The Black Sheep of Nutrition

Giving a Young Writer a Black Sheep Chance

2012-02-16T12:44:00.000-08:00

Eat. Live Healthy. Fight Cancer.

After a cancer diagnosis, most people are eager to do anything that will help their recovery. One of the most important things a cancer patient can do is make a diet change to eat well and pay attention to nutrition. Proper nutrition can slow cancer growth, lower the risk of infection and make recovery much easier.

It should come as no surprise that eating a nutritious diet will help the body maintain its store of vital nutrients. Many patients do not receive the proper nutrition during recovery, and their bodies have trouble maintaining weight. Patients who are not properly nourished may find their bodies unable to stay well otherwise. They will be more tired and more susceptible to common illnesses because their bodies don’t have the stores of nutrients they require.

A simple change of diet and nutrition can help cancer patients heal…period. Knowing as much about conditions by asking health professionals the right questions during treatment can mean figuring out the best and most effective meal plan for a speedy recovery. Questions like can garlic fight prostate cancer, what is mesothelioma, or what foods should be avoided when dealing with breast cancer can drastically change an outcome. This may seem like an overstatement, but the truth is that by satisfying the body’s nutritional needs, patients help their bodies fight off the cancer.

Patients all over are already seeing drastic change in their lives by adopting a healthier diet. Take Faith for instance featured on Free From Harm. After a bit of research and taking a crucial step toward vegetarianism, Faith realized, “the more I learned, the clearer it became that if I could meet my nutritional needs without causing any animal suffering, why would I choose to do otherwise?”. She credits her diet with helping her feel better during her recovery as well as helping her recover from cancer, and believes that continuing the healthier diet has helped her stay cancer-free for several years.

Proper nutrition helps a recovering cancer patient generally feel better naturally raising tolerance to various side effects from treatments. The nutrient dense foods create the energy needed to stay strong through cancer treatment and recovery. Junk foods and unhealthy foods fill up the body but don’t provide the nutrients needed to maintain energy and strength and can drastically have a negative effect on our moods as well. In recovery, any action which can make a patient feel even a little better is worth investigating, at the very least.

Katrina Evans is a recent college graduate and aspiring writer especially interested in health and wellness. She enjoys making a difference in people’s lives seeing how devastating cancer can be for people and their families. Katrina also likes running, reading and listening to cool podcasts.

http://www.cancer.gov/cancertopics/pdq/supportivecare/nutrition/Patient/page1http://www.cancer.gov/cancertopics/types/parathyroid
http://www.mesotheliomasymptoms.com/what-mesothelioma
http://freefromharm.org/health-nutrition/faith-terwilliger-a-cancer-survivor-turned-plant-based-nutrition-coach/
http://www.cbsnews.com/stories/2004/01/26/earlyshow/health/main595775.shtml

Heribert Watzke: The brain in your gut | Video on TED.com

2011-11-09T09:55:00.000-08:00

Heribert Watzke: The brain in your gut | Video on TED.com

Ramey Nutrition Takes You Beyond Type 2 Diabetes

2011-11-07T21:08:00.001-08:00

Ben Goldacre: Battling bad science | Video on TED.com

2011-10-23T10:31:00.000-07:00

Ben Goldacre: Battling bad science | Video on TED.com

Recipes for the Road to Recovery!

2011-10-23T09:51:00.000-07:00

Special recipe from patient experimenting with eating disorder Recovery... Add a Very Vanilla Boost (get free at Ramey Nutrition) to left over white rice heat up, add cinnamon, and raisins if you want and enjoy! Thank you RW!!

What Does Ramey Nutrition Have to Do With Dentistry

2011-09-26T16:01:00.000-07:00

Beyond Type 2 Diabetes -- Seattle Testimonial

2011-09-20T14:36:00.000-07:00

Testimonial from Ramey Nutrition Patient (no longer:)

2011-09-19T16:31:00.001-07:00

“I just wanted to thank you so much for being a huge part of my life’s journey, especially during a season that was very rough. Three years ago today was the LAST time I ever binged/purged. There were times that I couldn’t believe that I’d be on “the other side,” but you always believed. I am so thankful for you and the work that you do. The tools you’ve equipped me with, I will use for the rest of my life. Your encouragement and practice have helped me view my life as a redemption song (in progress). I know that God has used you to help me heal and transform and I am eternally grateful. I no longer look back at the woman struggling with bulimia with contempt, I look back with compassion.”

—	Ramey Nutrition Patient with History of Bulimia

RNEDA Ramey Nutrition Eating Disorder Awareness: Anorexia

2011-09-06T11:20:00.000-07:00

It is striking to realize that nearly half of all Americans personally have or know someone with an eating disorder. It is not uncommon for people suffering from anorexia to deny having a problem and it may be difficult to notice the signs of anorexia.

Anorexic signs and symptoms may include: dramatic weight loss, skipping meals, not wanting to eat in public, and fixation on body image. Anorexia can lead to fatal medical conditions including heart disease, liver disease and even heart failure.

People who suffer from anorexia can be treated and moved from the painful, self-destructive pattern of this disease to a life they are proud to direct through the programs at Ramey Nutrition. For more than 4 years Ramey Nutrition has provided outpatient intensive real world treatment and support for women, men and children of all ages going through the journey toward full recovery.

Our eating disorder programs are highly flexible and individualized to meet exact needs, regardless of coexisting conditions or stage of change. Located in the heart of the University District, each person is set up with a multi-disciplinary team of professionals dedicated to helping them become, what Ramey Nutrition calls recovered.

For information about our treatment programs at Ramey Nutrition, please call 1-206-909-8022 or visit us at www.rameynutrition.com

Fueling Minds, Empowering Bodies

Seattle Eating Disorder Treatment-It’s Not About the Food…

2011-07-19T14:07:00.001-07:00

Providing eating disorder treatment that leads efficiently to full recovery was the guiding principal on which Ramey Nutrition was founded. Eating disorders are frequently “treated” in the field of nutrition counseling; however we focus on getting to a state of Recovered and on with lives that are meaningful to our patients. We do this, not by educating or meal planning, but simply by listening, and reminding our patients of the power they have to heal themselves.
• Our Individual Consultations Individualized sessions designed specifically for you without meal plans. We focus not only on the source, but more importantly the issues that maintain disordered eating and fears around food.
• Our Outpatient Eating Disorder Program; A highly intensive medical nutrition therapy and eating disorder treatment program, including individual therapy, group treatment, meditative yoga, monitored eating, and food challenges for those suffering with an eating disorder that impacts their daily life, and ability to move forward.
• Our Eating Disorder Treatment Support Group Phase 1 and Phase 2 Groups provide consistent weekly support and treatment of those suffering with eating disorders, body image issues and media intimidation.
• Our Recovery Support Group provides specialized support to those beyond treatment and going through the process of Recovery toward, what Ramey Nutrition calls Recovered.
• Our Friends and Family Support Group Provides information and support for those with loved ones struggling with an eating disorder.
• Our Website www.RameyNutrition.com Provides information on eating disorders, and services we offer to aid in Recovery. Join online to receive our newsletter, follow us on Facebook, and Twitter.
• Our Ramey Fitness provides a safe and unique fitness program for people of all fitness levels, wanting an out-of-gym experience with no mirrors, pressure, or machines.
• Our Ramey Yoga is our gentle yoga class featuring meditative yoga for all skill levels encouraging a healthy relationship with the body, alongside stress reduction.

Lowering A1C's in Type 2 Diabetes

2011-07-19T12:55:00.000-07:00

Starting October 5, 2011 Beyond Type 2!
Have you had Type 2 Diabetes for too long with no success of lowering your A1C?
Do you go to the endocrinologist and hear the same speech again and again about weight loss, exercise and eating better, and think “that’s easy for you to say!” ?
Do you know what to do, but have a hard time putting it into action?
Have you been recently diagnosed with Type 2 Diabetes, and want an efficient way to get your sugars under control?
• Our Beyond Type 2 Diabetes Program lowers blood sugars and overall A1C by “…connecting people with Type 2 Diabetes to OWN their blood sugars.” –Beyond Type 2 Veteran. Providing support groups, yoga, and beginning level fitness we help utilize the information you have to go Beyond Type 2.
Here at Ramey Nutrition, we have dedicated ourselves and our company to action in its purest and most effective form. We have developed a purpose-driven attack against Diabetes depleting our community’s quality of life. Ramey Nutrition represents a rebellious freedom from what Diabetes represents, including diet restrictions, carbohydrate counting, and a reduced life span. We expect more, such as a quality of life that identifies your goals, talents and passions as who you are, instead of one that identifies you as a “diabetic.”
• Comprehensive Program to Lower A1C’s and keep them down!
• Includes:
o Type 2-Specific Support Group each week provides clarification on diabetes knowledge you already have, but more importantly provides support for what it’s really like to go through life with Type 2 Diabetes. Topics such as stress, fear, frustration, and coping strategies for going beyond your Type 2 Diabetes are discussed.
o Our Individual Consultations as needed are our individualized sessions designed specifically for you; focused on issues that pertain to your current diabetes challenges, including stress, your current lifestyle, and how diabetes presents itself.
o Our Ramey Fitness 3 times per week provides 2 levels of continuing, motivational, diabetes-specific fitness, for those wanting to maintain non-diabetic A1C’s, with an out-of-gym experience including no mirrors, pressure, or machines.
o Our Ramey Yoga provides diabetes-specific yoga for all skill levels to encourage lowered blood sugars by reducing lifestyle stress.

Fitness for All at Ramey Nutrition, Seattle, WA-Testimonial!

2011-07-12T16:31:00.000-07:00

Community Based Fitness at Ramey Nutrition-Seattle, WA

2011-07-12T16:28:00.001-07:00

Go Beyond Type 2 Diabetes at Ramey Nutrition-Testimonial!

2011-07-12T16:26:00.000-07:00

Taking The First Step – Seattle

2011-06-29T15:38:00.001-07:00

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

2011-06-29T15:37:00.001-07:00

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.

Don’t forget to sign up for our free newsletter to stay informed.

Diabetes Management – Seattle – The Most Common Question

2011-06-29T15:36:00.001-07:00

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.

Take that first step and sign up for our newsletter and stay informed.

Weight Management – Seattle – The Most Common Question

2011-06-29T15:35:00.000-07:00

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.

Take that first step, sign up for our newsletter to stay informed.

Eating Disorders and Endorphins – Seattle

2011-06-29T15:34:00.001-07:00

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.

Take the first step towards recovery, sign up for my newsletter and get to know Ramey Nutrition better.

Other Medical Nutrition Therapy – Seattle

2011-06-29T15:33:00.001-07:00

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.

Eating Disorders – Seattle – Giant Steps in Bulimia Nervosa Recovery

2011-06-29T15:32:00.002-07:00

Eating disorder Bulimia Nervosa client quote from KN in Seattle: “I have a fun update, which I have dubbed a “fupdate”. I figured this may make you do a little Scarlett dance. So last night, it was about 11, I kinda felt like binging…there was a leftover omelet AND a chimichanga AND macaroni and cheese in the fridge. I opened the fridge up, took out an apple and peanut butter, went to my room, ate it, and went to bed. The end.”

Why Is This Such a Big Accomplishment?
When trying to quit a cycle of binging, purging, and restricting (Bulimia Nervosa), it is often difficult to stop at any one of these stages due to the severity of the previous stage. When a person with bulimia tries to stop binging, it becomes difficult because, previous to this she has probably been restricting all day and is probably ravenous with hunger.

To eat normally at this point would be difficult due to her hunger. If she tried a different route, and tried not to purge, this would be difficult because, before the need to purge is generally a binge. Waiting through the digestion of this uncomfortable amount of food, however large it is, would feel like torture. If she tried to stop restricting, this would also be challenging due to the nature of wanting nothing to do with food after a binge/purge cycle.

There is a strong feeling of food being the reason for starting a binge/purge cycle, and control over another cycle means avoiding food in the first place. This wonderful girl went from vomiting everything eaten for 6 months to eating and keeping (not vomiting) 75% of daily food intake. This is almost an impossible feat.

Her Goals and Challenges

Her goals included eating a nighttime snack which she selected, and to keep it. This is very difficult due to a previous binge and wanting to avoid food that will be kept.
There was food in the refrigerator that often triggers her to binge/purge. “…there was a leftover omelet AND a chimichanga AND macaroni and cheese in the fridge.” This could have easily been added to the previous binge/purge, stopping the trigger once gone.
She had to take the least tempting food out, eat it, and then sleep while keeping it. Not wanting food while sleeping, and certainly not after a binge/purge episode.

She took this so seriously, and though she did not want to complete her goals, she put her fears away for enough time to force down her nighttime snack. When we are fearful and go on anyway, this is courage.

How did this person obtain her goals?
We started very slow with her, as we do everyone, however, her successes kept popping up in the face of extreme adversity. Completing her food goals while friends yelled, wanting to binge/purge, but instead, truly eating, lead her to stride toward recovery with the inertia of a wrecking ball.

Congratulations sweet girl for amazing feats in recovery! Please look for my next post on the causes of bulimia nervosa.

Eating Disorders – Seattle – Causes of Bulimia Nervosa

2011-06-29T15:32:00.000-07:00

Often, the eating disorder bulimia nervosa is caused by a combination of hereditary chemical imbalances, environmental triggers, family genes, family history of psychological disorders, family issues and is often ignited by a multitude of societal influences. Bulimia Nervosa often involves cycles of food restriction, becoming ferociously hungry, binging on large amounts of food in a hurried manner, followed by purging the binged food.

Binging is often characterized by the rapid and voluminous consumption of high-calorie food in a short period of time. Once the process of a binge begins, it becomes difficult to interrupt. A trance or stupor is often described when a binge takes over. Food can be consumed so rapidly that it’s often not tasted. An average binge can consist of about 1,500 to 60,000 calories or more.

Having seen many forms of binging, Ramey Nutrition has developed its own definition of a binge. When listening to our patients, as they discuss binge episodes, it’s not about calories, or portion sizes, and it rarely concerns hunger.

Scarlett’s Definition of a Binge: Any food eaten in a hurried manner while feeling out of control.

This definition, please note, has no calorie price tag. Patients have reported “binging” on an apple. Any time one of my patients says they felt out of control with food and they ate hurriedly, telling me they binged, I NEVER say “Don’t feel bad, because it wasn’t a true binge.” Acknowledging feelings of control loss is crucial to a patients trust in themselves and their provider. When a patient hears “Your feelings aren’t real,” as the above statement implies, feelings of distrust arise. Feeling crazy due to a provider’s flippancy with a patient’s worst fear, the patient often starts distrusting the provider. Our mission is to put feelings on the table, whatever they may be, and process them. Each feeling is a step toward recovery, and therefore valid. How dare we invalidate a step toward recovery?

Many think of purging only as vomiting, however, there are various forms purging can take on as well. Self-induced vomiting is the predominant method, however, misuse of laxatives, diuretics, enemas, medications; fasting or excessive exercise are also used frequently.

The Biology of Bulimia Nervosa
When a person purges, electrolyte imbalances often transpire, which generally lead to muscles failing to fire when called upon by the brain. The most common prognosis for severe bulimia is heart attack or a stroke. The heart is a muscle, and if not fired precisely, and accurately, could stop beating without the correct mix of electrolytes in the blood.

Some of the most common complications of bulimia are:

Erosion of tooth enamel because of repeated exposure to acidic gastric contents.
Dental cavities, sensitivity to hot or cold food
Swelling and soreness in the salivary glands (from repeated vomiting)
Stomach Ulcers
Ruptures of the stomach and esophagus
Abnormal buildup of fluid in the intestines
Disruption in the normal bowel release function
Electrolyte imbalance
Dehydration
Irregular heartbeat and in severe cases heart attack
A greater risk for suicidal behavior
Decrease in libido

The Psyche behind Bulimia Nervosa
Bulimia nervosa is usually a response to depression, stress, or self esteem issues, and is often a product of pressure a person perceives to succeed, or direct shame. During the binge there is a sense of control loss, however, the sense of a loss is followed by a short-lived tranquility. This calmness is often followed by extreme self-loathing.

People with bulimia are not one size; they can take any shape or size and tend to be high achievers. It’s often difficult to determine whether a person is suffering from bulimia, due to the nature of binging/purging being done in secret and they often deny their condition when confronted.

Eating Disorders – Seattle – Recovery vs Recovered

2011-06-29T15:30:00.000-07:00

People with eating disorders, of any type, usually go through a process of eating disorder treatment and recovery to attain what I refer to as a recovered state. Eating disorder treatment includes intense learning about how the eating disorder serves as a coping mechanism, and what feelings are being coped with, using the eating disorder. In recovery, the patient uses new coping skills to deal with emotional issues that arise when the eating disorder is gone, and feelings that were suppressed rise to the surface. Recovered is moving through life’s challenges, not related to the eating disorder or recovery.

Recovery is a phase similar to eating disorder treatment in that it is very much a process of dealing with emotions previously controlled by the eating disorder. Recovery in many ways is more challenging than eating disorder treatment. Eating disorder treatment might be getting over the fear of eating bagels, whereas a recovery challenge might be “Who am I now that I don’t have my eating disorder?”

Patients going through recovery receive one-on-one consultations and group sessions. One-on-one consultations deal with the individual goals and recovery challenges, whereas in group sessions, patients get support from others going through the same process of recovery. Group support comes from sharing similar challenges and instances that have less to do with food, and more to do with emotions. Recovery group is full of people trying to find themselves without the eating disorder.

Patients with eating disorders often experience a lack of identity, safety, or control, all which produce pain. Patients often think, “If I allow myself to feel, it will be too painful and if I focus on food, I’ll have control over my feelings.”

People with eating disorders often think about food related things 95% of their day, so the idea of not having an eating disorder can cause fear, due to losing 95% of their day, control, coping skills, etc. Now they have to fill that gap with an identity that they are not familiar with, and have to figure out who they are in recovery. It is a very different challenge going through “Who am I” and What is my identity?” versus “How many carbs are in this bagel?”

During recovery, a patient can be triggered without actually going into the eating disorder. For example, a patient is triggered to binge and purge and comes into recovery group and says: “I’m really really urged to do this and I’m triggered by the stress of my father in law, but I didn’t do it, because I used another coping mechanism instead.” They could also be in recovery and use their eating disorder, but be processing through it emotionally. In recovery, patients learn how to use healthy coping skills and put them to action.

Recovered people have graduated from the recovery group. Coping skills start to come naturally, and they seem to know who they truly are and what they need to have good self care. They are who they want to be and feel safe in the world with all the world’s stimuli that used to trigger, charge, or inspire their eating disorder.

They are now living the way they strived to in recovery. A person who is recovered rarely attends group or individual sessions. This is discouraged due to wanting them to practice living in the recovered state.

The goal for my patients with eating disorders is empowerment to deal with challenges that life has to offer, without having to continue eating disorder treatment or maintain recovery for life.

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Eating Disorders – Seattle – Media and Body Image

2011-06-29T15:29:00.000-07:00

Eating disorders, media and body image are intricately woven together. Unrealistic images of the human body portrayed in the media often influence the way Americans view themselves in their own bodies. There’s an idea of the perfect body, however, few attain it due to its consistent change. I think the media’s unrealistic portrayal of the human body, has contributed to the epidemic of eating disorders and unhealthy habits in Americans lives. For example, using radical diets that are not healthy in order to achieve something that, in the end, is not achievable.

I don’t blame the media for the rise in eating disorders by any means, but I do believe it contributes. If someone has a pre-disposition to an eating disorder, I believe that media can have a powerful affect on the tipping point of a disorder developing or not. A person may be pre-disposed to an eating disorder due to a trauma (85%), perfectionist ideals, high expectations from family, friends, or even perceived high expectations. People with eating disorders are hypersensitive and hyperintuitive. They become hyper-aware of everything going on. For example, if someone is whispering in the corner they know about it, if someone says “You’ve got a terrible hairstyle”, they think they are a terrible person. They are very permeable to most comments and their feelings are hurt easily and they feel everything more intensely than the normal person.

After these people are recovered from eating disorders their intuition becomes honed into mental health habits, such as intuitive eating, how they are feeling and what would feel best, instead of feeling hungry and not knowing what to eat.” They are still sensitive yet they now use it to serve them. They recognize and quickly process comments that would have bothered them in the past.

When looking at an advertisement, ask these questions:

What is the motive of the advertisement?
What emotional jugular are they accessing?
Are they targeting women or men?
What emotional response do advertisers want me have to buy the product or service they’re selling?

Educating patients on effects the media is looking for becomes critical. One exercise used in treatment group is perusing favorite magazines, selecting different ads and analyze what emotional response they are aiming for, which audience they are targeting, and how they entice each audience to be hooked into their emotion, enough to buy a product.

In group sessions, we go through different ads, emotions that are evoked and the reasons people fall for these tactics. My patients learn to critically analyze what advertisers are trying to do so they end up feeling empowered instead of victimized by media.

Inpatient facilities often disallow media due to possible triggers presented, however media is everywhere in the real world so instead of avoiding it I exploit the exploiters without judgment. It’s their job to sell using emotion, however we can be empowered to make cognitive decisions without falling privy to emotions that advertisers want to evoke. My groups become educated on how advertisers do their job, and empower themselves over emotions ads try to evoke. We see media in the grocery store checkout line, and all over the real world, so I want to teach my patients how to deal with it, rather than ignore it.

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Type 2 Diabetes – Seattle – Why is Type 2 Diabetes on the Rise?

2011-06-29T15:28:00.000-07:00

Type 2 diabetes is on the rise and is often caused by over eating or maintaining obesity for an extended period of time. When a person eats, food is broken down into manageable molecules and most food is broken down into sugar that enters the blood and supplies body cells that need energy. Depending upon the amount of sugar or food that enters the bloodstream the pancreas produces enough insulin to transfer that sugar to the cells in the body. When cells are receptive to insulin, they unlock and allow sugar in and use it for energy.

Typically too much food is consumed and can’t be processed. In order to transfer the large amounts of sugar into the bloodstream, the pancreas needs to pump more insulin into the veins. After doing this many times, the pancreas tends to fatigue and not produce as much insulin and sugar ends up staying in the vascular system. The body cells become resistant to accepting excess sugar and instruct the body to keep the sugar in the bloodstream until it’s needed. The cells start to reject the sugar. As more and more food is consumed as a society because it’s easier and more efficient to get food it is tempting and has become normal to over eat and eat more than the body needs on a consistent basis.

A major cause of type 2 diabetes is consistent over eating and maintaining an obese weight over an extended period of time. As a society we are consuming processed foods that break down much quicker than ever before in the history of time resulting in getting sugar a lot faster. And because we are over eating we are getting more fast sugar.

Symptoms that may indicate pre-diabetes or diabetes include frequent urination, extreme thirst, unusual weight loss (30 pounds in a month), because the cells aren’t being fed, extreme hunger, extreme fatigue, irritability, frequent infections, blurred vision, frequent bruising, numbness or tingling in the hands and feet. There are times when a type 2 diagnosis is made without any symptoms. This is usually found with obesity.

Pre-diabetes is a relatively new clinical diagnosis announced in 2002 by the American Diabetes Association. It was formally named “Impaired Glucose Intolerance” to highlight the seriousness of the condition. Pre-diabetes means that there are resistant cells and with motivated treatment, early intervention, and lifestyle adjustments; it can be slowed and I believe reversed. It is diagnosed with a similar test used to diagnose type 2 and may be found during a physical.

You are at risk if you are obese, have a family history of diabetes, or have a direct family relation with type 2. You are going to have those genes that are quick to resist insulin and/or quick to fatigue the pancreas. This doesn’t mean that you will get diabetes just that your pancreas gives up easier than the normal pancreas. If you are obese and have a history of diabetes in the family you are at very high risk of diabetes.

To prevent type 2 diabetes you can join our new program Beyond Type 2. In this program you can eat the same foods you always eat but in a different manner and timing. Timing is all about when you eat something with sugar in it. If you’re going to have cake, it’s better to eat it on a full stomach rather than on an empty stomach. The sugar has to sift through what is already being processed so it doesn’t raise the blood sugar astronomically when it’s eaten on a not hungry stomach.

When you eat cake on an empty stomach, your insulin will rise, your cells will resist and they will feel fatigued because they are not going to have the sugar that they need in the cells because the sugar comes too fast. It’s not no cake, it’s eat your cake a little bit later or eat your cake with your meal. Eat it with protein and fat.

For more information about Beyond Type 2 visit http://www.BeyondType2.com. Make sure you sign up for our free monthly newsletter.

Type 2 Diabetes – Seattle – The Impact of a Type 2 Diagnosis

2011-06-29T15:26:00.000-07:00

A type 2 diabetes diagnosis usually, but not always, causes a life changing impact. Doctors and healthcare workers are comfortable with diagnosing diabetes and delivering this message multiple times in a day. However, it is the first time for the person receiving the diagnosis and hearing that it is a permanent condition.

A type 2 diabetes diagnosis is not a message that anyone wants to receive. It can cause a psychological shift that can include denial, upset, anger, grief, or loss. Often a period of denial occurs and thoughts such as “this can’t be happening” or “there must be some mistake” occur. Many go through a period of anger and others may go through stages of grief.

Along with the diagnosis the healthcare worker usually suggests attending a diabetes class. A typical diabetes class teaches the exchange system of food, which is difficult to abide and live by. A list of food groups is provided from which to select or exchange. An exchange is an amount of food that is not usually normal for food packagers but is normal for diabetics. Each exchange contains a specific number of carbohydrates and calories, and that is what gets counted.

It is an extensive world of counting and calculating the number of carbs and exchanges which no one else does. For example, a regular sized apple at the grocery store is considered two servings of fruit and one banana is considered two pieces of fruit. It is learning a system of food counting that is not normal for the manufacturing world and not normal to the real world. It is difficult to use and it is not used in any other disease or diet.

In addition to attending the diabetes class most patients schedule 15 minute follow-up appointments once every three months with the endocrinologist to check their hemoglobin A1C. The endocrinologist will also suggest exercise and weight loss. The patient leaves the appointment not knowing how to do either one. This doesn’t feel supportive and creates a very defeating feeling. Many diabetics experience overwhelm and wonder how they are going to get through this.

Many believe it is a deadly disease and that eventually they will die from it. They also think they won’t be able to eat sugar again and this is not true. The pancreas is tired or the cells have become resistant to insulin. The body needs sugar to function and when food is consumed it is broken down into sugar and enters the bloodstream. The pancreas pumps insulin into the bloodstream and carries the sugar into each individual cell. Without insulin, the sugar stays in the veins and blood system and never reaches the cells. If cells are resistant, the body keeps producing more and more insulin, which the body does not react to. The over production of insulin results in a tired pancreas and eventually it produces less and less insulin at each meal because pumping the insulin does not work.

Most food turns to sugar and enters the blood system. For example white bread, quinoa, and table sugar all turns to sugar. The rate at which the sugar enters the blood system is the difference between the carbohydrates. For example, table sugar enters the blood quickly, whereas quinoa enters the blood very slowly causing a longer period of raised blood sugar level, whereas table sugar spikes the blood sugar and then sharply falls down. The difference is fast carbs versus slow carbs, not just carbs or no carbs. To be able to eat sugar, a type 2 diabetic has to monitor when they eat sugar, the kinds of foods they eat it with, and they need to know how to play the diabetes game. I make it into a game so that it’s easy. It’s easy to remember and do.

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Beyond Type 2 Diabetes – Seattle

2011-06-29T15:24:00.001-07:00

I have always held the vision of bringing the highest quality medical nutrition for long term solutions for one of the most dangerous epidemics, which is the exponential growth in diabetes mellitus. We have dedicated ourselves and our company to action in its purest and most comprehensive form. Our new program “Beyond Type 2″ is my purpose driven attack against diabetes mellitus, which I think is depleting our communities’ quality of life. Our program is for pre-diabetes and type 2 diabetes patients.

The components of the program go beyond what the diagnosis of diabetes mellitus presents. The program does not contain diet restrictions, or a strict medication regiment. Beyond Type 2 represents a freedom from the restriction and shortened life span in order to gain a quality of life that identifies our patients’ passions, goals, and talents. It’s about who they are rather than the word diabetic, they are more than diabetic and in Beyond Type 2 we use food support, real world nutrition, and gentle fitness. Our patients will easily find that diabetes is something they can manage and not just endure.

Beyond Type 2 addresses the physical, emotional, psychological, and nutrition elements. We treat eating as a game which allows patients to fit the food they like into their diet. Instead of avoiding foods, monitoring portion sizes or trying to figure out what an exchange is, we basically do it with foods our patients already understand. We use foods they like to eat, not challenging foods or foods they aren’t happy about. We do not change their food to diabetic food but add in foods that might lower the affect the food desire might have on their blood sugar.

We teach timing rather than don’t eat this or don’t eat that. If you’re going to eat cake, here’s how to do it. A piece of cake is better eaten after dinner with food in the stomach that keeps the sugar from going straight into the vein, allowing some padding and leeway. This enables patients to participate in life and recognize that diabetes is not a life sentence. Not being able to participate in the “coffee run” at the office or not eating birthday cake at a party is not going “Beyond Type 2”.

The exercise component of Beyond Type 2 allows the cells to be more receptive to insulin and sugar. Exercise helps cells open up to receive sugar rather than have it stay in the veins. If sugar stays in the veins, there is no energy; sugar must reach the cells for energy. Sugar must be removed from veins because it starts to deteriorate the integrity of the veins causing holes in the vein tissue, ultimately damaging nerves and causing blindness, and death of tissue, which could result in amputation.

The group component of Beyond Type 2 helps patients know that they are not alone and share frustrations about having this disease with people who understand. Family members know that you have the disease but they don’t really understand it. Often, diabetics don’t want to burden people by talking about diabetes all of the time, so they don’t. The group is the place to get it all out.

The one-on-one sessions with me enable each patient to talk about obstacles towards their best life and how to deal with them. It’s all about how to go beyond their diabetes to get to their best life.

I am really excited about our comprehensive program Beyond Type 2. If you or someone you love is pre-diabetes or diagnosed Type 2 I’d like to invite you to attend our educational evening June 19th at 7:00 pm at Ramey Nutrition. To learn more about the program, visit www.BeyondType2.com.

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Weight Loss – Seattle – Why is Childhood Obesity on the Rise?

2011-06-29T15:23:00.001-07:00

Childhood obesity is on the rise. In the report “Solving the Problem of Childhood Obesity within a Generation” found at http://www.letsmove.gov/taskforce_childhoodobesityrpt.html it states: “Prevalence estimates of obesity in the U.S. are derived from the National Health and Nutrition Examination Survey (NHANES), conducted by the National Center for Health Statistics of the CDC. Between the survey periods 1976–80 and 2007–08, obesity has more than doubled among adults (rising from 15% to 34%), and more than tripled among children and adolescents (rising from 5% to 17%).”

I believe childhood obesity is on the rise for many different reasons. As an example, I’m 30 now, and when I was young there was a lot of free play time, running outdoors, climbing trees, and playing for hours after school. Coming in for dinner was a big deal because I didn’t want to leave my friends and playing outside. Now, there are safety concerns with letting children run free and go to the neighbor’s house, or to play basketball with the children 4 blocks away. People driving everywhere cuts down walking and transporting by foot or by bike.

Childhood sports have become very structured. For example, ballet classes, soccer, or volleyball. Children could be involved in eight different sports simultaneously. However, when observing a child at a sports practice, it is easy to see that it is structured to the point that there isn’t much activity. A lot of skill learning takes place, but it doesn’t serve high activity for long periods of time. Even though children may be on multiple teams, there’s a lot of waiting in line and standing around learning different techniques and skills.

The increase in video games, computers, TV, DVRs, movies, and everything sedentary contributes to childhood obesity. Ordering everything from ice cream, hamburgers, groceries, and movies online eliminates the need to leave the house, if you choose not to. Companies have gotten very efficient at deliveries. For example, some pizza companies hold your credit card on file and when called they already know your credit card number and the type of pizza you like. You simply say your name and they deliver your pizza to the address on file. It is very easy for people to stay indoors and maintain a sedentary lifestyle. Many different forms of entertainment are indoors and the new upcoming forms are technologically available.

The family dynamic is different. People work longer hours, multi-task, and the busy Mom syndrome occurs. Mom spends her time taking children from event to event and in between needs to feed them. It’s easiest to go through a drive-in and eat fast food. The children are happy and fed. Going to a fast food restaurant is no longer a treat but a source of food, rather than going home and preparing food.

Children are getting too many calories for the activities that they are not doing, in whatever form. If exercise does not occur, it’s possible to get too many calories eating carrots. The more processed the food the better it tastes, causing children to eat more calories. If children eat a lot of calories in a small volume they can overeat very easily. The sugar drinks such as the new flavored milks, making it more appetizing, give a quarter of the day’s daily allowance in one pint of milk, which could be half of lunch.

The combination of lowered activity, higher calories consumed, societal changes, and lifestyle lead to childhood obesity. Watch for my next post on what can be done about childhood obesity. Sign up for our monthly newsletter to stay informed about what is happening at Ramey Nutrition.

Weight Loss – Seattle – What Can Be Done About Childhood Obesity?

2011-06-29T15:22:00.000-07:00

Childhood obesity can be addressed and it will take time. Many schools are changing from the old ways of pizza and hot dogs for breakfast and lunch to healthier varieties based on the school. However, many of the schools still serve pizza and fries at lunch. When children can choose what to eat they will always pick pizza and fries. The situation is a difficult conundrum because the fight is against society and against what children like and children are all about what they like.

Society knows that fast food isn’t the healthiest thing to eat after soccer practice but it’s done anyway. It’s done for convenience and I think it’s a fight against trends. Fast foods went from serving really healthy foods such as salads and wraps to deciding to feed the masses. The masses want giant burgers and the biggest bang for the buck in a down economy. A down economy and time are huge factors and when combined, a healthy meal at home doesn’t sound as easy as a meal out.

It is possible to eat healthy on fast food for an entire year. I’m not criticizing the fast food restaurants. Society is simply consuming high calories in low volume food. For example, a medium fries seems innocuous but it can have over 600 calories. People do not feel these calories nor do they feel like they don’t have to eat for another eight hours. The fries that came with the hamburger and the milkshake is another 1200 calories. An entire day’s food value is in one meal and it looks reasonable. It’s not a giant burger or super sized fries and super milk shake, but it is very high in calories.

Childhood obesity is not the parent’s fault or industry’s fault; it’s what our society has come to. Fast food is popular right now and people are going to eat it because they can and it costs $2.00 for a burger with six strips of bacon, what a deal. I think it’s a popularity thing. The restaurants wouldn’t offer the high caloric meals if they didn’t sell. I don’t think there’s anyone out there that thinks a burger with 6 strips of bacon on it is a healthy meal.

Children have a natural ability to run and play, to create forts, and games such as tag. If children are left for four hours on their own in an enclosed safe space they are going to get more exercise than they do in a soccer game, volleyball or basketball practice, or ballet lesson. Putting children in programs where they wait in line and learn a new skill does not create the constant long-term activity and necessary expenditure of energy. A lot of schools have cut recess due to the safety issue and recess is almost more important than physical education because all the children do is run around.

Schools could implement recess in a gym where the children have the space to create their own activities, run around, and expend energy. If you match inactivity with high calorie food you are going to see severe obesity and increase in diabetes. Childhood diabetes is on the rise because of the obesity in children. Diabetes used to be called adult onset diabetes and juvenile diabetes. Now it is called type 1 and type 2 diabetes because 12 year old children are getting type 2 diabetes. Children are getting diseases that only adults used to get.

The best way to prevent childhood obesity is for the parents to be the example. Go with your children to the park and let them run around. Play games with them, go bike riding together, create a safe outlet for exercise and energy expenditure. Make play safe again, take them to the beach and play volleyball with them, go into the water with them, don’t sit on the beach telling them not to go into the water and not to go too far. Get out there and exercise with your children.

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Weight Loss – Seattle – The Biggest Loser

2011-06-29T15:21:00.001-07:00

Weight loss is a concern to many people. “The Biggest Loser” is another TV show and those who are entertained by it will watch it and those who are not going to be entertained by it are not going to watch it. To some people, watching a heavy person loose quite a bit of weight and seeing the figures change can be very motivating.

I think that the way they set up the program is interesting because it’s very much an incubator and sterile environment. The trainer is there and the participants are working harder than they would ever work naturally. The participants are grunting, upset, crying, and emotional. If the participants were at home they wouldn’t have this environment.

The show is a snapshot designed to put the participants through the most extreme weight loss program possible to lose a lot of weight in eight weeks. When the show is complete, the participants are told to please continue the same lifestyle. A few will probably continue something less strenuous.

The show can motivate people to exercise along with the participants. People get motivated to exercise on the day that “The Biggest Loser” is on, have dinner and then watch the show. I’m all for it if it helps people come together. If you can get on the show, it is a way to lose weight.

I don’t’ think this process would work in the real world because people don’t have trainers readily available, 24 hour watches, or cupboards constantly stocked with the necessary food. The show does not teach grocery shopping skills or how to cook foods you like in an easier fashion and more helpful way. It is a boot camp and that’s fabulous for what it is.

Quick weight loss becomes difficult on the body and the body resists losing too much weight too quickly. When quick weight loss occurs in a short amount of time, the body goes into a stage of emergency. It stores everything it can, including water and food because it doesn’t understand if the stress is due to running away from a bear or if there is no more food. The body is used to being fed quite a bit, not exercising, and the change is seen as very stressful on the body. The body doesn’t know any different no matter what your mind or your eyes see the body is its own little entity. It will kick out hormones if it feels stress and the people on “The Biggest Loser” experience tremendous stress.

The exercise is stressful, the eating is stressful, the games are stressful, even sleeping is stressful because the participants know they have to get up at 4:00 am to exercise again. This stress can sometimes cause the body to kick out an amount of Cortisol that keeps the body from losing anymore weight. On the show the participants repeatedly push through this level. When the participants start to eat normal again and work out in a normal way, sometimes the weight can come back.

The psychology of weight loss is very important. If a person does not see themselves as a small person it’s possible to lose a lot of weight but gain it right back because of the mental equivalent. The combination of mind and body together defines a person’s size and when weight is lost quickly, there is no time to adjust the mind and body.

My approach is much much slower. Instead of losing 100 pounds in eight weeks, you lose 100 pounds over five years. There is little to moderate exercise, food changes are easily dealt with, that don’t impact your quality of life. If you’re a coffee drinker, I’m not taking away your coffee. If you like waffles we leave them in your diet and we pull something that’s not as important to you.

My process is changing without changing. I help the person identify with who they want to be when they have a new body, which helps prepare the body both physically and mentally so that it’s not stressfully losing weight. We explore the question “What of yourself did you lose?” We work with this question throughout the process to make sure that the people are becoming more and more of themselves and losing what they are not, what they don’t identify themselves as. Working with the mind and body over longer periods of time ensures that weight loss is gradual and permanent.

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Type 2 Diabetes – Seattle – How to Support Your Loved One

2011-06-29T15:20:00.001-07:00

Type 2 diabetes affects family members because they believe that a diagnosis of diabetes means there can’t be any more sugar and carbohydrates. Family members think:

Should I eat around my loved one?
I shouldn’t’ eat a candy bar around him or her.
I shouldn’t eat cake around him or her.
We can’t have pasta as a family anymore because it’s not good for people with diabetes.

There are old notions and myths around what diabetes means and it feels like a huge shift and a huge change in food.

As a result of these beliefs family members feel stressed about their own diet due to the fact that one family member has to go through just some mild changes in diet. The old notion that there can’t be sugar or carbohydrates in the house isn’t entirely true. There should be coverage done. For example, if there is a birthday and birthday cake, making sure the cake is eaten in a timely manner with the rest of the meal.

How Families Can Support Their Loved Ones with Type 2
Family members can ask the loved one with type 2 diabetes how they want to be supported. People with type 2 don’t want to talk about their diabetes or have the dinner conversation be about what they can and can’t eat. Have discussions about food away from meals. Treat them normal during dinner.

Asking your loved one what would help is probably the best course of action. Family members shouldn’t pretend to know everything there is to know about diabetes. The person with diabetes is going to be the expert; they are the one going through it. Family members can meet them half way and ask what can I do for you or what is it you want from me and the rest of the family?

Sometimes the best course of action is taking all of the sugar out of the house to eliminate temptation. This is one strategy but it doesn’t work for everyone. Everyone has their own need for different levels and types of support. The biggest support family members can give is love.

Working with the Family
I work with the family and the patient together and separately. Separation is necessary because venting needs to occur about what is happening. Working with the family members and patients together ensures that everyone hears everything said and the patient can’t say “I forgot.” The patient is there to witness the conversation.

The family sessions are centered on the best ways to support the patient in their efforts. There is a lot of information available about diabetes and re-education occurs. For example, any food is not completely off limits. Keeping that in mind, there is nothing they can not have ever again; all foods are available in moderation. The family diet will go to a healthier place, which might be good for the family, depending on their needs and goals. The family diet will probably experience an up level in nutrients, vitamins and minerals but it’s not going to shift dramatically.

Through discussion and asking me questions, I help family members understand and realize that the food shift is not going to be dramatic. Because there is so much education available without a professional and I don’t want to educate on what they already know, I ask family members what they know about diabetes. If they know a lot, I fill in the gaps and we don’t waste time.

The emphasis is focusing on the psychological impact of what they are going through as family members of a loved one with diabetes. I focus on the psychological impact between the family and the patient and practicing support techniques. The family learns how to support their loved one in a way that’s meaningful for the loved one, not to satisfy their own issues. I help create support techniques for the family and patient to use that helps the patient successfully go beyond their diagnosis.

A person with diabetes is going to experience more empowerment when the entire family does not focus on the diabetes and treat them like a disease. When a person is treated as the diagnosis it’s very difficult to shift away from that identity. When the person is treated like a normal person, that’s when the management of a disease can occur.

Watch for my next post on how the patient can support the family. Stay informed about what is happening at Ramey Nutrition by signing up for my free newsletter.

Type 2 Diabetes – Seattle – How to Support Your Family

2011-06-29T15:19:00.001-07:00

Type 2 diabetes and supporting your family requires patience. Family members, friends, and loved ones are going to make mistakes no matter how much training I give them and how many times I tell them to not make the dinner conversation about diabetes. There will be times when they do that because a diabetes diagnosis is the first time for them as well.

Family members are not trained in how to support someone with type 2 diabetes and one session with me is not enough, it takes practice. Having patience, encouraging the good support, and gently reminding a family member when they offer support that doesn’t work is critical. When feeling supported always make sure that the person supporting you knows you feel supported and they receive positive feedback.

Often the family will do really well supporting the patient for the first week in a way that doesn’t feel comfortable for them and they don’t receive positive feedback. The family has a different view of what support is best, such as making sure the right foods are eaten, wrong actions aren’t taken, and trying to control the situation. Especially when a loved one has a disease, there’s an uncomfortable feeling with the way the patient wants to be supported versus the way the family wants to support them.

When the family does support in the manner desired by the patient and positive feedback is not received, there’s this wanting to revert to old ways. When this occurs the family receives negative feedback such as “you weren’t even listening”. Notice the kind of support your loved ones give you, provide positive feedback and gently remind them when the support does go off track. For example, you could say: “I know you love me and want to support me and when you do ABC, it is wonderful but it doesn’t help as much when you do DEF.”

Family members come in about once a month to discuss support and communication. There needs to be practice in doing something new. Most family members don’t say “Thank you for supporting me the way I want to be supported.” It’s not normal conversation and it has to be practiced and honed. You may appreciate the support and because the feedback is not normally said it is an uncomfortable communication style that has to be learned.

Love and patience is the key between family and patient because the diagnosis is new to everyone. As the family and patient get better and better at communicating, things shift and people forget the new communication style but that is why regular check-ins are necessary.

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Type 2 Diabetes – Seattle – Beyond Type 2

2011-06-29T15:18:00.001-07:00

Often when a type 2 diagnosis is presented, the patient is sent to an eight hour class. The class covers exchanges in food, which is the correct portion size a diabetic should have every single time, and how to monitor that with different foods, vitamins, and water, how to exercise, and how to take medication. Usually the patient attends this class one day after the diagnosis is presented.

Since the information presented to the patient is new it creates a huge learning curve and they are expected to learn in all in one day. The class is multi-faceted including exercise, medication, food, insulin if needed, sleep, foot care, and what can happen if you don’t control your diabetes. Often times scare tactics are used, which are definitely motivators but not the way it should happen the day after the patient is diagnosed.

My comprehensive program Beyond Type 2 Diabetes is eight weeks long and covers the psychology, education, and exercise components.

I start out with an entire day on the psychology of the diagnosis. I ask these questions:

When did you get diagnosed?
What was your reaction?
How has your reaction changed today?
Where do think you’ll be ten years from now?
What are your biggest worries?
What are your biggest woes?

I don’t teach about diabetes because no one would be interested. The program is about the patients’ experiences and supporting each other in the process. My focus is always on the patient and their experience.

Every day that we have class, there is a check-in. I ask questions such as:

How did you do this week?
How did you feel this week?
Was it a good week or a bad week?
What are you coming up against psychologically?

The classes have a component of education to determine what people know and if there is any discord with that information and veering off into “I know I can’t eat sugar”, then I will gently bring them back to the research studies that have taken place that allow sugar in the diabetic diet. I take a very scientific approach. For example, I teach about what the pancreas is doing in a diabetic, which enables understanding exactly what the body is doing with food when food is eaten.

Most programs do not have the psychology component and they don’t combine the psychology portion with fitness. The combination of psychology with fitness works well because the patient is doing it. They understand the science of it and actually perform with the knowledge of what is actually going on with their bodies. Psychologically there’s a huge release of energy through the exercise and the huge release of the psyche and stress through the group. The patient is not only losing weight, but losing mental weight as well and in the process becoming more and more empowered.

A Typical Beyond Type 2 Evening
Group Setting – snacks and water are provided. In the group room, check-in occurs to see how things are going. The first week is spent on psychology, who are you with this diagnosis, who are you without this diagnosis, and who will you be with this diagnosis.

Workbook Exercises – this is about your own process, struggles, and successes throughout diabetes and beyond type 2. The goal is to figure out where you are with this diagnosis, where do you want to be, and what your goals are.
Group Closing – the group session closes.
Before Exercise – check blood sugar and weigh in. Confidentiality is kept and the numbers are not revealed.
Change into exercise clothes and exercise – gentle and motivating, fun, music, and camaraderie
Snack before driving home
Check blood sugar again

Other times you come in for exercise, group, or one-on-one sessions. Support group is offered once a week. One-on-one is every other week and is based on each patient’s struggles and successes as individuals and how they are doing with the group. The goal is to lower A1C and go beyond type 2 diabetes.

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