Navigating Food, Body Image, and GLP-1 Medications: An Interview with Robyn L. Goldberg, RDN, CEDS-C

Curt and Katie chat with Robyn L. Goldberg, RDN, CEDS-C, about how diet culture, medical messaging, and new medications like GLP-1s impact our clients’ relationships with food and their bodies. We explore how therapists can be more aware of their own biases, what role we play in supporting clients when doctors give confusing or harmful advice, and why intuitive eating may be a critical path forward for many clients.

Transcript

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(Show notes provided in collaboration with Otter.ai and ChatGPT.)

About Our Guest: Robyn L. Goldberg, RDN, CEDS-C

Robyn began her career at Cedars-Sinai Medical Center in Los Angeles as the in-patient dietitian in the Department of Cardiology. Over the last twenty-eight years she has developed her own private practice in Los Angeles, CA.

She is a contributing author and is a nationally and internationally known registered dietitian nutritionist. She has been quoted in The New York Times, The Huffington Post, and Vogue.

She has been on national television as the eating disorder expert on The Insider. Robyn is the author of the book The Eating Disorder Trap: A Guide for Clinicians and Loved Ones, Co-author of the online course Your Recovery Resource and the host of The Eating Disorder Trap Podcast.

 

In this podcast episode: Navigating Food, Medical Advice, and Intuitive Eating

We invited Robyn back on the podcast because so many therapists are encountering clients who are confused, fearful, or distressed by medical recommendations around food, body size, and new medications. With the explosion of diet culture messaging and the popularity of GLP-1 medications, therapists need tools to better understand how to support clients in sorting through mixed messages and reclaiming a healthier relationship with food and their bodies.

Key Takeaways for Therapists Supporting Clients with Food and Body Image Challenges

“I have found with so many providers I work with, even those that claim to be body image healers, eating disorder specialists that they use problematic language…Language, verbal, non verbal, looks and insinuations can be just as harmful as the words we say. And I would say for anyone who’s listening really to evaluate your own biases and beliefs regarding all bodies, because you can’t look at a person and determine if they have an eating disorder, or disordered eating. You know, it affects all shapes, sizes, genders, and you can be anywhere, and someone could be struggling.” – Robyn L. Goldberg, RDN, CEDS-C

• Therapists must examine their own biases and beliefs about food and body size to avoid unintentionally harming clients.
• Many physicians have very little training in dietetics—sometimes less than 30 minutes—and may provide inadequate or harmful food advice.

“Your doctors are not registered dietitian nutritionists. They are not trained in this. They are lucky if they obtain 30 minutes of training in dietetics…They are trained in medicine, and to be able to say, if you you really want to get to the root in how to manage whatever’s going on, it would be in your best interest to consult with an RDN.” – Robyn L. Goldberg, RDN, CEDS-C

• Clients can advocate for themselves in medical settings, including refusing to be weighed or requesting numberless scales.
• GLP-1 medications may reduce appetite, but can also contribute to malnutrition, fatigue, muscle loss, bone density issues, and digestive problems.
• Intuitive eating is the gold standard approach in dietetics and can help clients rebuild trust with their bodies, even when navigating confusing medical advice.
• Therapists can play a role in normalizing food as pleasure, rest, and self-care, while also knowing when to refer to nutrition specialists.

“Anything worth having takes work. The easy way is not always the safe way, is not always the right way.” – Robyn L. Goldberg, RDN, CEDS-C

Resources on Food, Body Image, and Intuitive Eating

• Robyn’s website: https://askaboutfood.com/
  
• Instagram: @robyngoldbergrdn
  
• Book: The Eating Disorder Trap
  
• Podcast: The Eating Disorder Trap
  
• Free course for caregivers: Your Recovery Resource

Relevant Episodes of MTSG Podcast

• Navigating the Food and Eating Minefield, An interview with Robyn Goldberg, RDN, CEDRD
  
• How Therapists Promote Diet Culture: An interview with Rachel Coleman
  
• Health At Every Size, An interview Laura Westmoreland, LMFT

Meet the Hosts: Curt Widhalm & Katie Vernoy

Curt Widhalm, LMFT

Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com

Katie Vernoy, LMFT

Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com

A Quick Note:

Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.

Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

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Modern Therapist’s Survival Guide Creative Credits:

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Music by Crystal Grooms Mangano https://groomsymusic.com/

 

Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):

Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements).

… 0:00
(Opening Advertisement)

Announcer 0:00
You’re listening to the Modern Therapist’s Survival Guide, where therapists live, breathe and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm and Katie Vernoy.

Curt Widhalm 0:12
Welcome back, modern therapists. This is the Modern Therapist’s Survival Guide. I’m Curt Widhalm with Katie Vernoy, and this is the podcast for therapists about the things therapists about the things that go on in our practices, the things that go on with our clients, how we can serve our clients better. And Katie and I admit from time to time that we invite guests onto the podcast, that sometimes it’s just disguised as a consultation, as far as things that are showing up with our clients, and we invite friends on to help make some of these questions a little bit more public, if it helps everybody else, too. It also helps when we have our friends on the podcast, and one of our friends who supported us very, very early on talked about navigating food as therapists, Robyn Goldberg, registered dietitian. It’s an episode that I still reference with a lot of clients, with just some of the vast, wonderful knowledge that she brings on everything. So thank you so much for coming back and helping us to continue on the conversation about food and how it’s showing up with clients, and I’m just excited to hear you talk again. So thank you so much for joining us.

Robyn Goldberg 1:21
Thank you for welcoming me back, Curt.

Katie Vernoy 1:24
Yeah, this is definitely one of those not so secret consultations, because I’ve been having a lot of this come up with my clients. So I’m really excited to talk with you about this, Robyn. But before we jump in, I want to ask you the question that we ask all our guests, which is, who are you and what are you putting out into the world?

Robyn Goldberg 1:43
I am a nutrition therapist. I help people repair their relationships with food and body and help them to be the experts of their body, as opposed to being told what they quote, unquote, should or should not be eating. The food and diet culture world is a very complex one, and seems to become more and more confusing as time goes on, that I have people that don’t have any problematic relationship with food and second guess all the choices they make based on what they hear, what they read, what their providers share with them. So I always think to myself, I am so grateful that I am in this profession, because I would probably be confused, too.

Katie Vernoy 2:39
I think it’s so hard not to be confused right now. It’s, there’s so many things coming out. There’s all the different diets that I mean, I guess that’s the tale as old as time. But then there’s also the new GLPs. Like, I’m really excited to jump into this conversation.

Robyn Goldberg 2:52
Yes, me too.

Curt Widhalm 2:54
I have heard from a lot of people who, on our end of things as therapists talk about working with eating disorders with a very specialized kind of training, and I fully believe that the education that we get early on in our careers is really, really inadequate for a lot of the complexities that come up. We asked you this question seven years ago about what therapists seem to get wrong about working with food. I’m going to ask you an updated version of this question. Is, what should therapists be aware of today that is coming out as far as food stuff that you think that they have no idea or no awareness about, just kind of the way that our culture, our society continues to evolve.

Robyn Goldberg 3:41
I don’t remember how I answered it then, but what stands out to me now would be their own biases towards bodies and the beliefs they have with how they practice their own food beliefs and what they disclose and say to clients. I have found with so many providers I work with, even those that claim to be body image healers, eating disorder specialists that they use problematic language. They are not up to speed, and I will say it’s a constant learning curve for me, and I’ve been in this field for over 28 years; that language, verbal, non verbal, looks and insinuations can be just as harmful as the words we say. And I would say for anyone who’s listening really to evaluate your own biases and beliefs regarding all bodies, because you can’t look at a person and determine if they have an eating disorder, or disordered eating. You know, it affects all shapes, sizes, genders, and you can be anywhere, and someone could be struggling.

Katie Vernoy 5:16
I think for me, when I think about the biases that I can have at times, it comes from talking with folks like you, registered dietitians, eating disorder specialists, and really going into All Foods Fit, Health at Every Size, those types of things, as well as my own medical conditions and my interactions with the medical system. And I’m finding that I’m having really a hard time sorting through: is this my stuff and I’m unfairly judging doctors, or is this actually a problem? And this is why I wanted to invite you, is because I feel like I’m hearing clients being prescribed very restrictive diets. They’re being told just to lose weight without guidance. They’re, they’re interacting with the medical system in a way that seems to be causing so much angst and fear of food and fear of messing up and all of those things. And I’m trying to sort through that. And I’m, I’m not sure where the the line is, and so I’m, I’m hoping that we can maybe start there, and we’re going to probably hit a lot of different topics, but sorting through, how do I help my clients who have all different medical conditions, all different body sizes, to find their path to health and hopefully a healthy relationship with their body and with food?

Robyn Goldberg 6:38
I just want to respond to what you stated earlier, Katie, so it’s changed a lot. Not all foods fit, and what works for one person may not work for another person, and a lot of that is through curiosity and experimenting and trial and error. So yes, I can say I come from a quote, unquote, All Foods Fit model, but not all foods fit for each person. Maybe they have an intolerance, they have a sensitivity. It can cause a flare up. They’re having gastrointestinal distress. There’s a multitude of issues. So that has changed.

Katie Vernoy 7:22
Thank you. That helps a lot. Sorry, continue, continue.

Robyn Goldberg 7:26
Yes. So I just wanted to Yes, respond and say that.

Katie Vernoy 7:30
So when, when clients come to us and they have a lot of either guidance, or, frankly, a lack of guidance from their doctors, that seem to be causing, in my mind, a really challenging relationship with food and with their body. What are the types of things that we can look at? How can we sort through this without, at least for me, without my bias coming in and potentially, I don’t want to harm their medical process. I don’t want to, I don’t want to harm their relationships with their doctors either.

Robyn Goldberg 8:03
Yeah, I can say, you know, in the physician oath, there’s, and I’m misquoting it, but the general idea is, like to do no harm.

Katie Vernoy 8:13
Sure.

Robyn Goldberg 8:14
And oftentimes they are doing harm, not intentionally. And I think a helpful reminder that you and Curt could actually say to your clients is that your doctors are not registered dietitian nutritionist. They are not trained in this. They are lucky if they obtain 30 minutes of training in dietetics. I’m actually in the process of doing an Instagram real on this.

Katie Vernoy 8:41
Okay.

Robyn Goldberg 8:42
So, I think to be able to say, like, our doctors are not perfect, they’re not God, like they are trained in medicine, and to be able to say, if you you really want to get to the root in how to manage whatever’s going on, it would be in your best interest to consult with an RDN. We are now called RDNs: registered dietitian nutritionists. We are the only profession in the world that is credentialed under the commission of dietetic registration requires a bachelor’s or master’s in dietetics, and then we apply for a dietetic internship, which is like a residency program that’s computer match, and then complete that, which can be anywhere from a year to a year and a half, and then we’re eligible to take our nationwide examination. So a weekend course, a webinar, one chapter you read is insufficient to call you an expert of nutrition, an influencer, none of this is adequate to put that you know out there.

Curt Widhalm 9:53
Some of the stuff that we’re dancing around is just some of the influence that medical insurance companies have on this whole process. Psychiatrists that I was listening to a presentation recently, Dr. Shelly Bar, who’s a fantastic eating disorder specialist, Robyn and I have both worked with her, was talking about how insurance companies, for some doctors, won’t reimburse general outpatient visits, unless obesity is brought up for clients that are deemed overweight by some comprehensive actuarial table, that some bean pushers end up pushing somewhere in the background. That some of these influences are systemically built in, is how I’m understanding this, am I correct?

Robyn Goldberg 10:41
Correct. And when a patient goes to their provider’s office, and like the standard protocol is to go on the scale, like taking your blood pressure and your you know temperature, you can refuse. It’s your right as a patient to refuse. The only reason that offices are doing this is when they’re audited by joint commission insurance companies. So you can tell them to make it up, write down what’s been there in the past. I mean, when I see my physician, when I walk in, the joke with my doctor and his medical assistant. Now they don’t even say, like, do you still not want us to weigh you? We again, when they refer patients to me, they know, like, okay, yes, we’re not gonna weigh you. You’re with Robyn. But I will say, like, you really don’t have to. Like, this is very stigmatizing. It creates a lot of anxiety for patients, like if they feel so compelled to do it. I’m going to give a shout out to clear step the first HIPAA compliant, numberless scale, which came out like during covid, a little before. It’s fantastic, because they have a blood pressure cuff and they have a scale, and it has nothing on it, like a client said to me yesterday, just oh, it’s esthetically pleasing. It’s not giving me anxiety because the number goes in my phone or my computer. There’s nothing that the individual sees. So if an office feels very attached to weighing their patient, that is what I would suggest, but it’s an unnecessary anthropometric measurement to be able to do this when taking vitals.

Curt Widhalm 12:32
And I have tried to work with clients, and this is something to really, really encourage and even practice with your clients who may be facing weight issues, who might be advocating for themselves, about, hey, I don’t want to know the number if you are insisting on weighing me and having doctors or nurses still tell them what their weight is. And I really like what you’re saying, as far as: make it up, put something down, and really helping your clients be able to learn how to advocate for themselves, because just kind of giving the first pass, like I don’t want to know what my weight is, isn’t always successful, either, for those who are vulnerable to that.

Robyn Goldberg 13:15
And when they agree, I think the part that’s very frustrating is, if they have that, they’re not digital, if they have a chart, it’s right there on the chart. So then the patient sees it after they’ve acknowledged, like, Okay, I won’t tell you it.

… 13:31
(Advertisement Break)

Katie Vernoy 13:33
It seems like there’s so many different ways that whether it’s the insurance or medical providers that are kind of sticking to systems that seem to be either antiquated or just plain don’t work. It’s so hard for our clients to navigate these systems and to really understand how to take care of themselves. And so what are beyond: Don’t, don’t get weighed, or don’t see the weight like, what are some other things that therapists can do to support our clients who are struggling with whether it’s eating disorders, disordered eating or medical conditions where food seems to be involved in either treatment or diagnosis?

Robyn Goldberg 14:15
Well, when you’re asking Katie, how can therapists help? I mean, I think if it’s not their area of specialization, I think, to be able to refer out, because I can tell you or anyone, a bunch of screening questions to incorporate, but then you’re going down a rabbit hole, the you know one might not have the skills to know how to respond. Being able to know what to do with that information, and sometimes a client will say to me, like, Oh, my therapist asked about such and such, and I know this isn’t their area, and I could see they were uncomfortable. So I’ll hear a client say like, so I played them. I said what they wanted to say. So I think it’s really. Looking at like, Look, if a person’s not going to really immerse themselves in that world, it’s like what there’s enough clients for all of us. Lke to even to say, okay, I can be your primary therapist who you know, I’ve worked with you for 10 years, but let’s bring a specialist in to help through these areas. Like I’m a part of several teams that they have, the general therapists, there’s eating disorder therapists, there’s me for the eating disorder. I mean, there’s, like, the whole team, but I realize that’s not an option for everyone, or to be able to say, like, you know, what about working with someone that specializes in eating disorders for some time? And you can always come back to me after you get through, you know, that rough patch.

Katie Vernoy 15:45
Yeah, I guess I’m thinking more instead of not, maybe not eating disorders and disorders dating, I’m just thinking about all the folks who are: they’ve medical conditions, they’re starting to have a weird relationship with food, or they’re getting onto the new GLP-1s, or there’s something I don’t think we can refer all those clients out. We’re, as a society, pretty sick, and there’s a lot of folks getting on these GLPs. And so it’s trying to sort through, what are the what are the basics that a straight ahead clinician can do to support clients who are walking down this road and are having a hard time because of all of the conflicting information, and medical doctors who, as you mentioned, don’t have that background in dietetics.

Robyn Goldberg 16:32
Yeah, like from the GLP standpoint, you can say to them, is this something you’ve been thinking about? Did this recommendation come from your provider? Have you, you know, gone through, you know, pros and cons about it? Have you researched it much for yourself? Because every medication has side effects, some may or may not affect you, but I do think it’s it can serve a purpose. Initially, you know, was developed for those with type two diabetes, and now people are taking them, like to fit, you know, in their jeans, or to go on a cruise. It’s sort of like not realizing long term complications like you were speaking about before. I mean, the the number one issue that I see time and time again is malnutrition. Malnutrition not taking in enough calories. Yes, there can be a deficit of carbohydrates. There can be unfortunately, a lot of these providers were like, just make sure you’re eating enough protein. Well, protein doesn’t give you energy. Protein is not helping your hair from not falling out, and if you’re not taking in enough food, you’re going to struggle with constipation. You’re going to struggle with satiety, even though these medications are like diminishing what a person would naturally feel. The problem is it slows down digestion and and, yes, it does reduce hunger, but it increases an insulin response after eating, so they are, in theory, slowing their metabolism down, and you can’t be on these medications long term. I mean, I know many people that are. And now they’re finding and it’s true, like, especially if you’re 40 years of age and up, it will decrease muscle loss, like we want to have more muscle, because the more muscle we have, the faster our metabolism is, the bone loss. Like I know people, and I’m thinking of people that are very established, that are providers that are on these medications and will tell me, You know what, I’ve osteopenia, or I’ve osteoporosis. And also, like, so do you think you’re gonna get off of it? It’s like, I’m never gonna get off of it. I’ll deal with having osteoporosis or, you know, brittle bones, like, to me, that’s not good, and the low energy and fatigue lingers. It has nothing to do with your age. Like I have someone I’m seeing in their 80s who can barely, like, walk from the front door to another part of their house and it’s like, Well, it’s because of my sleep. It’s like you’re malnourished. You know, they see a trainer, they cancel a trainer half the time they’re not taking in much. And we talk about how a growing baby consumes more nourishment than this adult, and the digestive issues. Between the constipation, the bloating, I mean, feeling uncomfortable all the time. This is a problem, and there’s so many other parts that are not even spoken about. I see you know, people that are not old, that have had reoccurring kidney stones, they just have had to take time off from work go on disability, because they just are, like, flat lined. They have nothing to give. And they’re like, doesn’t everyone my age feel this way? I’m like, No, you’re malnourished. If you don’t give your campfire another log. Like, what happens? Like, Oh, the campfire will burn out. Like, that’s what happened, what’s happening with your body. Everything is slowly shutting down, and it’s getting slower and slower. It’s very problematic, and it’s way more beyond weight loss, it’s what’s happening to just the body system.

Curt Widhalm 20:59
How do you respond to clients when you say everything that you just said, and they say, But Robin, it’s easier.

Robyn Goldberg 21:09
You know, I like to respond “Anything worth having takes work. The easy way is not always the safe way, is not always the right way.” And to to look at like there’s people I see that have been on these, you know, injectables, for quite some time, and then we’ll ask their doctor, and by the way, they maybe didn’t get these medications from their doctor. You can get them anywhere underground. There’s the black market. It’s like…

Katie Vernoy 21:44
And like, health clinics and stuff too. Are like, their own thing too.

Robyn Goldberg 21:48
Yeah, exactly. So they’ll say their doctor like, then their doctor doesn’t know they struggle with binge eating disorder or what their challenge is. And it’s like, well, it’s not working for me anymore. I’m not losing weight. It’s like, okay. Then they’ll come to me and they’ll say, Well, you know, what do you think? Do you think I should stay on it? And I’ll say, I’m not here to tell you if you should or should not be on it, but I always have them make a pro/con list, and we talk about, like, what’s working for them, what’s not working, and also long term, as I as I do say, part of having a body is having cravings. Part of having a body is sometimes we have a bigger hunger level. Other times we’re less hungry, but we trust our body will make up the difference for it. People that go on these medications, like our whole society wants a quick fix, no one wants to do the work. So I think of like throughout my life, whether it’s in academics or athletics, anything I’ve done I’ve had to work hard for. Nothing’s been handed to me on a platter. And I think, yes, things take longer. It’s hard, it’s hard to change your thought process. That’s the hardest part of all of this. A person can over consume any food or food group. And so that’s the other thing. Like, I’ll see people that are like, I don’t understand why things aren’t changing. I have my sweet green salad every day, and you know they’re talking about their salads and their roasted vegetables. But when you’re not learning how to listen to your body and you’re trying to like, trick your body and betray it, it’s more problematic. It doesn’t matter that you’re not eating cookies. You know, kale salad and cookies. It’s like learning how to listen to what your body’s telling you. Like there are indicators, there are signs. And it doesn’t have to be in your belly. It could be you’re tired, you can’t concentrate. Like that is a sign of hunger.

Katie Vernoy 24:00
I think that we’ve, as a society, lost trust in our bodies, and I think it is hard to get back to it. I’m kind of reflecting on what you’ve been saying. And there’s this element to what these GLPs and some of these other kind of medical recommendations have were initially for, potentially. You know, severe obesity can be one of them, but also it sounds like type two diabetes, or some of these other conditions where being able to address not just weight, but also some of these other pieces, at least ostensibly, feel like that might be a reason a client might decide to go on these medications. You talk through these things, you the client comes back and says, I don’t really want to be on these, but this is my doctor, and I have talked through all of the different things we’ve done to try to help improve my condition. This is where I’m headed. This is what I have to do. And they use them, right? They they, they take these medications as prescribed. Maybe there’s a path to get off of them. It’s a short term use, whatever it is, right? So there’s, there’s some potentially responsible use of these medications versus I just, you know, I’m micro dosing to fit in, to go on a cruise and fit into my clothes. How do you, how do you, as a registered dietitian support clients who are going through, whether it’s GLPs or other medical treatment, where they’re really engaging with food in a very different way. How do you support them to try to get to get them to a healthier place?

Robyn Goldberg 25:35
I always say to them, you know, I’m happy to support you in whatever way feels comfortable. I’m not here to judge you. But I think it’s important for you to learn how to eat, to support blood sugar stabilization, to prevent another artery from being blocked, to have another Crohn’s attack, whatever it is. So, I teach them all how to be intuitive eaters, and whether they’re on these medications or not, it does make it more challenging, because all you’re like, I’m never hungry, Robyn, I don’t have a craving, like I’m doing what you’re asking because I know it’s important to put something in my body, but it’s more very robotic and mechanical, versus coming from a genuine place of feeling that my body’s needing it. And the hope is, over time, that they can fly without having these broken wings, to be able to say, like, Oh, this is what I’m doing, without questioning and believing what they’re doing. Like, I was just looking this morning at a client of mine that uses one of the eating disorder apps I use, and and so I had, you know, said to him several weeks ago, like, one piece of chicken is not a meal, like, could we add some rice to it? Could we add green beans? And I was looking for I was like, Oh, this is cool. He’s like, starting to add things. And you know, when I see him sick, I’m gonna ask him, like, how’s it been feeling? Because sometimes someone will say, like, feels the same, especially when it feels the same when you’re on these medications, because you lose any kind of insight to know how you’re feeling, I find it’s harder for people to express how they are truly feeling versus if they were not on a GLP medication. They can be more definitive too.

… 27:38
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Katie Vernoy 27:40
I’ve had somebody tell me that they didn’t enjoy eating, even like it was nothing really was pleasurable, which makes me very sad.

Robyn Goldberg 27:50
Yeah, all the time. They’re like, I wish I could take a pill like the Jetsons. Eating is stressful. It gets in my day. It’s not productive. We talk about like eating is productive, rest is productive. Taking time for you is productive. Many people find it being a hassle, an inconvenience, versus food provides pleasure. It’s fun, it’s social, not to mention it can make us sleep better. It can help us focus better. It can help us poop better. And there’s like so many interesting foods to be curious and explore around. It doesn’t have to be, you know, something awful that we dread, but sometimes too It could come from our upbringing, our family of origin, the messages that we’ve picked up throughout our life, that it’s like I was listening to someone yesterday, and she said, Oh, my mother always said, you have to earn your food. Like the mother was visiting my client, and the mother said, Let’s go for a walk so we can earn our dinner. And my client is like, working through, you know, her journey with food. And so when you have a family member that hasn’t resolved their own issue, she’s like, that always sounded so weird to me. I have to earn my my food.

Curt Widhalm 29:21
There’s a lifetime of messages like this, and Katie’s talking about clients that are not enjoying food. Some of the clients that I hear are also very much in the food is a triggering, fearful response, because messages like this are even more pronounced that parents withholding food as children as punishment. Do clients ever get to the point where they are really actually naturally enjoying it, or is this always kind of a lifelong process that is having to talk themselves into, okay, I can actually enjoy this. I can put aside all of these lifelong, very harmful messages, and get to a place where that intuitive eating stops being work.

Robyn Goldberg 30:10
I would love to say Curt that everyone can be an intuitive eater. Some people are not able to, they’re not capable of. But it’s years and years of practice, especially looking at how long one has heard these messages, how long they’ve been embedded in their hard drive. You know, there’s some people that are like, I eat because I have to. They’re not foodies. They never have been, they won’t be. They’re, like, not scared to, you know, meet people, or if they’re invited somewhere, they’re able to go in those situations. But there’s, I would say, like, different levels of where a person can and will be. But it takes years and years of work and repetition and working with a team that helps them with this. It’s not like, oh, in four weeks [unintelligable].

Curt Widhalm 31:12
You’re really gonna love eating this in four weeks. It’s almost similar to kind of, I’ve heard some of the shift away from body positivity, and for some clients, that the maximum that they might ever get to is body neutrality. That it doesn’t mean I have to love everything. It might mean I don’t have to hate everything. That’s kind of what I’m hearing you say here.

Robyn Goldberg 31:35
Yes, like I can tolerate or I can appreciate. Wow, my body works for me 24/7, it’s there for me unconditionally. How can I be there for my body? I don’t have to feel like, Oh, my body is amazing and awesome. I love it. It’s like, yeah, thank you for allowing me to be an able bodied person and to be able to function, especially when you have an injury and you are disabled, develop so much gratitude and appreciation for just a body working. Like it’s it’s a year and a half almost that I have stopped playing tennis after 35 years torn elbow, and I was at a point I could not even floss my teeth or pull up my pants, and like I was saying to my husband, like, wow, I need you to put my socks on. Like, when you’re not able to exist doing activities of daily living, it reminds you how blessed and grateful you are.

Katie Vernoy 32:41
I think it does if you have a good, positive attitude about it. I think it can also be pretty frustrating.

Robyn Goldberg 32:47
Yeah, for sure.

Katie Vernoy 32:49
I’m thinking about the question around intuitive eating, and if you know you can’t get there necessarily, or you can’t get there quickly, when someone’s working on this and they’re wanting to enjoy food, they’re wanting to have a healthier relationship with food, regardless of kind of what’s going on outside, you know, whether it’s messages from doctors or messages from society, what is the advice that you give on how to I don’t know if this is the right phrase, but fake it until you make it? Like how do you get people on their way when they may not meet, they not may not make it. You know, you’ve got your 80 year old clients, a 65 year old clients that you know, the people who are potentially not in the place to do years of work, or it’s so entrenched, what’s the what’s the hack if you can’t get too intuitive eating person?

Robyn Goldberg 33:41
Well, I want to respond to what you said before, Katie, and anything fast is not sustainable long term.

Katie Vernoy 33:48
Sure. Of course.

Robyn Goldberg 33:49
I would never want someone to try to do intuitive eating fast. Like I’ll see someone, and I’ll suggest the book as we’re talking about it, and then they come back a week later, like I read the book. Well, reading it and being able to absorb it and apply it and live it are different. Like to be on one principle for six months. So I just wanted to say that. I really believe in the statement of fake it till you make it. It’s really learning how to say, like, there’s a sheet I use the clients called a rethinking sheet. So basically, there’s like the feeling that comes up, there’s the automatic thought, which essentially is like the inner voice, and then there’s what’s, what’s called, like the soul self, like the that’s Carolyn Costin’s term, the healthy self, like the voice we were born with. So most people are automatically saying the negative statement and to reverse it and say something positive is a struggle for most people. And we’ll talk about like, I can help you come up with something to, you know, counteract what what was just written here, but it’s important that you’re saying it over, and it’s like exercising a muscle so you have that muscle memory too. So you know, if you’ve been doing something for 50 or 60 years, it’s going to be a long haul to develop that callus where you’re like, Okay, I’m saying it over and over. I just, I just remember when I used to see my dear friend Mari Windsor of Windsor Pilates, who passed away from ALS, and I would go to Pilates with her, and she would always say to me, I don’t, I don’t know if I can say this on the podcast, but I, but I will, and if you need to edit it, great. When I would walk over to this machine, she would say, like, tits up, girl. And anytime I’m Pilates now I literally, I feel like the machine’s talking to me and saying this to me. Because it was years she would say this to me every time I would do these different exercises. And I was like, Yes, I don’t want to have a round, you know, spine and this and that. So literally, I feel like, oh, the Cadillac is saying to me, tits up, girls, so yeah. But yes, I think it’s like the repetition over and over to say things, eventually it starts to change the you know, development and thoughts in the brain, your amygdala comes back to life.

Katie Vernoy 36:45
I really love that, Robyn. I love this idea of of using whether it’s the book or other things, and we’ll link to the book, and the show notes are at mtsgpodcast.com, but it sounds like Intuitive Eating is really a very important step for folks who are struggling, whether it’s eating disorder, disordered eating, or even what I started with at the beginning, these clients who are getting really interesting messages from their doctors that seem incomplete. I know for myself, I refer to you, I refer to dietitians in my neighborhood, and try to get my medical, I guess, medically involved clients into that so that they can get some really good advice on what to eat. But I’m also hearing, and maybe you can speak into this little bit more, that a pathway back for clients who are just getting a weird relationship with food. They’ve not had an eating disorder. They’ve not really had disordered eating in the past, but their doctors are giving them these messages that maybe a pathway back might be intuitive eating? Can you talk a little bit more about that?

Robyn Goldberg 37:45
Yeah, so intuitive eating is the gold standard in the field of dietetics. So, when I’m seeing someone that’s trying to avoid dialysis, you cannot feel your kidney function declining. It’s not like you feel your blood sugar dropping or having a high glucose reading. So as I speak to clients that many times will start out saying, Oh, Dr. so and so said, avoid this and eat this. Talk about like, I want to clarify misconceptions regarding these various foods and food groups, but also teach you what it feels like to listen to your body, and if you were to eat more of the such and such, sure your b01 and creatinine. These are just, you know, kidney values over time could increase, but I really like to explain to them, like, Okay, if they’re eating such and such and it’s not like supportive to maintaining their kidney function being stressed is oftentimes worse than having it occasionally. So, I really like to reframe it as speaking to trusted, educated, trained providers as your physician is not in this.

Katie Vernoy 39:07
That makes a lot of sense. I think there’s so much more to talk about here, but I think we’re way long on time, so I think we’re going to have to invite you back for another conversation that I’ve been thinking about. So we’ll do that.

Curt Widhalm 39:17
And people should listen to Robin’s podcast, where can people hear you talk more and also find about your practice.

Robyn Goldberg 39:25
Thank you very much. So my podcast is the Eating Disorder Trap podcast. It’s on iTunes, Spotify, wherever podcasts are. It drops every other Monday. My website is ask aboutfood.com and my Instagram is @ Robyn R O, B,Y, N, Goldberg, r, d n, and on my website, I actually have a free course for parents, partners and caregivers that have a loved one struggling, called Recovery Resource. And, yeah, I have my monthly newsletter. I talk about something medical, something body image, something eating disorder, a variety of things. There’s, there’s a lot of info there, so hopefully you’ll find it helpful.

Katie Vernoy 40:14
And you’ve also got your book, The Eating Disorder Trap.

Robyn Goldberg 40:16
Yes. Sorry, yes, yes. My book, The Eating Disorder Trap. And I have the book website theeatingdisordertrap.com, but the book is on the website, askaboutfood.com and it’s on Amazon, Barnes and Noble, everywhere. And it’s written in a very basic, gentle way for family, friends, clients, clinicians, and really helps to get you thinking about other questions that can be incorporated when you’re speaking with someone that might be having a tough time.

Curt Widhalm 40:50
And we will include the links to all of Robyn’s things in our show notes over at mtsgpodcast.com. That way you can find them more easily and go and continue to just absorb all of Robyn’s wonderful information. Follow us on our social media, join our Facebook group, the Modern Therapist Group, to continue on with this and other conversations, and until next time, I’m Curt Widhalm with Katie Vernoy and Robyn Goldberg.

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