‘Stay consistent’ – success story: Simone de Pinho

Chat Leave a comment March 18, 2019 nutritionadsa

We chatted to Simone de Pinho about her journey with registered dietitian Michelle McDermott.

Why did you decide to see a dietitian? (the before story)

I have been a yo-yo dieter all my life. I struggled with my weight from the time that I became aware that weight means something in the world. I have lost a considerable amount of weight often but always put it back on as I failed to stay consistent.

The reason that I went to Michelle, which is the reason that I always start, is because I became so uncomfortably large that my only option was to lose weight. Sometimes I wished that I had a medical reason to lose weight (it might have pushed me to be more motivated) but my health has generally not been a factor.

Tell us about your journey with the dietitian?

Michelle is not like other dietitians. Her approach is one of realism, when all I strived for was perfection.

Michelle helped me realise that my excess weight was a result of emotional eating – although this could sound obvious to someone else, I only realised this when I would go to weekly sessions, see weight gain on the scale and then cry while Michelle tried to console me and give me the motivation I needed. How Michelle didn’t fire me during those weeks, months, years, I have no idea!

I think Michelle now knows me so well that she can see when I am motivated and when I am slipping. Michelle also gives the most amazing advice just when I need it. 

I also want to mention that my boyfriend and I see Michelle together. I can see how Michelle’s approach to a man differs to that of a woman and that is a testament to her experience and the wealth of knowledge that she holds! Our sessions are always fun (especially when we know we have stuck to our plan) and Michelle always gives us great feedback and measures all sorts of other things (such as body fat, water retention and metabolic calorie rate).

Tell us about your results / successes?

Most (if not all) of my over eating stems from emotional eating. This is something that I have researched over and over in an effort to understand it. I am successful with my plan when I remember to focus on eating healthily and within my plan. I am unsuccessful when I let me emotions overwhelm me and my brain literally doesn’t engage. Binge eating cannot be stopped no matter how much my brain tries to see the logic!!

I first started seeing Michelle in October 2014 and lost about 30kg’s from October 2014 to September 2015. I then started falling off the wagon and during 2016 and 2017 put all the weight that I had lost (plus an additional 10 kg) back on. In January 2018 Michelle put me on a strict medical weight loss program using meal replacements and I have lost 18.4kg’s in approximately 3 months. 

What was the hardest part of the journey?

Definitely maintaining the weight loss! The hardest part of the weight loss journey is not losing the weight, it’s about maintaining a healthy lifestyle and being consistent, after you have reached your “goal weight”.

The other difficult part is to actually start – for me it’s all about getting my mind right. Learning how to self-motivate has been a journey and is still a journey.

What are the top three tips you can share?

• Stay consistent

• Have treats but make sure you get back on your plan immediately afterwards

• Exercise is key to ensuring that your mindset is correct

What the dietitian says

Simone has been a dedicated patient and is a true example of how you can do things when your mind is in the right place. We have worked together to find a plan that works for her and all I did was provide the tools and the guidance – Simone did all the hard work after that and is achieving wonderful results. Starting on any new plan needs clear guidance,  goal setting and tools to make it work within your lifestyle so that the changes made can be sustained long term.

This is what a dietitian would aim to achieve with a patient as well as offer encouragement and  ways to make easy sustained changes to reach the health and nutrition goals of the patient.

Congratulations and well done to Simone – a few more steps to go!

 

To find a registered dietitian in your area, visit the ADSA website.

Success Story: Zandra Sissing

Chat Leave a comment February 8, 2019 nutritionadsa

Having been a runner from a young age, Zandra always thought “I can eat what I like” and just run it off …. until she couldn’t.  She met up with registered dietitian Maryke Gallagher to help her develop better eating habits that would complement her training and recently completed her first ever Half Ironman triathlon. Here is her story:

Why did you decide to see a dietitian? (The Before Story)

At the age of 38 I hurt my knee while running, and three months later had surgery.  I was off exercise for over six months, and during that time I ate: depression from a difficult relationship, depression from not being able to get out there and run, poor eating habits within the household.  My blood sugar and cortisol levels had gotten so disrupted I used to keep a glucose monitor with me.

Fast forward some time and I started training again, but was struggling to shake the weight.  Nothing I did helped, and if I wanted to keep the knee and joints healthy, I needed to do something.  I was referred to Maryke by my coach and that’s when my life changed.

Tell us about your journey with the dietitian

Firstly, I have an unpredictable schedule and she was so accommodating. Most of our communication was Skype, telephonic or whatsapp. Maryke took all this in her stride.

I have always thought I ate correctly, and had tried banting with no great success. Maryke taught me balance, how to realise when I was emotionally eating (and how to fix that).  She taught me how to include that one (or two) glasses of wine a week. Best of all, she taught me how to adapt my meals to meet my ever-changing schedule.  She did not give me an eating plan, she taught me which choices to make to suit MY body.  This sounds strange but even for my pre-run snack we went back and forth on options until I knew BOTH what worked for me and what I liked.

Tell us about your results / successes

My results were the things a runner dreams of: steady and consistent.  From a start of 74 kg I lost 6 kg to reach my goal of 68kgs.  I remember sending her the picture of the scale at 67.9kgs with great excitement.

I stopped looking at the scale but in my head I wondered if I could reach 66kgs, which my run coach had advised would be a good weight for me. It was a month later when I got on the scale and there it was: 66kgs!

I had lost almost 10% of my original weight, and a total of 9% body fat.  All the while enjoying life.

Since then, I have got married, moved home and changed jobs, changed countries and damaged a ligament in my foot. All these things combined have meant I could once again not run for a while.  The best part about having all the skills taught to me by Maryke is that I didn’t pick up the weight again.  I was able to deal with anything and still be healthy and happy.

What was the hardest part of the journey?

Starting out is the hardest part. The first weeks as you are learning and adapting. If you are consistent in the first few weeks, you see results and that really motivated me to keep going.  Think long term and not short term, because you want these results to last.  Changing my mindset to one that includes better carbs and fats.  Learning to remember that I need to eat for my body, and not for what works for someone else.

What are the top three tips you can share?

• Don’t design your eating from what you read on Google/social media/books. A dietitian takes years of study and trains to put this learning into something unique for you.  Different bodies, different solutions.  Do not be caught up thinking you need to do your eating in a “specific way”.
• Make sure you like what you are eating. You should not resent the food but enjoy a meal. Slow down your eating, enjoy the flavours and you will find yourself eating less.
• If you  need that 5pm snack, plan it in.  Many a time the snack suggested by Maryke has prevented a ‘carb’ craving dinner (you know that one where you walk in the door and open the cupboard, ready to consume anything ).  I now carry snacks with me every day to work.

What the dietitian says

I met Zandra for the first time through a Triathlon club meeting and noticed her bubbly and determined personality. A few months later she contacted me to assist her with her diet and weight loss goals – for health reasons and to achieve her training goals. She was motivated and questioning, willing to work through the main areas in her diet and lifestyle that were hindering her to achieve her goals. She was willing to let go of the ‘all or nothing’ approach of certain food groups and foods being ‘bad’ or ‘good’, to eating habits that are best for her personal needs. Seeing her achieve her weight loss goals slowly but surely, and most of all being able to make the necessary changes and develop a healthy relationship with food and her body was very rewarding! Thank you Zandra for choosing me to help you in this journey.

To find a dietitian in your area visit http://www.adsa.org.za

 

 

The Role of the Dietitian in Eating Disorder Treatment

Chat Leave a comment April 16, 2018 nutritionadsa

Eating disorders are complex illnesses with both psychological and physical aspects that require treatment. For this reason, over the past few decades, it has become more common for the treatment of people with eating disorders to be managed by multi-disciplinary teams which can deliver the necessary medical, psychological and nutritional help. As society’s foremost expert on nutrition, the dietitian has an important role on the treatment team for a person suffering from an eating disorder, and more opportunities are opening up for dietitians to develop as experts in this role.

Julie Deane-Williams, a registered dietitian and ADSA (Association for Dietetics in South Africa) spokesperson who has a special interest in treating people with eating disorders, points out that in some cases, the dietitian may also be the first port of call for help.

“Even though there are high levels of denial associated with disorders such as anorexia nervosa or bulimia nervosa, the dietitian is often the health care professional on call, especially when it comes to a person struggling with emotional/comfort eating or binge eating disorder. Typically, in the first session, a sufferer, usually female, confides that she is desperate to lose weight; reveals disgust at her body, even if she is within a healthy BMI (Body Mass Index) and feels shame that she has been unable to stick to a diet. The dietitian soon discovers that the emotional eater has tried many different diets. Patients commonly are keenly aware of the energy content of different foods but that doesn’t mean that they know much about nutrition. Often the patient hopes that the dietitian can provide a ‘miracle’ diet that is finally going to help her lose weight and keep it off.”

In combination, these are the warning signs for the dietitian who can recognise the symptoms of disordered eating. It is important that the dietitian doesn’t play into the patient’s scenario but instead helps them to acknowledge disordered eating and address it appropriately.

Deane-Williams makes it clear that the dietitian who works with people with eating disorders needs to acquire particular expertise and skills.

“It is important for the dietitian to understand how the different eating disorders develop and are maintained by patients, as well as to have sound knowledge of the medical, psychological and physiological aspects of the range of eating disorders. In order to play their role effectively on a multi-disciplinary team, they also need to have a general understanding of the mental health issues as well as the various psychological interventions and their applications. It would be an advantage to the dietitian to have expert communication, counselling and behaviour change skills. This is a relatively new role for dietitians, and the complexity of eating disorders demands education and training that goes beyond the minimum required to simply qualify as a registered dietitian.”

The dietitian who works with people with eating disorders plays an important role in the assessment, treatment, monitoring, support and education of the patient. As advocates of evidenced-based science, they serve as important resources of nutrition knowledge for the patient, the patient’s family and the other health care professionals on the treatment team. They need to be skilled at determining a patient’s nutritional status, eating patterns and behaviour, food rules and beliefs. It is the dietitian who takes into account the patient’s meal planning, food shopping and cooking skills. The dietitian works closely with other team members to understand how the patient’s underlying psychological and emotional issues impacts on their eating behaviours, as well as their motivation and capacity for behaviour change. The dietitian will work collaboratively with the patient to develop the nutrition aspect of the treatment plan, and to support the patient and the rest of the team throughout its implementation.

In the light of recent research in the UK that has attributed more deaths to eating disorders than any other psychiatric disease, Deane-Williams urges people with unhealthy relationships with food to seek help sooner rather than later.

“Using food, or the lack of it, to cope with distressing emotions and situations is a maladaptive way of managing life,” she says. “All eating disorders are addictions, and it is the nature of an addiction to further and further alienate a person from their own inner truth. Addictions also usually drastically stunt emotional growth. Once a person accepts that they have an eating disorder, and they seek good medical help, the healing journey is one that is difficult yet immensely rewarding. Not only can they recover, but they find out who they really are – bright and exceptionally intuitive people who had developed a coping mechanism to keep their ‘heads above water’ during extremely challenging times in their lives. Once they develop healthy ways of managing difficult emotions, they can go on to thrive, and create healthy and very happy lives.“

If you think you or a loved one might be struggling with an eating disorder, consider visiting a registered dietitian for expert guidance and advice. If you are looking for a dietitian in your area, please visit www.adsa.org.za