they set us up for deprivation and failure, and they end up setting us up for self-hatred and self-harm. But diet and diet culture are so prevalent, we hardly even notice how much they have woven their way into our bodies and our brains and our lives. Indoctrinated into this failed system, before we're even old enough to consent, we're taught over and over and again, our intuition cannot possibly be trusted. Diets are a part of our societal DNA, an internalized failure of their genetic expression. But what if we want to lose weight? What if we have health concerns? What if we want to optimize our well-being? How do we reconcile all that we know about insulin resistance and metabolic health and a desire to live a low-carb lifestyle if diets and restrictions don't work, and worse, they set us up for failure? Diet may be a four-letter word, but weight loss and health are not. So full disclosure, about 15 years ago, I myself was disenfranchised with diets and diet culture and tired of just being living so unpeacefully with food, and I tried intuitive eating. I did it, I gave it an old college drive for about a year, year and a half, and full disclosure, I gained a lot of weight, about 40 pounds. So how did I go from the picture on the left to the picture on the right? By combining the principles of low-carb eating with intuitive eating. What this slide represents for me, for many of us, is the cycle of obesity that kept me stuck for years in prison for serving, you know, pretty much like a death row prison sentence for a crime I didn't know I had committed. I started with a genetic propensity towards insulin resistance. I was put on a diet early. I couldn't stick to the diet. I was put on another diet. I couldn't stick to that diet, and then I, shame and guilt and self-blame and more diets and incompetent doctors and a predatory diet complex of an industry that was only too happy to take my parents' money and then my money, rinse and repeat, and then you factor in the mental health aspects that sort of baked into my psyche after failing for 50 years, and you get stuck in a cycle of obesity that is nearly impossible to escape from, and I didn't quite understand when I was trying intuitive eating. It became crystal clear when I went low-carb because I was no longer battling blood sugar fluctuations and extraordinary hunger and cravings, and so, you know, low-carb intuitive eating didn't resolve this, and what I didn't quite get when I went low-carb is why I'm still sort of on that binge diet roller coaster of unsustainable over-restriction and just getting off of that cycle. Why was I still struggling even with low-carb foods? Intuitive weight loss combines the strengths of both intuitive eating and low-carb into one paradigm. I'm going to go through some of the principles and show you sort of how to marry that with the intuitive eating principles and marry that with the low-carb world. Intuitive eating asks us to block out the external noise of what we've been told is good for us or what we've been told is forbidden and tap into an instinctive knowledge about what to eat based on how we feel and how it impacts our bodies and our minds. The first line of defense is not being hungry. Hunger always wins, always, no matter what, and if you've been a chronic dieter on the binge restrict cycle, not being hungry feels like a superpower. Eating more satiating food now allows you to eat less later and this is where low-carb truly excels. It gives us a way to eat that does not make us hungrier. It allows us to eat until reasonably full and it helps us rebuild the trust that has been beaten out of us by diets and diet culture that if we are hungry and we need to eat, we get to eat nutritious satiating foods. And while no food is considered good or bad, all foods do have different nutritional profiles. With intuitive weight loss, you connect back to how a food makes you feel, its impact on your body, your brain, and your psyche, in other words, your intuition. And this is where panic usually sets in, right, when I tell people this. Reject diets, eat whatever I want, honor hunger, I will gain 100 pounds, oh my god carbs, I'll never stop eating. You don't understand how much I can eat. Yeah, trust me, I do. So this is a quote from the book Intuitive Eating. The forbidden object is elevated to an overvalued level of specialness. When a diet dictates that a particular food is forbidden or should be avoided, it makes you crave that food even more. And this is not going to come as any news to anybody who's ever tried a diet because we know this, right, we've lived this. The minute you, things get tough, stress, mental health, difficult times come, social situations as Joe talked about this morning, that list of five musts, you know, sort of need to address. Anytime this happened and there's a good, forbidden food is there, first chance we get, we eat it, we probably overeat it, we maybe end up binging on it if that's our thing or that's our issue and, you know, rinse and repeat. So how do we reconcile this with a carb-restricted lifestyle when by its very definition, carb restriction is restriction? The fear for many of us is that if we eat whatever we want without assigning a moral value to a food, we will never stop. And intuitive eating tells us to do just that, eat how we want and assess how we feel after. But most of us have already done this repeatedly. We know how this story plays out. With intuitive weight loss, you get to choose, you make a choice rather than having one imposed on you by external rules. You can think of all foods as an option without eating all foods by using your own past experiences with the food as information. In other words, eat what you want without restriction other than what your body and your brain tells you. So just some quick how-tos to do this because it can seem a little overwhelming. Honor your hunger and satiety cues instead of eating around external rules. Eat when you're hungry, don't eat when you're not. Prioritize what feels good within your body and avoid what doesn't. I just want to make special note that, you know, I sometimes say that our bodies are often smarter than our brains. Our brains will tell us, you know, it's vacation, I deserve it. Our brains will tell us grandma made this just for me. But our body knows that we don't feel good when we eat that. Our body knows that we're going to get a migraine or that eczema is going to come back or our blood sugar is going to spike. We're going to need to bolus insulin for that food. Our bodies are smarter. So listen to your body more than your brain. And if you detach a moral judgment from the food, do you want it strictly because it was or is forbidden? Oops. Eat when you're hungry and when you're hungry, eat a meal. Avoid snacking because you want to really tap into your hunger. And if you're snacking even the low-carb breeze all day, it makes it very difficult to hear that call of hunger. It may take a little trial and error to figure out what you're going to need to fill up and satisfy, keep you satisfied longer. But a sk yourself is what foods fill you up for longer? What foods leave you hungry shortly thereafter? What foods can you eat endlessly, endlessly? And what foods do you have a turn-off switch for? Intuitive eating is noticing how you feel when you eat. It's doing what supports your health and avoiding what doesn't and finding ways to move your body that are sustainable and enjoyable. Intuitive eating is not indulging every craving, intentionally eating to excess and eating without regard to nutrition. First and foremost, eat foods you love and that love you back. Don't stay in a toxic relationship. So all that is well and good, but what do we do with cravings? How do we handle that? Shouldn't I be able to eat a little bit of everything? Moderation appears to be a common-sense approach, but it rarely takes a few factors into account. There are many reasons we might not choose to eat something. Our food sensitivities and allergies, preferences, tastes, religion, cultural traditions, health, psychological impact of the food. If you find it nearly impossible to moderate certain foods or the impact your health or well-being, you get to decide how to proceed. If a food continually causes harm, discomfort, distress, that is all you need from the most reliable source, yourself, about whether you should eat it. Abstinence from foods that cause you harm is not an eating disorder, it is self-care. So what gets in the way? We are up against a myriad of personal, social, psychological, and cultural systems that drive us to eat. No diet is going to change childhood memories of sentimental favorites. No diet is going to change that we celebrate with food at every turn. No diet is going to change traditional cultural foods and norms or the biological hormonal drive to eat, and no diet is going to outlast the lure of hyperpalatable modern processed foods. Bet you can't eat just one. They boast about it right on the bag and in the commercials. Processed food companies use the idea of moderation to convince us how their products can be part of a healthy diet in order to sell us more of their products, and then they craftily shift the blame back to consumers for not being able to limit them. But these foods have been created in labs by teams of scientists to hit every bliss point in our brains. It is not our fault we cannot moderate them. They were designed for us to keep eating and eating and buying and buying them. We are not to blame. This is a whole lot of words here, but it's in 2015, the New York Times revealed that Coca-Cola funded a global network of scientists to divert attention from the contribution of sugar to the obesity epidemic. A year later, a senior official at the CDC was found to have communicated with a former Coca-Cola executive, strategizing how to convince the World Health Organization to collaborate with the food industry to spread the same message. This slide is an internal talking points memo from Coca-Cola where their goals were to shift the perspective from sugar to blame consumers for overconsumption by promoting. We are unwittingly a part of a brilliant marketing campaign that has us believing that we are not exercising enough, not MyFitnessPal-ing enough, not tracking enough, and not moderating enough. Enough with the rabble-rousing in the front row, please. And from the Washington Post, again, a lot of words here, but an article in the Washington Post last year, the food, beverage, and dietary supplement industries were found to be paying dozens of registered dietitians to post content that encouraged their millions of followers to eat candy and ice cream while downplaying the health risks. They were also paid to push on proven dietary supplements. All messages run in counter to decades of scientific evidence. The Washington Post review also found that among 68 dietitians with 10,000 or more Instagram and TikTok followers, about half had promoted food, beverages, and dietary supplements to their combined 11 million followers. So the moderation myth is just that, a myth created to sell us processed foods. Not everybody can or should eat everything. So what do we do with that information in the face of modern life, right? How do we take that into our day-to-day lives when we keep telling ourselves over and over, the food I'm craving is going to taste awesome? Yeah, it will, maybe for a few seconds. But then if you pay close attention, most of the time that food you are craving offers greatly diminishing returns. It rarely gives the reward you're looking for. Tell yourself the whole truth about the foods you're craving based on your own lived experience with it. Have you ever been able to moderate that food before? Or does it lead to more poor food choices and a week-long rabbit hole binge? How do you feel after eating that? Overeating and binge eating are rarely about food enjoyment. When you enjoy something, you savor it, you celebrate it, you don't sneak it, you don't hide it, and you don't feel ashamed about it. Tell yourself the whole story about the foods you're eating, not just what the immediate gratification might offer. How has this eating, but eating those things, impacted you every other time? Recognize and respect your own previous experience and factor that into whether eating it is something you want to do at that moment. The drive to eat will never completely disappear, much like the drive to breathe, to manage it. Don't waste your time and energy trying to cure it. Perfection is unsustainable. How often have you tried to be your ideal self, but for whatever reason could not adhere and fell off entirely? This sort of goes back to a little bit what I was talking about this morning on moment zero. So rather than attempting and failing at moderation and perfection, consider a harm reduction strategy. What is a good, better, and best option for every challenging scenario you're going to face? In the moments you're implementing good and better, your goal is not maintaining a perfect idealized vision for yourself, but rather a way to not fall into all or nothing thinking that you've seen play out all the other times, and Tro showed you exactly what that all or nothing thinking does. It delays getting you the help that you need. Ask yourself every time the inclination to eat comes to you, am I hungry? And stay present to try and understand what is driving you to eat in that moment. Take note of the circumstances and triggers that drive you to eat, especially if you're driven to eat when you're not hungry. What are the people, the food, the places, the times of day, the situations that you find yourself driven to eat, especially when you're not hungry, and then have good, better, and best strategies for each of those. Build defenses, not willpower. Prepare for your very worst day, not when motivation is high and things are easy. You got a speeding ticket on the way to work, your dog threw up on your new rug, you're fighting with your partner, your kids are annoying you, you're under a tight deadline at work, and you slept like crap. What are you going to need on that day to make sure that you don't have to rely on moderation and willpower? Without a plan, willpower will always fall short. Willpower is having a plan. The next thing I'm going to talk about is how to cope with emotions without food. Emotional eating is not a food problem, it's a coping with emotions problem, but eating satiating, nutritious foods is the first line of defense. I'm an emotional eater. How many of you have labeled yourself that? I certainly have. And while that very well may be true, I think that assigning a label to yourself, calling yourself an emotional eater, is just a way to shift the blame back to you, to say to yourself, see, it's all your fault, you just couldn't do it, you're just an emotional eater, you don't know how to handle all this stuff. Emotional eating is not our fault, but it is our responsibility. The cost of using, of chronically using food is just way too high. Food is often used to numb, distract, to avoid difficult feelings, but the cost is just too high. Assigning fault stops progress, and the resulting shame keeps us from moving forward. It just keeps us stuck. So rather than label yourself an emotional eater, just create good, better, best strategies for yourself, and have a practical playbook. If you've observed your triggers, don't judge them, just have a practical playbook for how you're going to handle when X happens, when this set of circumstances happen, how am I going to get through this, and whether it's the good or the better or the best category, you have a way out that doesn't completely throw you off track for months and months at a time. The next thing I'm going to talk about is respecting your body and exercise. Exercise is not a weight loss tool. Separate exercise from weight loss. Move your body because it feels good, not because it's going to burn calories or change the number on the scale. Exercise is amazing for metabolic health, reduced disease, mood, stress relief, mental health, increased energy, strength, endurance, flexibility, but it is not necessarily a weight loss tool. I used to believe exercise was a luxury only afforded to thin people, and I could not have been more wrong. Without placing a moral judgment on your body or your fitness level, ask yourself, who is the person I want to be? How do they act? What does that mean for me right now? Exercise does not need to be a grueling slog. Find something that you enjoy, or at the very least, don't hate off the top, and do and be realistic about where you and your body are. So if you are completely sedentary, take your step count, add 10. Do 1% better. Just start. You deserve that. Do what you can when you can, and make movement a non-negotiable part of your life. The size of your body is not a measure of your self-worth, and I'm going to say that again for the people in the back and for the people right here, right? The size of your body is not a measure of your self-worth. You are deserving of dignity and respect no matter what body you're currently inhabiting. Long-lasting and sustainable weight loss must come from a non-judgmental and internal drive, not from self-hatred. Has self-hatred ever led to lasting change? Ever? Honestly, as a health coach who has devoted her life and her career to helping others escape the obesity cycle that I lived in, if I thought for one second that self-hatred would work, I could be convinced to use it for the greater good. But it doesn't. It never has. If self-hatred worked, we all would have hated ourselves one time, we would have started one diet, we would have been done with this, and we wouldn't be sitting here right now. We would all be perfectly metabolically healthy. Self-hatred doesn't work. It is just part of an internal thought pattern that keeps us stuck. Recognize it for what it is, and it has never worked. So just break that cycle of self-hatred. Transformation begins with the radical acceptance of what is. Acceptance doesn't mean that you love everything about your body at the moment or your health. It doesn't mean that you don't want to change, but be okay with the reality of where you are now rather than beating yourself up for some perceived crime. Healing is a result of self-love, never self-loathing. Respecting that body includes letting go of regret for time lost, for all the failed diets, for all the bad information. That only keeps you stuck. I'm going to take a few minutes to just quickly talk about that and then I'll wrap up. We talked a little bit about the hijacked brain, that modern processed food, that hyper-palatable food that is so impossible to withstand. We talked about eating food versus using food, mental health, emotion, stress, sleep. We talked a little bit about diet brain and learning to trust yourself and your satiety, forbidden foods, and I'm going to talk about some frequently repeated internal messages that make it awfully difficult to listen to your intuition. The self-talk that goes into, I found myself unable to resist. Often that is preceded by a number of these thoughts. Again, if you think any of these things, it's nearly impossible to let your intuition take over. So the first one I call is efforts. I've been so bad. I'll start over on Monday and Tro talked a bit about why that's so damaging, that all or nothing thinking. I've been so good. I deserve it. What else do you deserve? Don't you deserve good health? The next one is what I call fat thoughts, which is, oh my god, I'm so fat. Seeing unflattering photos, clothing feels snug, the scale goes up, or it doesn't move nearly as fast enough as you're expecting it to. Everyone else can have it. Why can't I? Those feelings of deprivation. And the next one, and the last one to talk about is learned helplessness, which is, I have so far to go. I'll never get there. I may as well give up. I'm too far gone. I'm broken. This is going to fail like all the other times. Maybe so, but what if it doesn't? Would you give up if you knew that success was guaranteed? Guess what? If you don't give up, it is guaranteed. I'm going to tell you a little secret that not a lot of people say and not a lot of health coaches say. This is hard. This is really hard. What my dramatic before and after picture doesn't show, what Tro's dramatic, what anybody's dramatic before and after pictures don't show, is all the blood, sweat, and tears that went into this. Low carb is the easiest way I've tried to lose weight of the thousands that I've tried, but it is not easy and I still struggle. I am still learning nine years in. But so I think when people, when it's hard, people think they must be doing something wrong. No, it's just hard. So no, but living in a body that hurts, that feels trapped, that is so much harder. Please, please, please be as kind to yourself as you are to those you love. You are worth it. This is a lifelong journey and be realistic and know that perfection does not exist. Know that every moment is not going to be about weight loss. Sometimes the goal is weight stability or dealing with your food relationship in a deeper way. Sometimes you will do everything right and the scale will not move for weeks or months at a time and the road ahead is going to seem impossibly long and incredibly painful. This is part of the process, not outside of it. Keep putting one foot in front of the other. Choose your heart and keep going. Just start now, not tomorrow. Keep showing up for yourself because it's never too late.