November is my birthday month, so it has me reflecting on getting older (and, I hope, wiser). In my midlife years, I’ve been trying to savor all the benefits of entering this stage of life, like caring less about other people’s judgements, feeling more appreciation for my body and what it can do for me, and focusing on what really matters to me - my values, my relationships, my inner peace. In a culture that demonizes any physical sign of aging, including natural body shape and weight changes, I view this as a necessary act of self-care.

When I explore my clients’ feelings about aging and the body changes they experience, I hear similar intentions. They want to be free in midlife (and beyond), not preoccupied with counting calories or following a diet. But many find body image struggles only intensify in their 40s and 50s and that social media is a huge reason for this.

What often prompts people to begin working on their relationship with food is distress they feel with binge eating.  Bingeing can feel chaotic, frustrating, or confusing, and it’s common to assume the bingeing itself is the problem that needs to be “fixed”.

Whether you’re getting home late from a long work day, trying to make lunch happen in the 10 minutes between meetings, or simply feeling a bit overwhelmed with life, some days cooking just isn’t in the cards. Luckily, you can quickly pull together a balanced, satisfying meal without turning on the stove.

I love to read, and I’m in two book clubs that meet monthly in person. We recently met during Halloween week, so naturally the topic of trick or treating and Halloween candy came up. I was hosting this month, and my stash of Halloween candy for the kiddos was sitting on my table, open because I’d been nibbling on some throughout the week. Amidst the chatter about favorite types of candy and Halloween night plans, one of the ladies said, “If I had Halloween candy around the house, I wouldn’t be able to control myself.”

It’s been hours since you’ve last eaten and it’s well past lunch time. You know you need food, but you don’t feel hungry and nothing you have sounds good. Even when you scroll through the options for food delivery near you, it’s all falling flat in your mind. You pick up a bag of tortilla chips and eat a few. They taste like nothing so you shove the bag back into the pantry and go back to what you were doing. You skip lunch, hoping your appetite returns for dinner, only to repeat this cycle at 7pm.

The hype around GLP1s is at an all-time high, with most Americans having heard of this class of weight loss drugs and a large percentage currently or recently taking them. The frenzy in the media, healthcare community, and public discourse is unlike anything I’ve personally seen for any weight loss drug or treatment in my professional career. It’s overwhelmingly positive, singing the praises of the new “miracle weight loss drug” we’ve all been waiting for.

Perhaps you’ve seen the terms “weight-inclusive care” thrown around on social media, or you have a friend who’s mentioned they’re working with a weight-inclusive dietitian or other healthcare provider. If the idea intrigues you but you’re not quite sure what’s different about it, or if it’s a good fit for you, this post will hopefully shed some light.  I’ll share my professional journey toward adopting a weight-inclusive approach as a foundational principle in my clinical practice, give you a little background on what the term means and evidence to support it as an ethical and patient-centered approach to healthcare, and then explore some specific ways we work within that framework to improve your health and relationship with food.