Sunday, October 13, 2013

Countdown to TTC: Week 43

Coqui the Chef Nutrition Workshop Building Healthy Habits

See a Nutritionist

Normally, I avoid seeing medical or health professionals unecessarily.  I believe preventative care is important, but the U.S. healthcare system really isn't set up for people to visit their doctors and other care providers just to check in.  Plus, as a graduate student I really don't like to do anything that increases my medical expenses.  However, a flyer in the office recently reminded me that my university provides several free services to employees and students to help them stay healthy or get healthier.  One of these services is an initial consultation and several follow-ups with a nutritionist.  Given my ongoing goal of getting ready for pregnancy over the course of this year, it seemed like a perfect opportunity.  So, this past week I added consult a nutritionist about preconception planning and weight loss to my list.  

In preparation for the visit, I had to track my food for several days.  Since I am a veteran user of SparkPeople, the only difficult parts about that were (1) being more self-conscious about my food choices knowing they would be scrutinized by a dietitian and (2) having to simplify my tracking to fit onto the form I was asked to use (since I usually make my food, I am often tracking a dozen ingredients per meal).  In the end, I brought both a filled-out form that was impossible to read and a super long printout of my food from the same days taken directly from SparkPeople.  The dietitian didn't seem to mind and actually looked more at my long, detailed printout.  

I really wasn't sure what to expect from my appointment, since I didn't have any choice over the dietitian and her philosophy--I was just visiting the person who works for my school health center.  The only time I've ever known someone to visit a nutritionist was if they had to lose a substantial amount of weight for medical reasons, which is pretty different than my situation.  Plus, a university is unlikely to employ someone to work with undergrads whose expertise is in chronic medical conditions.  So I shouldn't have been surprised when I came to the appointment explaining that I was frustrated with my current weight loss efforts because I am not losing pounds despite having recently reduced my caloric intake and tracking my food vigorously and her first question was "What would you say if I told you that you should stop trying to lose weight?"  

I don't think she particularly believes I am at an ideal weight, but she is a person who subscribes to a philosophy of being healthy at any size.  Throughout our conversation, she encouraged me to focus on healthy behaviors rather than fixating on the number on the scale.  She also pointed out that I may be making physical changes in preparation for weight loss right now (don't see any evidence of that, but who know maybe I'm stealthily gaining some muscle mass).  She also discussed some flaws with BMI as an indicator of health risk (click here for some alternative measures of ideal weight and here for an article about a new way of calculating BMI that may be more accurate for adults).  I have not yet found any research on the subject, but she suggested that even the "common knowledge" that BMI is directly linked to negative health outcomes may be flawed.  According to the nutritionist, studies which are able to include health-related behaviors directly in their analyses along with BMI typically find that body mass has not additional impact on health outcomes above and beyond healthy behaviors like exercise and eating right.  I don't claim to endorse this opinion, but it certainly gave me something to think about and I will want to research this more.

Although I have made a lot of improvements in my healthy lifestyle and the nutritionist was very positive about my health indicators like cholesterol levels, I still couldn't quite get on board with the idea that I should stop caring about my weight.   But I agreed with her that I am focusing too much on the scale and too little on the positive health changes I am making.  In the end, I didn't have a great answer to her question about my weight.  Honestly, if someone told me I don't need to lose another pound to be maximally healthy and ready for pregnancy, I just wouldn't believe them.  I'm sure I am at a weight that would make it possible for me to get pregnant and probably have an uncomplicated pregnancy, but I know I could have more energy and a fitter body to deal with the stress of growing a new life and then caring for a small child.  Perhaps getting on the scale every day and agonizing over the number isn't the right way to do that, though.  Based on my appointment, we agreed I would cut back to weighing in twice a week and pay attention to my hunger cues.  At my next meeting, we'll discuss making some changes to my eating habits that focus more on hunger levels than on how many calories I think I have "left" for the day.  It's a good start.  Hopefully the scale and my healthy improvements will match up soon, but if not I will try to focus on getting healthy with weight being a secondary component rather than my main indicator.  

For more in this countdown series, see last week's challenge about Planning with Pinterest.  

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