Be compassionate. When the mean voice comes in, the downward spiral kicks in and that’s when people give up on their journey. Allow your body to fluctuate because that is a normal part of life. Allow yourself to eat whatever is available or whatever you are feeling like eating. That is perfectly healthy and okay. No one day of eating can possibly do as much damage as a restrictive diet can.
So many of us have tried dieting. All too often though, many of us lose 10–20 pounds, but we end up gaining it back. Not only is yo-yo dieting unhealthy, it is also demoralizing and makes us feel like giving up. What exactly do we have to do to achieve a healthy body weight and to stick with it forever?
In this interview series called “5 Things You Need To Do To Achieve A Healthy Body Weight And Keep It Permanently” we are interviewing health and wellness professionals who can share lessons from their research and experience about how to do this.
As a part of this series, I had the pleasure of interviewingRachelle Heinemann.
Rachelle Heinemann is a licensed mental health counselor in New York City and Brooklyn. She specializes in treating individuals struggling with eating disorders and disordered eating as well as depression and anxiety. Rachelle is trained in psychoanalytic psychotherapy, the deep work therapy, and has taught classes on eating disorders and body image to high school and undergraduate level students.
Thank you so much for joining us in this interview series! Before we dive into the main focus of our interview, our readers would love to “get to know you” a bit better. Can you tell us a bit about your childhood backstory?
Growing up, I went to school with people who were all like me, dressed like me, talked like me, had similar lives as me. Honestly, it was quite boring. I know people who would’ve done anything for that boredom, but maybe I was spoiled and I craved something different. I didn’t want to just finish high school, maybe go to college maybe not, get married, have 5 kids, have grandkids, and go to the gym every day. I wanted to make something for myself, something different and special that I can be proud of. How? I had no clue then.
What or who inspired you to pursue your career? We’d love to hear the story.
It was probably my therapists and analysts over the years that deeply inspired me the most to pursue a career as a psychotherapist. They taught me that I already had all the answers to my biggest mysteries. They taught me how to ask the right questions, find compassion for the parts of myself I’d rather not pay attention to, and really tease out my past from my present. Basically, the thing they helped me with is the thing I wanted to help others do. Maybe that’s cliché but clichés are clichés for a reason, no?
None of us can achieve success without some help along the way. Was there a particular person who you feel gave you the most help or encouragement to be who you are today? Can you share a story about that?
In middle and high school, I was that brazen kid who asked questions all the time and found a way to poke holes in every theory taught. Most teachers either got angry with me or didn’t know how to respond so they ignored me. Especially the math teacher. She avoided my raised hand at all costs. There was another teacher that almost failed a presentation I gave because I was too flippant talking about great scholars. (This was in my attempt to appeal to a bunch of bored 17 year old’s who, by the way, all loved the class.)
There was one particular teacher in high school that was different. She not only took the time to answer every question I had, she even gave up so many of her lunch breaks to continue conversations. I’m sure my teenage insolence was quite challenging. She was the first one who had the patience to ask what was behind my questions and give me the time of day. She taught me that I can ask whatever question I wanted, and she’d still be there for me. She showed me the power of unconditional support. And she allowed me to embrace my personality and say what I mean directly. I’ve learned to be true to myself, trust myself, and embrace reaching out for support, because of her.
Can you share the funniest or most interesting mistake that occurred to you in the course of your career? What lesson or take away did you learn from that?
On my first day of my counseling internship I had an intake scheduled with this guy who was at least twice my size. I think it was pretty obvious that I was terrified and kept stumbling over my questions. At a certain point, he’s like “uh, are you a student?” I mumbled something inaudible and he got up, walked to the door, and said, “Seriously? A student?” He left and never came back. After many conversations with my supervisors, classmates, and professors (I think they got bored after a while), I realized that although imposter syndrome is a real thing, it doesn’t actually mean I can’t do this. If anything, when you’re new, you bring a whole different perspective to the consulting room. In hindsight, just for some validation, my supervisor told me the intake probably should’ve been vetted better.
Can you share your favorite “Life Lesson Quote”? Why does that resonate with you so much?
“Until you make the unconscious conscious, it will direct your life and you will call it fate.” -Carl Jung
This is the motto by which my work is dictated. I see it happen every single day, with every single one of my clients. In fact, I see it with everyone I know. It’s really the only way to crack the code of your inner motivations.
What are some of the most interesting or exciting projects you are working on now? How do you think that might help people?
At the time of this interview, I’m working on launching my podcast, Understanding Disordered Eating. On the podcast I’ll be doing a combination of interviews and solo episodes all about healing from disordered eating and gaining a deeper understanding of human behavior. I’m hoping it’ll help people to adopt a more curious and less judgmental stance toward themselves in their efforts to work toward a healthy relationship with food.
For the benefit of our readers, can you briefly let us know why you are an authority in the fitness and wellness field?
I am a licensed mental health counselor specializing in eating disorders, disordered eating, and body image struggles. I am trained in psychoanalytic psychotherapy which is just a fancy way of saying “deep work, getting at the root of the issues work”. I’ve helped many individuals heal from their disordered eating and eating disorder and rediscover themselves.
OK, thank you for all of that. Let’s now shift to the main focus of our interview about achieving a healthy body weight. Let’s begin with a basic definition of terms so that all of us are on the same page. How do you define a “Healthy Body Weight”?
I want to preface the conversation by saying I’m an anti-diet clinician. I do not promote weight loss for the sake of weight loss and believe the focus must be on other indicators of health. Weight, in and of itself, is almost never an accurate indicator of health or lack thereof.
A healthy body weight is the weight at which the body is functioning optimally (all the organs and systems are doing what they are supposed to be doing; bloodwork numbers check out, and energy levels are balanced.)
How can an individual learn what is a healthy body weight for them? How can we discern what is “too overweight” or what is “too underweight”?
Healthy weight always exists within a range. We call it your set point. It means that when you are eating enough food for your body, this is the weight your body will naturally settle at, with a bit of normal fluctuation. The body will try its best to stay within its range. This is why playing around with your calorie intake is often ineffective.
If someone is concerned about their weight, I’d strongly encourage them to see a doctor and/or dietitian who is trained to work with eating disorders and who practices from a Health At Every Size and anti-diet perspective. They’ll know what to look out for specifically. You’d be surprised to learn that many doctors and dietitians aren’t well versed in this. Clinicians who are familiar with these issues will have you take some necessary tests (i.e. a full blood panel to check for various key measures, take your vitals, etc.) For those who may be concerned about more significant health concerns, they may do an EKG, bone density scan, etc.
Some questions to ask yourself are: for women, are you getting your period regularly? Do you feel energized during the day? Are you able to sleep well? How is your A1C, cholesterol, heart rate? Are you thinking about food all the time? (That one means you may be hungry.) The BMI chart or recommendations online about optimal weight for your height is not an accurate way of determining health. Someone may look to be what pop science dictates as overweight but, in fact, is at a healthy weight. Someone may look as though they are at an average weight and actually be underweight. Moral of the story: be a critical thinker and don’t take what Doctor Google says for granted.
This might be intuitive to you, but it will be instructive to expressly articulate this. Can you please share a few reasons why being over your healthy body weight, or under your healthy body weight, can be harmful to your health?
If someone is malnourished and their body is below their ideal body weight, they may suffer from heart issues, gastric complications, reduced energy, endocrine issues, cognitive impairment, bone issues and sleep problems. Sadly, all of this leads to increased mortality.
I think the media and medical community inundate the public with all the issues that are associated with being “overweight,” so I’ll be brief here. Metabolic issues, diabetes, loss of mobility, early mortality, and heart complications.
Whether someone is overweight or underweight, we have to look out for the likelihood that they also suffer from an eating disorder.
In contrast, can you help articulate a few examples of how a person who achieves and maintains a healthy body weight will feel better and perform better in many areas of life?
I prefer to focus on a developing a healthy relationship with food, because this will help you to not only maintain a healthy body weight, but also enable you to address the core issues that may have led to eating problems in the first place. Someone who is struggling with maintaining a healthy body weight will almost always have a complicated relationship with food. By addressing these underlying issues, they’ll have the mental and emotional bandwidth to focus on what actually matters in their life. They won’t be getting in their own way all the time, be able to make more deliberate decisions, and feel happier. This can look like increased concentration in school or at work, being more present with their friends and family, and feeling more emotionally balanced.
On the physical side, someone who is at a healthy body weight will have more energy and the ability to do all the things they want to do without feeling tired or faint. They can spend more time outdoors if they want, with friends, and engage in movement.
Ok, fantastic. Here is the main question of our discussion. Can you please share your “5 Things You Need To Do To Achieve a Healthy Body Weight And Keep It Permanently?”. If you can, please share a story or an example for each.
- Eat enough food. Most people knowingly or unknowingly don’t eat enough. This will almost inevitably cause them to binge later or go for foods that’ll give them a quick boost. It can happen over the course of a day, weeks, or years but the cycle will happen.
- Make room for all foods. By saying you can’t have certain foods, it creates a situation of energy scarcity which tells the body that when food is available, stock up. Think about the “diet starts tomorrow” way of life. You stuff yourself on cake that day as if it’s going out of style because it kind of is. By allowing yourself to have treats, there is no need to get it all in in one sitting. Over time, your body learns to trust you will make all foods available and this will become easier.
- Pay attention to emotional connections with eating. If someone is struggling with their mental health, it’s not uncommon to channel their feelings into food. This isn’t inherently a bad thing, but when someone continually makes choices that don’t align with how they’d like to behave we have to take a deeper look at the underlying issues connected with their relationship with food. (For example, if someone finds themselves running for the food table each time they get together with a certain group of friends, it’s worth a shot to explore what feelings, thoughts and memories these people bring up. What are you feeling with them? If you’re anxious, what is it about? How can you address your fears directly as opposed to turning to food?)
- Challenge the status quo. Just because the culture says you need to be a certain size, it doesn’t mean it’s healthy. You do not have to choose to subscribe to these expectations. Every body has a different set point at which it is healthy. Seek out help from a registered dietician or doctor well versed in this area to help figure out what that is for you.
- Be compassionate. When the mean voice comes in, the downward spiral kicks in and that’s when people give up on their journey. Allow your body to fluctuate because that is a normal part of life. Allow yourself to eat whatever is available or whatever you are feeling like eating. That is perfectly healthy and okay. No one day of eating can possibly do as much damage as a restrictive diet can.
The emphasis of this series is how to maintain an ideal weight for the long term, and how to avoid yo-yo dieting. Specifically, how does a person who loses weight maintain that permanently and sustainably?
I’ll start by saying that if the focus is on the weight loss (or gain for some people), you probably will never be able to stay at your set point. This is because the real problem, your relationship with food, is secondary to the number of the scale. Once your relationship with food and body acceptance becomes settled, the body finds its comfort spot and stays there. (For the most part, barring hormonal changes etc.) The best way to heal your relationship with food is to begin the process of intuitive eating. If you haven’t already read the book, I highly encourage you to do so. It’s called Intuitive Eating by Evelyn Tribole and Elyse Resch. Intuitive eating is a framework that encompasses physical and mental health to work toward a healthy relationship with food. It is comprised of 10 principles that revolve around learning your body and its signals (both physical and emotional), paying attention to and respecting your body, and gentle nutrition.
What are a few of the most common mistakes you have seen people make when they try to lose weight? What errors cause people to just snap back to their old unhealthy selves? What can they do to avoid those mistakes?
Wanting a quick fix. Focusing only on weight loss. Following restrictive diets. Subscribing to ridiculous beauty standards. Ignoring underlying issues related to food behaviors.
Besides for embarking on the intuitive eating journey which I’ve mentioned above, it is really important to begin exploration about your relationship with food and body. Some questions you can ask yourself are:
What is my food story or narrative? How was food, eating, and bodies talked about when you were growing up? How have I integrated all of that into my life now? How is continuing to think and behave this way protective for me? You can journal on these and/or seek out a psychotherapist who is well versed in this.
How do we take all this information and integrate it into our actual lives? The truth is that we all know that it’s important to eat more vegetables, eat less sugar, etc. But while we know it intellectually, it’s difficult to put it into practice and make it a part of our daily habits. In your opinion what are the main blockages that prevent us from taking the information that we all know, and integrating it into our lives?
Resistance is the term that psychotherapists use for “getting in our own way.” It’s our psyche’s way of protecting us. It may seem counterintuitive; how can a behavior like bingeing be protective? Behaviors that seem to be hurting us now may have played an important protective role earlier in our lives. We may not remember how or why, but when the behavior was established it was meant to help us to adapt to difficult situations. Something in our formative years was upsetting, and letting go of these protective behaviors continues to feel scary as a result. Making these protective measures conscious will help us to modify them slowly, over time.
Let’s use the example of bingeing. When Cassidy started bingeing she was 12. At around that time, her parents were getting divorced. She felt lonely and scared. For forever it seemed like her parents were fighting, and when she felt clingy or anxious she was usually met with anger or indifference. The one thing that was not missing from the home was an abundance of food. Cassidy learned to soothe herself from her fear and loneliness with food. For us to tell Cassidy today just to “eat healthy” and “cut out carbs” and “just exercise” is to ignore the avalanche of fear and loneliness that she does not yet have the tools to cope with. By working gently with how her coping behaviors formed and how they kept her safe, she can learn to tolerate difficult emotions without turning to food.
On the flip side, how can we prevent these ideas from just being trapped in a rarified, theoretical ideal that never gets put into practice? What specific habits can we develop to take these intellectual ideas and integrate them into our normal routine?
Similar to what I’ve been saying thus far, it’s pretty impossible to follow a list of habits to accomplish the above. You may hear people saying things like “having a morning routine is imperative” or or “do more movement,” or “incorporate meditation”, the list can go on and on. I’m not saying any of these things are bad, I’m just saying the point is that you know all of this already. You just keep getting in your own way.
If you haven’t already, I’d suggest you look for a therapist and/or dietitian who specializes in eating disorders and disordered eating. They can help you look at your life individually and work through your difficulties. At the very least, go get the Intuitive Eating book. And start asking yourself some questions:
- How was food, eating, and my body talked about when I was growing up?
- What am I hoping will change when I achieve my perfect body?
- What would I be afraid about if I couldn’t diet ever again?
Ok, we are nearly done. You are a person of great influence. If you could inspire a movement that would bring the most amount of good for the greatest number of people, what would that be? You never know what your idea can trigger.
To make psychoanalysis cool. We’ve done a pretty decent job tearing down the stigma of therapy and this would take it one step further. For a long time, if someone needed help with an issue, it would always be about symptom reduction in the fastest way possible. Kind of like dieting. Even if it does work, it probably won’t help long term. You have to dig deeper in order to heal completely.
We are very blessed that some of the biggest names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US, whom you would love to have a private breakfast or lunch with, and why? He or she might just see this, especially if we both tag them 🙂
I’d have to go with Brene Brown. She is a genius and a vulnerability expert. Treating eating disorders is basically treating a disease of isolation; difficulty with trust and vulnerability is a common theme. Her work on vulnerability and trust has had a profound impact on me and so many of my clients (well on everyone who is familiar with her work.)
How can our readers further follow your work online?
You can find me at my website www.rachelleheinemann.com or follow me on IG @rheinemannlmhc. And stay tuned for my podcast launch!
Thank you for these really excellent insights, and we greatly appreciate the time you spent with this. We wish you continued success.