Taking The First Step – Seattle

Eating disorder recovery, diabetes management, and weight management can be life altering. Deciding to take action by setting up your first session can be the most difficult step in the recovery process. Fear around this first appointment, whether it be with me or any provider, means telling your story to a stranger. Just scheduling a time to do this can be anxiety provoking.

Not only does it feel fearful to schedule an appointment, but anticipating what will happen in the appointment is hard. Questions that arise about me include;

• Who is she?
• What will she do to my food?
• What will she force me to eat or give up?
• What will she think of me?
• Is she already judging me for even showing up?
• Am I too sick or not sick enough for her practice?

Due to my adherence to food being a symptom or side note to true issues with food, we spend the first session talking about what lead to the food issues with which you are struggling. I don’t usually weigh patients, or discuss food with them in the initial appointment. As important as the food is, the story behind it will give us the solutions to your ultimate health goals. Trust is usually built in this session due to the vulnerability that naturally comes with telling your story and my intense and active listening.

I usually do not give food goals, after the first session, but do give non-food goals. I will also forecast our next session’s discussion in order to not seem mysterious or surprising.

Take that first step, call and make an appointment for your first session. Also, don’t forget to sign up for our free newsletter.

Eating Disorders – Seattle – Common Questions

Eating disorders can be traitorous and difficult coping mechanisms to relinquish. People struggling usually are functional, however mentally slaves to the disorder. Because eating disorders, usually take excess time, energy, sleep, and physical health, they can have detrimental effects not only on the struggler, but their family as well.

As opposed to drug and alcohol rehab, eating disorder treatment is a long road with many chances to resort to it as a coping mechanism. The reason for this is the presence of food being more prevalent than alcohol or drugs. Food is legal, celebrated, eaten at least three times each day, and more advertised each year to connect emotion, desire, and love with food.

One of the first questions I get from patients with eating disorders is: “Are you going to make me fat?” Your weight is not my first concern. Your weight might be indicative of your food habits; however, your emotional state is the reason for the food habits. If you are struggling with an eating disorder, you are hurt, emotionally, mentally, or physically, usually from nothing to do with food. In order to cope with the emotional pain, you use food (restrict, binge/purge, binge) instead of eating it to keep your emotions from overwhelming you.

As you use food, often your weight changes. Why would anyone start with what is affected by a symptom of a problem? I focus on the issue that got the weight to where it is, and then the food follows naturally, not forcedly. In order to make this clear, we discuss your safe weight range, which is often too low, and make a pact that we’ll stay within that until we decide not to. This makes you feel trust in the process, and I get the benefit of moving past your surfactant fears to the issues that are really making you sick.

Dealing with weight changes is imperative to my practice, though. Not revealing weight, I still allow you to know if you are in or out of your safe weight range. If you are above your weight range, it is important that we deal with that in session, not at home alone.

Trust is crucial when we go through this process due to the absolute vulnerability of the clientele with which I work.

Another question I frequently hear is: “Are you going to put me on a meal plan?” My answer to this is, “not if I can help it.” Meal plans, in my opinion are like crack to an addict. When you have an eating disorder you crave order, and the worst place to give you order is in your food. It can become, a new disorder to hyper focus on, grade, count, succeed or fail at. I also do not use any type of forced eating or weight contracts. This is outpatient and if you don’t follow your contract, what am I going to do, take legal action? It doesn’t work. Eating disorder recovery is all about trust, taking small obtainable action steps you can feel good about and celebrate.

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Diabetes Management – Seattle – The Most Common Question

Diabetes, I believe, can be controlled, managed, and overcome. A diagnosis of diabetes can have a huge emotional impact including denial, anger, hopelessness, and grief. You may wonder what you’re going to have to sacrifice, and how your life will change from the way it is today, which leads many to believe diabetes is in control of life. These are all real concerns and with the right tools and mindset, you can control your diabetes rather than allowing it to control you.

One of the most common questions I get about diabetes management is: “Can I lower my hemoglobin A1C while I eat the foods I like?” My answer to this is absolutely yes, because my style is to work with all aspects of your lifestyle, because that should be the natural progression of gaining control over diabetes.

Questions I focus on when working with patients include:

• What do you normally eat on a daily basis?
• Would it be possible to add food options that could lower your A1C?
• What’s the one thing that might be threatening your diabetes management?
• What are foods you’re not crazy about, that if manipulated, you would not notice?

By never asking you to give up your favorite food, we are able to work toward reachable goals without resistance on either side of the table. We then start to work on emotional aspects of change, what that might mean, and when ready, take the next step.

My approach is to work with foods you already like and focus on moving times they are eaten throughout the day, making change easier by keeping them part of your life. You start to become comfortable with food and timing that stabilizes blood sugar. My motto for diabetes management is to “Go Beyond It”. By this, I mean that food becomes normal, and not something you must think about. This allows you to focus on other areas of your life aside from diabetes.

Ultimately, at Ramey Nutrition, you gain full control of your diabetes, which means that you have a hemoglobin A1C less than 6mg/dL, and your life becomes your focus, not your diabetes. It is important to me that you ultimately find yourself free of diabetes and free to live without the stigma of disease.

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Weight Management – Seattle – The Most Common Question

Weight management is often an ongoing battle, however, I believe you can create a whole lifestyle around your likes and dislikes that can help you loose weight permanently.

The number one question I hear about weight management is: How long is this going to take me to loose all of this weight?

My response is: “It depends on your level of commitment to permanent change.”

Permanent change means changing your habits at a snail’s pace. If you drop 80 pounds in 4 months, it’s almost guaranteed that you will gain it back. This is due to losing it too quickly. When this happens, the body feels unbalanced and strives to gain back to what it thought was normal for so long. If you loose one ounce a week, your body is not going to notice the loss and will readjust to change much easier, creating a new sense of normal to keep pounds off permanently.

Going at a snail’s pace does not require you to meet with me on a regular basis. We work together to create a weight loss plan that works for you charting your progress regularly, then you follow through on your own. We set up consultations based on your needs. The amount of consultations will vary with each person.

Emotional therapy is almost always a part of weight management and based on your circumstances, it may or may or may not be a part of your program. Again, through listening to your personal experiences with weight, we come to a realization of where and why the weight gain started, why it progressed and the current reasoning for sustaining a body with extra weight. For example, a person may not identify with their larger body, so they are shocked when they look in the mirror, and do not truly identify with that body. It is imperative that people struggling with weight issues attain a body that fits their identity as a person.

Losing weight can be psychologically damaging due to confusing the psyche. The body likes to maintain a state of equilibrium to sustain. When the psyche is disrupted, often it sends the body signals to return to a state of normal. People gain weight again to feel safe due to their body wanting less stress. In order to transcend to a state of happy and change, one must first feel completely fulfilled, safety wise. Safety often does not feel happy or good, but due to its nature of being familiar, we often chose it over a higher consciousness of happy.

Losing weight slowly is the easiest modality for permanent change. The reasoning behind this is that the psyche doesn’t notice slow change and it gives us time to prepare your psyche for a time when you’ll identify with a smaller body. How are you going to tie your shoes, wash your hair, dress in the morning? Losing weight doesn’t have to be a battle. Do it slowly and keep it off.

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Eating Disorders and Endorphins – Seattle

Eating disorders and endorphins are highly connected. Teaching the science to my patients has made it easier for them to recover, getting great results.

Let’s talk about the science behind eating disorders and endorphins to increase understanding about why there are such dynamic fears when it comes to eating for someone with an eating disorder. Endorphins are polypeptides produced in the brain which act as natural pain relievers. They relieve pain by blocking nerve connections between the brain and the hurt area of the body.

Normally, when we get hungry, our stomach’s rumble and hurt, however if we go too long without food, we might feel dizzy and lightheaded, but the stomach stops hurting. This is due to not feeding the stomach when it sends its signals to the brain. If not fed, there is no point in your stomach just continuing to hurt, so endorphins block the nerve that feels that hunger. Not only is physical pain reduced, painful mental feelings are often snuffed out as well.

As endorphins flood the brain to block different hunger pains, they often create a euphoric mental state that some describe as powerful. As people with eating disorders naturally develop low self esteem and issues that feel too large to deal with, they tend to feel an overwhelming sense of their lives spinning out of control.

The goal of an eating disorder is to put control back in the world of someone who feels out of control with life. As the endorphins swim through the brain, the person tends to feel more in control. This is due to the constant control they exhibit over food, which distracts them from daily struggles and bad feelings. As they feel control over something external, endorphins are swimming around the brain creating a sense of euphoria. Now it feels good (endorphins in the brain) to control food (distract one’s self from real life).

As this persists day in and day out, the person gets used to the euphoria, and they tend to feel “in control.” As they continue controlling and restricting food, they become disconnected with the body. Pain is not often felt, so as they become emaciated it feels normal. The emaciated body begins to represent the amount of control one has, not only over food, but in life. Eating and gaining weight become the largest fear in this scenario.

Once a person with an eating disorder starts to nourish the body, endorphins are no longer needed for pain relief. The stomach is now free to signal for food, knowing it will be nourished. As endorphins go away, so does the euphoria or feeling of control. It is imperative that my patients know that I know how painful truly eating for the first time can be.

When the emaciated body is refed, the person loses the bodily representation of control. People develop eating disorders because they feel out of control, then they find control with the eating disorder. When I suggest they eat anything, I know exactly how much pain I am causing. The euphoria goes away, leaving them with horrible feelings they experienced before the eating disorder. This is why I do not believe that eating is the only solution for curing eating disorders. They must sincerely process what will happen to them when they take the first bite.

I educate my patients so they have a clear understanding of what will happen with the addition of food. Also it becomes highly imperative that my patients know how slowly I work in order to renourish the body while being able to process feelings as they come up, not just handing over a meal plan for weight gain and telling them to continue eating through the pain. My patients only eat what they come up with, and we move at their pace to deal with the real issues beyond the food.

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Other Medical Nutrition Therapy – Seattle

Medical nutrition therapy I provide at Ramey Nutrition includes pre-natal, post-natal, Crohn’s disease, Irritable bowel syndrome, allergies, Celiac disease, and many more nutrition related medical issues. Due to extensive study on medical nutrition therapy, I understand the emotional impact any one of these conditions have on you and your loved ones.

Feelings associated with your diagnosis need to be acknowledged in order to truly move through it and beyond. Often grief and pain accompany serious diagnoses, and if processed well, can be healed.

More important than anything else, I need to understand what’s important to you. For example, if anyone took away my coffee and said it was healthier, I would have no reason to come back. Coffee is part of my daily life, and if a professional doesn’t understand that, I need to find someone who does. In our consultations, we address goals your doctor wants you achieve and break them down into smaller more manageable steps that fit in with your lifestyle. We problem solve together to come up with solutions. Often times, based on the questions I ask, you will come up with your own solutions and end up healing yourself.

My number one concern is trust building and creating easy, highly manageable solutions. Sign up for my free newsletter to stay informed.