I hate diets. I hate the restriction diets demand. I hate the shame around diets. I hate the stress diets create; yet, I’m about to go on a very strict diet. To understand why I’m doing this, you need the backstory.
In 2010, I’m 27 years old. After a decade of avoiding bloodwork, my gynecologist basically forces me into a blood test, for which I was clearly overdue. The results of that bloodwork land me in the endocrinologist’s office awaiting a diagnosis. The doctor diagnoses me with Hashimoto’s thyroiditis, which is a surprise to me because I am feeling just fine. He prescribes a pill and sends me on my way.
Great! Problem solved!
The prescription is intended to treat hypothyroidism, and I’m delighted at the prospect of losing weight. I have been on a steady diet of 23 Weight Watchers points a day for the last month. I hope the pill will help me ditch enough weight to also ditch Weight Watchers.
The only thing that changes after the Hashimoto’s diagnosis is my daily dose of thyroid medication. I feel better than I had been feeling, but I didn’t think I was feeling that bad to begin with. The thought never occurs to me that I haven’t actually cured my Hashimoto’s.
Two years go by, and I find myself lying on the couch evening after evening, unable to muster the energy to do anything. I’ve spent my entire adult life leading mentorship groups for underprivileged youth, crafting, and enjoying the company of my husband and my girlfriends. All of sudden, I’m too tired to do all the things I’ve always loved to do. I can’t think clearly, and I never know when major stomach issues are going to strike. The only way I know how to cope is to stay home all the time. I’m afraid that if I make plans, I’ll be too tired to follow through; and if I’m not too tired to follow through, I’m likely to spend half the night in a public restroom with stomach issues.
Eventually, they fear of missing out on what my friends are doing gets the best of me. Against my better judgment—I make plans to go to a paint night with my girlfriends. At the last minute, I have to bail due to a combination of exhaustion and nausea. A couple of weeks later I make plans to attend a crafting workshop. Again, I bail. I miss everything—baby showers, bridal showers, dinner parties, and couples’ retreats. When I do go out, I’m so stressed about managing my symptoms that I don’t enjoy myself.
I resign myself to being a prisoner of my couch.
By this time, doctor’s offices and bloodwork are part of my daily routine. I have a legion of doctors with all different specialties, but none of them can tell me why I feel so terrible all the time; none of them suggest my symptoms could be related to my autoimmune disease. I don’t suggest it either because I’ve forgotten I even have an autoimmune disease. The original diagnosis was so anti-climactic—and so easily “solved”—that I never really thought about it again.
Months go by. I am chronically queasy and I can’t tell if it’s my symptoms or the result of the gallons of blood they’ve drawn to run endless panels of inconclusive tests. I’m eating more antacid medication than food on most days, and I don’t even have the energy to be pessimistic about this whole thing, so I wait.
Eventually, I receive another diagnosis: IBD. Irritable Bowel Disease.
The doctor prescribes a diet of white bread and rice; I comply.
I understand that some foods cause problems with my digestion and some foods don’t, but I have no concept of how food impacts the way my body functions.
I was raised in the Midwest on a steady diet of lucky charms and chicken breast. In high school, my mom would get up at 5 in the morning before my rowing practice to make two, egg, bacon, and cheese bagels. She understood the importance of eating when you’re exerting a lot of energy. She would occasionally throw in a, “make sure you have some protein,” and she always served vegetables with dinner, but that was the extent of her nutritional knowledge.
While I’m on my 100% carb 100% bland diet, my sister, Karen, suggests I learn how to cook and try to address my health problems with a diet-first approach, rather than the pills-first approach I’ve been taking for the last couple of years. She is super health-conscious and has been cooking from Diane San Filippo’s book Practical Paleo for a few months. The cookbook has meal plans for all kinds of health issues including thyroid health and autoimmune conditions; Karen is sure to remind me that I’ve been diagnosed with both conditions.
The autoimmune diagnosis from three years prior still seems irrelevant, but since I’m still on hypothyroid medication, I figure it can’t hurt to go on a thyroid health diet. What does hurt is the idea of a strict diet with lots of cooking, but I’m so tired of being tired that I agree to give it a try.
I order the book, and two days later I’m flipping through the meal plan for thyroid health. I’m on the phone with my sister and I tell her the meals aren’t nearly as unappealing as I thought they would be. At this point, she clarifies: “you have an autoimmune disease. You should follow the autoimmune condition meal plan.”
I flip to the autoimmune protocol (AIP)…
My first thoughts are No seeds? No nuts? No eggs? No tomatoes? No way!
But I am desperate enough to try it, and this is how it goes:
Day 0: Made a meal plan, got all the food.
Day 1: This is fun and scary. Am I really doing this? Yes, I’m committed to 4 weeks.
Day 2: My stomach hurts. I NEED sugar, carbs… oatmeal… oh, how heavenly something “healthy” like oatmeal would be right now. Everywhere I look I see food that I yearn to be able to eat.
Day 3: My stomach hurts. I call my sister. I’m having a breakdown! I can’t do this for 3 days let alone 4 weeks. She assures me I can. I feel better.
Day 4: My stomach hurts. I call my girlfriends. I can’t believe I’m doing this crazy thing. This really is horrible.
Day 5: My stomach is better. Maybe I can do this.
Day 7: I made it one week! Hallelujah!
Day 9: Hmm…I have more energy. I don’t crave sugar. I feel completely satisfied with the food I’m eating. Chicken thighs with the skin on, yes, please! Maybe this is working!
Day 14: Two weeks. I feel SO much better.
Day 21: I feel amazing. Full of energy, anxiety-free, clear-minded. I’m at a graduation party, and I’m happy to eat my food while surrounded by BBQ, cakes, cheese, chips, etc.. I have no problem at all.
Day 28: I’m not surprised I’ve made it four weeks. Not surprised at all. I feel great and now see the foods I’m avoiding as potential poisons for my body. As a bonus, I’m down 15 pounds.
The author recommends you follow the protocol until your symptoms get better. My symptoms were completely gone after 7 months. I stayed on the diet for 15 months.
This is my first foray into the idea that it’s often easier to follow hard and fast rules than it is to experiment. Since then, I’ve learned a lot about diets, and I can’t fathom being on such a restrictive, therapeutic diet for such an inordinate amount of time.
There are three types of diets in this world.
A therapeutic diet has a specific purpose and specific rules. In the case of the autoimmune protocol, the purpose is to reduce inflammation and the rules are no processed sugar or oils, no grains, no dairy, no legumes, no caffeine, no nightshades, no eggs, no preservatives, no nuts, and no soy.
Therapeutic diets are intended as a short-term way to address your goal, and it’s generally accepted that you won’t be on a therapeutic diet forever. Once you’ve reached your goal, you’ll transition to an experimental diet.
In an experimental diet, you strategically re-introduce foods that were off limits during the therapeutic diet, you observe how your body responds, and you decide whether or not it’s in your best interest to continue eating that particular food. The first time I ate tomatoes after AIP, I got a headache. The second time I ate tomatoes, I got a headache. By the third time I ate tomatoes, I was ready to give up tomatoes. Once you’ve discovered what works for your body and what doesn’t, you can settle into a maintenance diet.
A maintenance diet is a sustainable way of eating that helps you maintain your goal—which is not necessarily weight loss. It’s sustainable because you’ve decided what works and what doesn’t, and you get to decide if and when the decisions you’ve made about your diet need to change. A maintenance diet allows you to indulge when it’s worth it because you are making conscious decisions about what you want to eat based on what you know about the way your body responds. Ideally, this approach hones your awareness of how your body responds to certain foods, and your sensitivity to that prevents your diet, and more importantly your health, from spiraling out control.
It’s been eight years since my Hashimoto’s diagnosis. I’m a certified nutritional therapy practitioner. I am a certified eating psychology coach, and I’m in a bit of a health conundrum. My symptoms are back. My body has changed and the maintenance foods that were ok before aren’t ok anymore.
I know it’s time for me to revisit the autoimmune protocol, but I HATE the idea of it.
I’ve built my entire platform on intuition, self-compassion, stress reduction, and setting your own standards for what you will and will not eat. I’ve built my entire business on an anti-dieting agenda because I genuinely believe most people don’t need an extreme therapeutic diet. I believe restrictive diets do more damage than good. They stress people out. They create an obsession with food, and they desensitize people from their own intuition. Most people can start with an experimental diet.
But I am not most people. I need a therapeutic diet right now. My bloodwork, my energy levels, and my weight are the writing on the wall.
It’s challenging to navigate a therapeutic diet and maintain a healthy relationship with food. There are some fundamental things about a therapeutic diet that go against the tenants of eating psychology; yet, I have to go on this diet.
But I don’t have to go on this diet with the same mindset I had the first time around.
Instead of obsessing about what I can’t have, I will focus on why I’m doing this. The conversation shifts from, “ugh, I can’t have that.” to “I can’t have that right now, but it’s in service to a greater goal of figuring out my health.” Instead of using weight loss as my gauge for when I get to transition to the experimental phase, I will rely on how I feel. Instead of fighting my way through this process alone, I’m going to share what it’s like to be on a strict elimination diet while trying to maintain a healthy relationship with food.
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