01 Harriet White
CNN  — 

The word “fat” has haunted Harriet White her entire life.

“When I was little, probably seven or eight, the doctor told my mom, ‘She’s fat, take her to Weight Watchers.’ I ate Melba toast and cottage cheese,” said Harriet, now age 50.

School lunches, she remembers, turned her into an object of ridicule among her elementary classmates.

“Kids would laugh at me because I would have this nasty brown bread with unsweetened peanut butter, carrot sticks, celery sticks and black olives, while everyone else got baloney on Wonder Bread and potato chips,” Harriet said.

“Then when I visited my grandmother I’d gorge on chips and candy,” she added. “So I grew up with a very unhealthy relationship to food.”

And all the makings of a childhood eating disorder that would follow her for life.

“No one wakes up one day and says, ‘Hey, I’m going to have an eating disorder.’ It’s a slow descent into hell,” says registered dietitian Evelyn Tribole, the co-author of “Intuitive Eating,” an anti-diet plan that stresses re-learning the body’s cues for healthy eating.

It would take Harriet years to shed her childhood trauma and turn to intuitive eating to heal her broken relationship with food. It’s a struggle shared by hundreds of millions of adults around the world who also suffer from an eating disorder.

A global problem

In the United States, at least 30 million people suffer from disordered eating, according to the National Association of Anorexia Nervosa and Associated Disorders (ANAD).

It’s not just obsessive Americans or members of other Western societies who suffer. A 2019 study found eating disorders doubled globally between 2000 and 2018, rising from 3.5% for the 2000 to 2006 period to 7.8% for the 2013 to 2018 period.

Considering the planet holds approximately 8 billion people, that would be about 624 million of us with unhealthy relationships with food, a growing number of those in Asia and Middle Eastern countries.

You don’t have to starve yourself into anorexia or binge and purge to have an eating disorder. Anyone who spends a good deal of their day “thinking about food, weight and body image” could be on the eating disorders spectrum, ANAD says.

Shame of being different

Born into a Southern family with a Greek mother that mixed “good Southern food with good Greek Mediterranean food,” family dinners at Harriet’s home always included salad, broccoli or Brussels sprouts, healthy greens like turnip greens, chard, kale or spinach, brown rice and chicken or fish.

Despite both healthy choices and dietary restrictions, Harriet’s body continued to defy society’s standards.

In high school Harriet was diagnosed with polycystic ovary syndrome, or PCOS, a hormonal disorder that triggers the female body to produce too many male androgens.

Women with PCOS gain weight like a man, centered around the abdomen. Losing weight with the condition is extremely challenging; today, doctors often turn to various medications to block the excess hormones.

It should have been a turning point in understanding her body. But doctors knew little about PCOS back then, Harriet says, and they were extremely unsympathetic to her weight loss struggles.

Her self-esteem continued to plummet.

“I was trying to hide myself in PE [physical education class] because I was fat and I was dumpy,” she said. “I grew up with self-loathing, you know, and all the stuff that comes along with that baggage that you carry when you don’t look like what society thinks you should look like.”

Shame is a painful reality for many people who are born into a body that isn’t meant to be thin, says registered dietitian Elyse Resch, who co-authored “Intuitive Eating” with Tribole.

“So many people with a higher weight are embarrassed to go out on the street and walk because stigma is really more toxic than the weight on them,” said Resch, a nutritional therapist who specializes in eating disorders.

“Many of my clients haven’t gone to a doctor in a really long time because they’re humiliated when the medical profession gets them on the scale and tells them to lose weight – as if they haven’t already tried.”

In adulthood Harriet became even more obsessed with her size. She began to jump from diet to diet while frantically exercising. At one point she went from a size 24 to a size 16, but her hair fell out in tufts and the weight always came back.

The tipping point came when Harriet visited a doctor for a routine work physical last year.

“She was this beautiful, very thin woman,” Harriet recalled. “And she starts yelling at me, literally screaming at me, ‘Don’t you care about yourself? You’re going to die you’re so fat.’

“And I remember calling my husband and bursting into tears and just feeling like the biggest piece of crap.”

A change in thinking

“Harriet came to me with a totally negative relationship with food,” said Atlanta registered dietitian Rahaf Al Bochi. “If she would eat something she would automatically feel very guilty about it. Food was a complete stressor in her life.”

Al Bochi is one of a growing number of nutritionists who promote the “no-diet” intuitive eating concept, which stresses a positive relationship with food.

“People feel like they have no idea what to eat anymore,” Al Bochi said. “They’ve been listening to all these different food rules – don’t eat carbs, don’t eat after seven, eat this to increase your metabolism – and intuitive eating helps you unlearn that unhealthy relationship with food and bring enjoyment back to the act of eating.”

The concept and “Intuitive Eating” book, developed by Tribole and Resch in 1995 and now in its fourth printing, is composed of ten principles that emphasize rejecting a diet mentality

“Intuitive eating is not a diet or food plan. Period,” Tribole stressed, adding that the plan is backed by over 120 studies that show success with overcoming disordered eating.

“If there’s a focus on weight loss, it sabotages the intuitive eating process,” Resch explained. “If they’re constantly thinking, ‘I need to lose weight. I shouldn’t eat this piece of pizza,’ then they’re gonna get into that same cycle of feeling bad if they do eat it: ‘I’m broken so I’ll just keep eating it.’ “

Instead, the ten prinicples focus on self-care: teaching how to learn the cues of hunger, satisfaction and fullness; respecting the body and emotions; adding movement; and making peace with food.

“Fight diet culture. Let go of this culturally thin ideal, this belief that you are only your body and you’re being judged,” Resch said. “We’re far more than our bodies. Let it all go and just tune into yourself. Enjoy food.”

Giving the body permission

In intuitive eating, no food is off limits. You can eat brownies or french fries or have a soda. In fact, you may be encouraged to consume as much as you want of that guilty pleasure until you no longer crave it. The idea is to “make peace with forbidden treats” by eating so much it becomes just another food.

“When your body feels it has full permission to eat it whenever it wants, you’ll start to crave other types of foods, including more healthy foods. For many people this is like a light bulb moment,” Al Bochi said.

For Harriet, the approach has been life-changing.

“I don’t feel like I’m tied to food with a ball and chain anymore,” she said. “Because I wasn’t listening to when I was hungry, I was overeating because I couldn’t tell when I was full.”

Working with a trained dietitian helped Harriet relearn her body’s cues, like not waiting too long to eat and then being ravenous.

“One of the things that I teach my clients is to view hunger and fullness on a scale of one to ten,” Al Bochi said. “Ideally you want to be eating when you’re at a four to a six, that’s when you’re hungry.”

Now, Harriet says, she carries snacks to eat when hunger strikes. That way, when she goes to lunch, “I can eat a normal lunch because I’m not stupidly hungry.”

“If I want a piece of cake, I have a piece of cake,” she says. “I don’t have a big piece. I have a small slice. Most of the time I only need half of it because I know I can have it.”

Harriet also learned to listen to feelings of fullness, something she had never been able to do.

“I don’t feel a compulsion to clean my plate any longer but I also set myself up for success,” Harriet said. “I don’t fill my plate. I put a little bit, I eat it, I wait a little bit and if I’m happy and satisfied, I leave. If I’m not, I have a little bit more.”

It’s been over a year and Harriet has yet to get on a scale. Her clothes are fitting a bit looser now, she notices, but that’s no longer the point. Instead, she is pleased with the variety of foods her body craves, and feels satisfied – both physically and emotionally.

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“I know I’m heavy. I’m never going to look like Chrissy Teigen. I’m never gonna look like Nicole Kidman. I’m never going to be that thin woman, but it’s okay because I’m going to be healthy,” she said.

But Harriet is incensed about a culture that can make a child hate herself.

“I think about all the time I’ve wasted worrying about how I look because of my weight when I should’ve been worrying about other things that were more important,” Harriet said. “And I’m angry. I’m angry that our society promotes this unrealistic ideal.

“I know now that food is not my enemy. Food is a tool. Dieting is not helpful. You have to embrace who you are and understand your body is your body, and there’s never going to be an ideal than any of us can ever reach,” she continued. “We are who we are, we are the way we were made, and that’s life.”