I am honored to connect with Dr. Sandi Scheinbaum today.
Dr. Scheinbaum is the Founder of the Functional Medicine Coaches Association, an initiative focused on helping practitioners and businesses hire health coaches who focus on chronic disease and reducing healthcare costs. She is an educator and clinical psychologist with a career spanning over 40 years, lecturing prolifically on the psychology of well-being, mind-body medicine, and the psychology of eating, and writing several books on health coaching, panic attacks, and anxiety.
In our conversation today, we dive into nutrition confusion, scientific evolution, biased myths and beliefs, contradictory messages, and how cognitive dissonance affects people’s eating patterns and attitudes toward food. Dr. Scheinbaum shares how she transitioned from being a vegan to becoming an omnivore, and we explore the role of Erikson's stages of development and family dynamics in shaping theories and behaviors around food. We look into the psychology of eating, social messaging, and the consequences of appetite judgments, food shame, and orthorexia. Dr. Scheinbaum also explains how to find local practitioners who can assist you in navigating your relationship with food, mind-body medicine, and cognitive-behavioral therapies.
Stay tuned for today's insightful discussion, where Dr. Sandi Scheinbaum unravels the psychology that shapes our eating patterns, attitudes, and approaches to food.
IN THIS EPISODE YOU WILL LEARN:
Why is there so much confusion around nutrition?
The psychology of food labeling
How eating habits get shaped by childhood experiences and cultural influences
How we need self-compassion without judgment to develop a healthier relationship with food
The potentially negative impact strict food rules can have on the mental and physical health of children
How social influences and the desire to fit in affect people’s eating habits
Dr. Scheinbaum tells her story of shifting from veganism to becoming a meat eater
How gender differences impact eating habits
The benefit of having a health coach to support lifestyle changes
How thoughts and physical sensations are interconnected
Bio:
Dr. Sandra Scheinbaum trains people to become Functional Medicine health coaches and helps practitioners and businesses hire them because she believes that health coaches are the key to combating chronic disease and reducing healthcare costs. As the Founder and CEO of the Functional Medicine Coaching Academy, a collaboration with The Institute for Functional Medicine, Sandi is a leader in the field of health coaching education. As an educator and clinical psychologist for over 40 years, she has lectured extensively on the psychology of well-being, mind-body medicine, and the psychology of eating. She wrote several books on health coaching, panic attacks, and anxiety. Sandi founded FMCA at age 65 because, rather than retiring, she is on a mission to grow the health coaching profession so that millions of people can get the support they need to lead healthier lives.
“Our attitudes toward food start when we are really, really little.”
-Dr. Sandi Scheinbaum
Connect with Cynthia Thurlow
Check out Cynthia’s website
Submit your questions to support@cynthiathurlow.com
Connect with Sandra Scheinbaum
Books Mentioned:
Salt, Sugar, Fat by Michael Moss
The Dorito Effect by Mark Schatzker
Transcript:
Cynthia Thurlow: [00:00:02] Welcome to Everyday Wellness podcast. I'm your host, Nurse Practitioner, Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.
[00:00:29] Today, I had the honor of connecting with Dr. Sandi Scheinbaum. She is an educator and clinical psychologist for over 40 years. She's lectured extensively on the psychology of well-being, mind-body medicine, the psychology of eating, and has written several books on health coaching, panic attacks and anxiety and she founded the Functional Medicine Coaches association that helps practitioners and businesses hire health coaches who we feel are key to combating chronic disease and reducing healthcare costs.
[00:01:01] Today, we spoke at length about nutrition confusion, the evolving science bias, myths and beliefs, contradictory messages, cognitive dissonance, the impact on eating patterns, our attitudes towards foods, her story going from being a vegan to an omnivore, the role of Erikson's stages of development and families that helps impact theories and behaviors around foods, the psychology of eating as well as social messaging and the impact of appetites, judgments, food shame and orthorexia, keys to finding practitioners in your area that can help you navigate your relationship with food and lastly, mind-body medicine and cognitive behavioral therapies. I know you will enjoy this conversation as much as I did recording it.
[00:01:56] Welcome, Dr. Sandi. I'm so glad we were able to coordinate calendars finally and bring you on as a guest. You are a wealth of information and I know that my listeners will really enjoy our conversation.
Dr. Sandra Scheinbaum: [00:02:07] Thank you. I'm so excited to be here talking with you.
Cynthia Thurlow: [00:02:11] Absolutely. So why do you think there's so much confusion around nutrition? I know this is a topic you and I are very passionate about, but is it the messaging that we're receiving from food companies? Is it a combination of misinformation that we receive from well-meaning healthcare practitioners? What is contributing to all the confusion? Because I know when you were still seeing patients, you saw this yourself. And I certainly feel like almost every day across social media, my team and I will field questions specific to what to eat, when to eat, and all the things that impact those decisions.
Dr. Sandra Scheinbaum: [00:02:50] It's a number of factors. It is very, very confusing because this is not an exact science. It's constantly evolving. But we have our food myths, so we have our beliefs that came from time when we were perhaps much younger, where there were certain theories, we accepted those theories. But then we may see a study and it contradicts what our previous belief was. So now we're maybe questioning that or maybe we dig in our heels a little bit more to say, “No, the study was flawed and a lot of those studies are flawed.” And most people don't go further than the headline. So you wake up one day and it's front page news, “Coffee will kill you. It's bad for you.” And then you go to maybe another source or an expert you'll be scrolling on Instagram and somebody will say, “Coffee is the best thing. You should be having three, four cups a day. Great for dementia, for example.” So you don't know and you become very confused because you don't look at the data, you don't dig into the research.
[00:04:02] Well, how was the study done? How many people were participating in the study? Was it observational research? Nutrition research is so difficult. People don't remember what they had for breakfast this morning, let alone if they're asked to recall what they ate several days past, for example. They're notorious in underreporting, overreporting healthy food. So there're flawed studies. And many of the-- if you want to be exact and do some of the studies that would beg to be done, you can't because they're on human subjects. And so, then you have animal studies and then, “Well, okay, does that transfer over?” So there's a lot of confusion about the studies that are out there. And for many people, food and attitudes towards food, attitudes towards eating has becoming like a religion. It's dogma, it's politicized. So you have your camp. I'm carnivore. I'm plant based. And the farther you go to those extremes, the more you are so set in following this that you put on blinders if there's any attempt to contradict.
[00:05:11] And I saw this all the time when I was working as a psychologist, where they would dig into this belief that all animal foods are bad. I can't touch. I can't even take fish oil. And when you would question them, it was traumatic, and they were so set in these beliefs. And so, yeah, I wish it were different, but the science is constantly changing. And the best thing is to question and there's a character strength of judgment where you weigh both sides, you weigh the evidence. That's what we're lacking.
Cynthia Thurlow: [00:05:46] Yeah. I think that you bring up so many good points that there are limitations to the existing nutritional research that's being done. And it's woefully unrealistic for every research scientist to control every single variable about our diets because the only way to really do that would be to keep humans for three to six months in a controlled environment and that's not realistic. And then I love that you touch on this rigid dogmatism. And for full disclosure, I think there are things that have worked well for me as an example, like when I was in the hospital for 13 days, I was full carnivore for nine months. And that helped me heal my gut. And it wasn't that I didn't want to eat vegetables as an example, it's just that the fiber really inflamed my gut. And so, I had to kind of slowly work towards a carnivore-ish diet. But that doesn't mean that there's not therapeutic value for someone to consider a carnivore diet for a short period of time. And if there are listeners that have been doing carnivore for years and that works for you, that's great. I'm not being judgmental of that. I think the power of bio individuality is something that I think we both speak to. That for each nutritional paradigm, there are probably bits and aspects that work for many of us.
[00:06:55] And I think that's something that's so missing from the traditional messaging that healthcare practitioners are not saying to their patients. I'd really love for you to experiment that makes people uncomfortable, that in many ways they want to be told, this is the paradigm you should-- this is the bucket you should fall into, and it should work for everyone. Just like intermittent fasting doesn't work for everyone. As great of a strategy as it is, I acknowledge it doesn't work for everyone. So really fine tuning, what makes you feel like you have good energy, what impacts your sleep in a positive way, what makes you be able to maintain a healthy weight? And for each one of us, that's a little bit different. And so, you are so right that there are so many factors that impact the messaging that we are receiving and then even the messaging that we receive as children and young adults, depending on the families we grew up in. I grew up with an Italian mom and she was crunchy before we even had that term. But we had homemade everything and we ate organ meats much to my dismay. I'll be completely transparent. I didn't like eating liver, not even as a child, because it was very metallic tasting. But I think as I got older, I really appreciated that I grew up that way because it certainly gave me a different perspective than perhaps some of my peers.
[00:08:08] And when you're working with patients and talking to patients about their childhood experiences, the impact of their families, I'm sure that you probably see a wide range of experiences, both positive and negative. So as an example, if someone grew up eating a hyper-processed diet and 70% of Americans are eating most of their nutrition from hyper-processed foods, and we know there's a lot of research to identify the problems that can come from that. For you, being a mental health expert, I'm sure depending on the way that people ate, it probably impacted how they felt about themselves and their behavior vis-a-vis with others.
Dr. Sandra Scheinbaum: [00:08:45] Oh, absolutely. So I've always been really fascinated by the psychology of eating. And there's that old saying, “You are what you eat.” And I've looked into how we come to have attitudes towards food that start when we're really little and how they evolve and how they change. So I want to get back to something that you said about being carnivore, because I think that is so critical. And that is, it was for a short period of time, you were doing an experiment and you were open to discovery. I wonder how I will feel, I'm going to heal. But you did not have that all or nothing belief. I will never, never eat a plant again, carnivore is the way for me, this is it. And I think many people fall into that trap and it does start. Our attitudes towards food start when we are really, really little. And it is how someone is described is often based on how they eat. And it starts when they're really little. And we describe our parents that way. Like, “Oh, we ate processed foods. My mom hated to cook.” Or as you just said, “She was giving us really homemade, nourishing meals.” So we learned from our parents, but they also describe us.
[00:10:08 So, I have twin grandchildren, they are 15 months, and they are in their twin high chairs, and there are differences. So one is very delicate, she takes a blueberry and it's like, precisely gets it to her mouth and studies it. Whereas the other twin, he is like, scoop it up, shove it in his mouth, half of it goes on the floor. So what do we do as parents or as grandparents? One's a messy eater, she's a picky, she's a meticulous eater. And these labels stick. So how your personality is really tied in to how you approach food and how people then label you. So the good eater, baby, is she a good eater? And then what about if the good eater starts to eat too much and then they start having weight issues or the picky eater becomes the picky child, the difficult child because she won't eat or he or she is just eating everything in sight or has these radical food preferences. And so, it starts there and then a lot of times, parents are, it's stressful. And so, of course, just like you may say, “My child's not going to watch TV.”
[00:11:28] My toddlers and I, we're going to just have all these books and interactive activities. All of a sudden, you've got a stressful day, you're working from home. You find that, okay, the iPad, the TV, well, it works. And same thing with food. So you may set out with really good intentions. I'm going to have all home-cooked meals and from scratch. And, well, then what happens is you're harried, you're home from work, you're tired, and so you reach for something that is processed. And that's where the food companies know this. And they are so, so good at hijacking our taste buds. They spend billions of dollars on research for that combination of sugar, salt, and fat. Then it's a true addiction that can take over. So, of course, they're going to want that over perhaps your homemade version. And so, it really does boil down to balance as opposed to an all or nothing. Again, we're going to that not, they'll never have any processed food. They're never going to have a snack that is just store bought or something that might be ultra-processed. But it is how you balance that with other foods that are homemade, nutritious, whole, unprocessed foods.
Cynthia Thurlow: [00:12:42] I think you bring up so many good points. It's about finding balance. I know when my boys were younger, now they're teenagers and one drive, so if he wants to go get Chick-fil-A, he could easily do that without-- And he has a job as a teenager, he could go easily do that and I would never know. But when they were younger and I prepared every single meal, I was so fully entrenched as a parent. And then you start to realize as they go to birthday parties or they go to school, they get exposed to different things. I have one child who, he has some food allergies to peanuts and tree nuts. He's a little more sensitive. So, if he were to eat Chick-fil-A, he would get digestive distress. He would be the first person to tell me it tasted good at the time. And then I feel miserable afterwards. And then my other son, when he was younger, if he had artificial food dyes. Both my boys have been well-behaved young men, but he would go from being a well-behaved child to all of a sudden just being super hyperactive, couldn't control his mouth, couldn't control his body. And I would say to my husband, it's red dye number 40. We got to the point where we knew, don't ever give him liquids with that in it. If you went to a birthday party, it was always a disaster afterwards until he kind of worked it out of his system.
[00:13:53] But acknowledging that it is okay if 90% of the time you are eating a nutrient dense whole foods diet and doing most of your cooking. When I say most of your cooking, meaning I'm a realist, I acknowledge not everyone can do 100% all the time. I think you can get away with a little bit of meals out, and if you have a bag of chips, I don't want people becoming the other direction of being orthorexia. That's one of the concerns that I have, is that we can go on to develop very unhealthy relationships with food and starting to call things good and bad and being very pejorative about our relationship with food. And so even though I tell my children this, like, listen, you spend most of your time during the day away from your parents, so you know the things that make your bodies feel good and you acknowledge the things that make you feel not so good after the holidays and a lot of sweets and eating out. And both my kids were like, “I can't wait to get back to eating the way we normally do.” But having said that, helping people understand that giving yourself grace is certainly very important. That internal dialogue that we have with ourselves is very important.
[00:14:57] I think that we should speak to ourselves lovingly and without judgment, because many of the things I hear, especially from women as an example, are that they judge themselves so harshly. They're like, “I can't believe I ate X again. I can't believe I ate that box of cookies or that bag of chips or whatever it is.” Helping people understand that you can find a reframe and get back on track. And helping people understand that we're not suggesting that everyone eat this pristine, monk like lifestyle. That's not what we're advocating. What we're advocating for is attempting to determine what foods make your body feel good, eat more of them, and avoid the foods that don't make your body feel good. I mean, those two simple premises alone can be very, very impactful.
Dr. Sandra Scheinbaum: [00:15:42] Absolutely. And that's really the message that you want to pass on to your children. And I love what you said about your son, coming to that realization himself. I was a walking example of what not to do raising kids, my two daughters. So this was in the 80s, early 90s, and I decided-- I read Diet for a New America and I was going to be a vegetarian and then later a vegan. So I raised them that way. This was the days before whole foods. I had a food co-op with a bunch of friends. We would get caseloads off a truck of organic and they were raised that way and had some time, which one of the biggest mistakes I made was thinking that it was okay for kids to be vegan. And I look back and if there was one thing I could have done differently, there are many things I could have done differently, but that was definitely one. So I was so self-righteous. I thought that everything I did was right. And what happens when you have these food rules that go to the extreme, and I've seen this where kids are not allowed touch that cake at a birthday party.
[00:16:49] They are the distress that you are causing and the upset psychologically or as a family system can really be more deleterious to their physical health and your physical health than letting them have the treatment. Unless they have celiac diseases, unless they have life-threatening food allergies where they need an EpiPen. But people decide that-- I've seen people say, “Well, they don't eat gluten, they don't eat soy, they don't eat corn, they don't eat sugar.” And so, they are really at a disadvantage in terms of they are going to rebel. And we can talk about the stages of development and what happens when they reach adolescence or by middle school. So having that sense that you decide, “Well, okay, there are certain things you may decide, this is how I'm going to run my household.” But having it too dogmatic. And I remember having argued. My husband took my younger daughter to a McDonald's. I'm like, “I went ballistic McDonald's. How could you do this?” And so, the stress of that so many times that when I look back at family events say, “Well, why did I get so upset about what they were eating?” My younger daughter said something to me a few days ago. She said, “You know mom, they were over with their twins.”
[00:18:03] And she said it was a Christmas Eve and we ordered Chinese food. And she said, “It was so nice to be with you that you just ordered off the menu and you didn't make a big deal about the seed oils or what you were eating or have your own food as opposed to eating what we were eating. Said it was just such a nice experience.” And that really meant a lot because she remembers, my other daughter as well, times when occasions were ruined, I would go to a restaurant and, oh, I didn't even have to say anything, but they could tell by my body language unconsciously, that I was disapproving of what they were ordering. And so two words that come to mind, if you think you know what's good to eat or for your kids to eat brown rice, because that was it. In that time period, I was macrobiotic for that-- brown rice was like I would remember walking out, ‘Oh, my God, they don't have brown rice. This is terrible.” Well, what are we finding today? We're finding that Dave Asprey talks about that, our mutual friend. Like, it's the white rice that's actually better for you than the brown rice, which is full of arsenic. So, who knew?
Cynthia Thurlow: [00:19:12] Yeah. No. And I thank you for sharing your story. And I think it really speaks to the fact that we even as parents, we evolve. I will share with my community. I don't know if I've shared this before that from the time that I've had my very first dog, I stopped eating mammals, I still ate fish, and I ate poultry, and I ate plenty of protein that I thought at that time until I met Dr. Gabrielle Lyon four years ago. Having said that, when I was hospitalized in 2019, the thing that I thought about, I though about two things during my 13-day hospitalization. Number one, was water because I was so dehydrated. Number two, I thought about a bloody burger. All I wanted was a juicy, rare to medium rare burger. And from that point on, I started eating mammals again. And I will never forget. My oldest son thinks this is the funniest thing. They ate turkey bacon for, like, the first 10 years of their lives. And so, when I got out of the hospital, first thing I said is, “Okay, there's no more turkey bacon, which we all know doesn't taste all that great.” And so, my kids were like, “What is this?” I was like, “That's pig bacon.” They were like, “Oh, my God, this is amazing.”
[00:20:13] And so, understanding that my own issues, it's not even that I'm being pejorative with myself. I thought that was the right decision for me and my family at that time. And now they laugh about the fact, like, mom will order steak or bison most days of the week or make that at home and rarely eats poultry and eats fish occasionally. But it's like the whole paradigm of nutrition shifted. And I always tell my kids, “Listen, know better, do better.” So if you at some point in the trajectory of your nutritional philosophies have evolved. That's a sign of someone that is open minded, that is working on their internal personal development. And I always say, “Know better, do better.” And so, there's no judgment for any of us. My mom, for a period of time, was vegan for over 10 years and it's taken a long time to get her health back on track because there were so many years where she was chronically undereating protein. And she's now retired. She's 77. She talks openly about this. I'm not sharing anything that my mom doesn't talk about herself, but she says all the time. I just didn't realize how much better I feel eating an omnivorous diet. So eating plants and eating animal protein. And so, for each one of us, if what you're doing isn't working, it's okay to change or shift, your perspective, and your narrative internally and externally?
Dr. Sandra Scheinbaum: [00:21:34] Oh, absolutely. And our mutual friend, Dr. Gabrielle Lyon, she was the one who convinced me. Yes. And now I am carnivore-ish most days and I would never, never order a steak in a restaurant for example. And now, yeah, I eat mostly meat and love it and crave it.
Cynthia Thurlow: [00:21:54] Yeah. It's amazing how that happens. Now, you kind of alluded to Erikson's stages of development, and I think this is particularly helpful for listeners to understand these. And if anyone has taken human psychology, you've been exposed to this. But not only how does that impact how our children are navigating food choices? And I'm speaking to parents of teens in particular, because now the teenagers will push back a whole lot more. If there's something they don't want to eat, I'll say, “Can you just eat some broccoli? Like, eat two bites of broccoli?” Sometimes they'll say, “I just don't want to.” But how these stages of development impact not only ourselves and our families, but also the dynamics within our families.
Dr. Sandra Scheinbaum: [00:22:34] Sure. And when he did his original work, we're still in very much of a traditional way of looking at particularly gender differences. So his theories are now interpreted as being much more fluid than they were at the time. But generally, you can look at each stage and see it played out in food, food choices and eating behaviors. So what's most crucial when you're an infant, trust. That trust that when you're hungry, that milk will be there. And then you get to a stage beyond that, which is about 18 months to round two, where it's all about autonomy, me, me, me, me. And so that's where we [unintelligible 00:23:17] about the terrible twos. And so, they will have fits. They'll only want to eat a certain food or they'll reject, they'll throw what they don't want. And that can be very, very challenging. And often parents feel very guilty about that. And the more you can give them some choices and then the next, there're other stages, the preschool stage, where there's still like initiative and then you reach what in Freudian terms is called latency. The school age, those are blissful. And that's where you find the kids want to take cooking classes, they'll cook with you and they're much more obedient at that stage. And so, you may falsely think, “Oh, I have these food rules and they're so compliant and it'll always be that way.”
[00:24:02] But then the next stage, which is it could happen at middle school, adolescent in high school and definitely they go off to college. And that is identity. That's their task to have an identity. So how is that displayed? Well, if you have kids and I know you have son, going off to college, they come home at Thanksgiving and there's some change. They've changed their politics, their political views, but it's often over food. It's often if you raise them as I did, as vegans, vegetarians, they're going to-- my daughter, she's like, “Yo, my God, we stopped it. Oh, that beef jerky was so good-
[laughter]
[00:24:38] -on the road.” They are establishing that. Or if it's the opposite, you're going to have someone come home and say they're a raw vegan, plant based and reject everything that you are cooking for Thanksgiving. And so often battles ensue because of that. And then you get to a point where there's the role typically in the 20s, but it's pushed back to the 30s where it is intimacy to have connection with somebody and we are so influenced by our peers, what we eat and how we eat. So, I've had people say, “I'm in a restaurant and I was with my friends and I didn't really want that, but I ordered it because I was feeling like shameful or embarrassed or I would be judged if I didn't eat what they're eating.” So, it's like from Harry Met Sally, “I'll have what she's having.” Well, yes, you do it. You may not want to do it. We see it often play it out around alcohol because you don't want to upset people. You don't want to be judged as being different. And this can start in grammar school, middle school as well. But it is often you are what your friends eat. And then you get to a point where often habits change in your 30s or 40s.
[00:25:58] Now, maybe you have a family, you have a career, you are looking at leaving a legacy. And so, you're starting to think about, “Oh, I'm going to start, maybe I should work with a nutritionist, maybe I should get a personal trainer, maybe I'm going to get in shape. And so that's the time for that.” And then there's another category that we often ignore, and that is as we get older, and it's ego integrity versus despair. What is ego integrity? Well, you're curious about the world around you. Maybe that means you're going to have new adventures. Maybe you're going to change how you're eating. I see this now. I'm like your mom. I'm in my 70s, about to be 74. And amongst my friends, they are stuck just like they have the same hairdo, the same makeup, the same dieting approach. They're calories in, calories out. Often they've had success with Weight Watcher or they are focusing on old theory because they are not curious, they're not reading new things, they're not focusing on moving forward. They're just focusing on the past.
[00:27:00] And when we get into serious old age, it's losing appetite, you're lonely, you're alone. And I saw this with my mom where she would only eat ramen like packaged, awful, because often your taste is compromised. But so, if you're listening and you have older parents to make sure that they are not starving themselves. And usually, it's with protein. And that's an area where we see so many issues, particularly with women, with animal foods, for example, the gender differences, we can get into that as well, kind of the traditional gender differences that really shape our habits.
Cynthia Thurlow: [00:27:38] Yeah. I think it's really important just understanding that whether we are lifelong learners, whether we are able or capable of being flexible or trying new things. I do see in my parents a degree of rigidity now that I didn't see when they were younger. And I think that's a byproduct of many factors. But people may be listening and they may say family members, loved ones, we start noticing they want to eat dinner at 5 o’clock, they're rigid about that. They only want to eat four or five foods. That's how my dad has become. He's very focused on probably four or five foods and that's all he eats. And I think as an example, he's chronically under nourishing his body, to your point about the protein piece and I think that for a lot of individuals, whether it's changes when they become empty nesters, whether it's changes in job roles, whether it's changes in their relationships with their significant others, I think some people weather that better than others if they've done a lot of personal development. I feel like personal development is one of the most important things I do for myself, just so that I can continue to show up as a healthy, well-adjusted adult.
[00:28:45] And maybe it's pivoting and making changes. Maybe it's changing relationships that I have with friends. I always say I've been very fortunate that most of my friends I've had my entire lifetime, but sometimes friendships aren't meant to be lifelong friendships, and acknowledging that that's okay as well. When you talk about the gender differences, what are some of the things that you saw with your patients in terms of men versus women? You mentioned CICO, so calories in, calories out, which is what I was taught as a clinician, tell your patients to eat less and exercise more. And we know that it's just not that simplistic when we're dealing with weight loss resistance or dealing with wanting to lose weight. What are some of the things that you saw characteristically with the differences in genders that had the biggest impact on their kind of health and wellness goals?
Dr. Sandra Scheinbaum: [00:29:32] So I'm going to talk about what I saw anecdotally, as well as what the research in-- it's more itself psychology of eating it, more accurate might be the social psychology of eating. So those who are listening, if you've ever been to a bridal shower, a baby shower, and I also want to preface by saying that I'm talking about traditional masculine/feminine roles. There's blending, there's fluidity and these tend to be the stereotypes. But I think it's worth noting these stereotypes because they are often deeply ingrained. So, I have never been to a ladies luncheon where they would serve a steak, they would serve a salad, and maybe little strips of chicken on the top. That would be your lunch. Now, if you are my age category or if you're getting older and middle-aged women, you want to increase, we know and you've talked about that on many of your podcasts, the need to up your protein intake and particularly how that could be so important for your physical health and your mental health. So that would be the traditional approach. But if the guys were going out and again, this is very stereotypical. But what would be on the menu? What would they order? It might be a piece of meat. It plays out in restaurant design.
[00:30:53] So there's a lot that goes into the surroundings of how you eat the China, the table settings. There used to be this evolved from tea rooms. So the ladies’ little cucumber sandwiches that were served in tea rooms that were all decorated in pastels, where the steakhouses where the guys would eat their business lunch. And we're talking about 40s, 50s in that era. But it would be masculine. There'd be dark paneling and stuffed animals [chuckles] that would be on the wall. You would feel as this were not catering to women. In fact, they even had, I don't know if they still do. I'm sure they don't do this, but they would have a ladies cut. Do you remember that if you would order a steak, you would get the ladies cut? And men, I was talking to people who would say-- they would make fun. Let's say you were at the poker game and you didn't order the Italian beef sandwich, you'd order the salad. Oh, they would make fun of you for that. And so, these stereotypes die hard.
[00:31:56] In fact, there was a yogurt brand that this was about 20 years ago, maybe 10 years ago, they wanted the men to be buying more yogurt. But the problem is they weren't picking up, they weren't buying them because the yogurt cartons were too feminine. They were these pastels. So then they changed the name. They made it brown and black with a bull on the package. And guess what? Sales to men tripled just because of the packaging. Brian Wansink used to be at Cornell. I don't know if he still is. He's written a book about this topic and how restaurants and food companies are working so hard. And it's often the environmental cues. How you say something on the menu, for example, is going to influence whether you order it and whether you're going to think it tastes good and how much you eat. So yes, gender differences do, they die hard?
Cynthia Thurlow: [00:32:51] Yeah.
Dr. Sandra Scheinbaum: [00:32:51] And often, if you've been raised in that environment especially, I think we're talking about people more in my generation who are older, who were raised in that way.
Cynthia Thurlow: [00:33:00] It's fascinating because I think about every steakhouse, I've ever been to has had this very masculine feel versus True Food Kitchen, which is probably leaning more in a plant-based difference. You get very small pieces of protein. The aesthetics are equally beautiful, but just completely different. And what I find interesting is when I reflect back over my lifetime, when I was in a sorority in college, I remember these unspoken rules, if you will. There were definitely young women that struggled with eating disordered behavior, both anorexia and bulimia. But I don't recall ever being at a place where women ate a lot of food. It was like this unspoken rule about, you control your appetite, you control your weight.
[00:33:46] And I think that unlike men, I feel like a lot of the gender messaging that most people feel throughout their lifetime that come from back when people used to read magazines. But you see on social media or that you see on the news, it's almost as if women are expected to control what is an otherwise normal thing to eat food, socialize, etc. Men can drink to excess, eat to excess, it's very different, but somehow, it's not socially acceptable for women to do the same. Is that something that you've seen kind of evolving over the last 20, 30 years? Because when I reflect back and when I was preparing for our discussion today, I kept thinking, I was like,” Wow, you talk about these social messages that we maybe don't even acknowledge they're subtle, but they are impactful.”
Dr. Sandra Scheinbaum: [00:34:33] Yes, absolutely. And I think what this gets to is, what is the real implication if you have a healthy appetite, a big appetite, a hearty appetite? Well, it's not just what you eat. The implication is sexual, that you have a sexual appetite. And so, this was 100 years ago. This was women were corseted and they couldn't eat. But how would we judge somebody who was a hearty eater? Something you would be looked down upon by society because of that. And there's been films that show that. Chocolat, for example, there's an old movie, Tom Jones, its in 60s. And the sex is played out, overeating. They're gnawing on these chicken bones. And so, the idea is that if you're a female and you have this hearty appetite and you order the steak and you finish it, well, what is that going to say?
[00:35:31] There actually used to be a food rule that this was in the 50s, for example, you don't order spaghetti on the first date. Why? Because it's going to make a mess and you won't look dainty and delicate and have good table manners, and you'll be judged. So, yes, we're talking about the past and things have evolved and changed a whole lot. But for some people, particularly in an older age group, this is still, you may not recognize it, but it's still ingrained where you might not be the one eating everything on your plate because you wouldn't want to be judged. I remember, but I was starting to date my husband. This was in the late 60s and college, and his parents would take me out to dinner as I was first getting to know them. And I remember hardly eating anything. And they would say, “Oh, she eats like a bird.” But then coming home and what would I do? and take the cereal, I would basically eat bowls of cereal. And that evolved into really bad habits in terms of binge eating on sugar and being really out of control with eating, but never in public. And there are a lot of people. One of the signs of binge eating is you do it in secret, you are comfortable alone, but if you might go out with other people, you would be restraining yourself.
Cynthia Thurlow: [00:36:44] Yeah. Let's talk about the shame around eating, because I have a family member who eats secretively and it always pains me when I know that this behavior goes on because it's a sign of a larger issue. Whether it was messages this person imbibed from their parents or their father or whomever, they just don't feel comfortable eating a nourishing amount of food around other people. But they will then go home and they'll eat a lot of, like, sweets or salty foods. And it's because they have a very shameful impression, not only of themselves, but of the eating itself. And so, I know this can be very profoundly impactful and some ways can lead to other, disordered relationships with food, but I'm sure that you probably saw lots of patients that struggled with this as well.
Dr. Sandra Scheinbaum: [00:37:36] Yeah. There're so many reasons, but often, what are they thinking? What are their thoughts? And first of all, it might be eating is not safe. And so even getting a menu, what am I going to order? And it might be a real fear of being judged. Maybe I can't order, this is too expensive, I'll be judged that way. Or perhaps and this is where orthorexia comes into play. I used to look at a menu like that and it was, “Oh, wait a minute, that can of fish because of the toxins of mercury. Wait, is this beef grass fed? Is the salmon farm raised or wild?” And those are good questions to ask, but when it paralyzes you, and again, it comes down to balance. Well, how will this one meal really impact me? So, it is seeing danger in every choice and then is the danger of being judged. What will they think of me if I eat this? Sometimes it is also just a fear of the eating process. I know somebody who takes everything home with her. She doesn't eat, but she asks for a doggy bag and she takes it home. So, it's feeling uncomfortable with the actual mechanics of eating and swallowing and what if I choke? And there are all kinds of distortions and it's usually the ‘what ifs.’ ‘What ifs’ are really so detrimental when you find yourself saying that and it's seeing danger everywhere.
[00:39:02] The problem is that what you're doing is inducing a stress response. So, it's probably having a worse impact. Certainly, your mental health, but even your physical health, that stress response of being so worried about what you're eating is going to, in the long run, do you in a lot more seriously than if you had just eaten it. And then you say, “Well, I might have enzymes with me, or ways of detoxing, so that the effect will not be so consequential.” So there's that. And yes, many people, particularly with binge eating, will go home. And often it is the ultra-processed food. So, we have to take that into consideration, because maybe they're at a restaurant and there are good choices. Maybe they even are eating a little bit. But what's hijacking them? They're hostage to the cereal decay, the crackers, whatever is like in its that carb addiction, that or addiction to the ultra-processed foods, which, as we said, those manufacturers have worked so hard to make this attractive.
[00:40:06] And the end of the day, it just could be like, it tastes good and it's also habitual. So I'm going to get into my-- And often you're uncomfortable. Let's say you're going out and you're in a restaurant with other people. Well, maybe you're not so comfortable. Your pants are too tight and you're thinking about looking good. That's another issue. You don't want your stomach to look like you have a pregnant belly, but now you're home and now you got your comfy PJs on. And so, the situation there is, yeah, you're going to reach for that pint of ice cream or that bowl of cereal, and maybe you're pairing it with watching TV, for example. So those situations, it becomes a habit after a while.
Cynthia Thurlow: [00:40:49] Yeah, that's really helpful. And there are two books that I think, for me, really shifted my perspective about ultra-processed foods. Number one is a book by Michael Moss, so it's Salt Sugar Fat, excellent book. And then most recently, I read The Dorito Effect by Mark Schatzker. And boy between the two of them, if anyone wants to learn more about the impact of bliss point and how food purveyors, if you will, they make these foods as addictive as possible. So if you think it tastes good and you keep eating and eating, and eating and you never get full from the Dorito or the really super fatty ice cream that you're consuming, there's a reason for that. And it is not that you are weak or that you don't have willpower. It has a lot to do with what's going on with the neurochemistry in your brain and nulling responses that we would have if we sat down and ate a 10-ounce steak and we were like, “Oh my gosh, I can't eat another bite.” That leptin signaling is also dysregulated.
[00:41:46] Now, if someone's listening and they feel like they need to find a practitioner that can talk to them about their disordered relationship with food, what is a good resource point for them? If they're looking for a clinical psychologist to work with or mental health specialist that can help them navigate the uncomfortable feelings that they're experiencing and their relationship with food. Are there resources or places that they can go to look for a qualified practitioner in their area?
Dr. Sandra Scheinbaum: [00:42:15] Yes, absolutely. So, first of all, we do have a severe shortage of mental health providers. The number of people retiring as psychologists, social workers in droves. We also have not enough people going into the profession. So there's that one issue. There might be a long waiting list. It might be out of your reach in terms of your insurance plan, but it also, I think there's a danger here and that is you are into a medical system and you may be receiving a diagnosis too quickly and now you've pathologized what are some patterns, some habits that you can learn to break? And so, what I would suggest actually start with a health coach, because a health coach is going to be aware of where you are and where you want to be, and they are going to help you see what's right with you and not what's wrong with you, because that's what we do in, often psychology, we get the diagnosis and we are quick to diagnose. So a health coach could spot those individuals who seriously need more, a higher level of intervention. If you're anorexic, for example, which that's life threatening and so that would be critical.
[00:43:27] But often in the mental health side, they are not taking into account nutrition or functional nutrition. They might not even ask what you're eating. They're already jumping to the conclusion that you have a mental health disorder, an eating disorder. And I used to do a lot of testing on units for women particularly, it was adolescent women with eating disorders. The food that they served [laughs] is not really good. And so, there's that carryover. They are not trained in nutrition; they're trained in mental health. So you're not going to get that side of you. And we know that if you have somebody to help them with getting better nutrient, a nutrient-dense diet, then their decision making will change because those ultra-processed foods are what their brains are being hijacked. And when David Perlmutter wrote about this and brainwashing. So we want to make sure that they are getting the right nutrients. So perhaps having starting with a coach and then you may have a nutritional consultation where somebody can help you develop food plan.
[00:44:30] And often people are smart, they know, but we have something called an intention-behavior gap. What is that? Well, we don't need more education. We read blogs, we are on social media, we hear influencers speak, nutrition experts, we know often what we should be doing. Maybe we wake up every day saying, “Okay, this is the day.” And then by the end of the day, life happens. And so, there's their gap between their intention and their behavior. And a coach can really help you start where you are, making some really small changes. It's changes in your food choices, it's also changes in your attitude and your belief. So they might ask you the situation we're talking about where you're not eating in a-- you're out with people and you're not eating in that restaurant, let's say. And then you go home and you binge, well, what is it? Tell me more about what is the consequence if you were to eat? And they might say, “Well, I get gassy, I'm bloating. I don’t want to--” [chuckles] That's a big deal. I'm with people, I don't want to be looking that way or it's embarrassing. And so, then they might really walk you through how you might change that and that can be really, really beneficial.
Cynthia Thurlow: [00:45:42] No, thank you for that. It's interesting, even as a nurse practitioner, I know that for my friends who recently finished residencies or went through medical school, for the nurse practitioners that are still students, there is a lack of or there are not enough clinicians going into mental health areas. So, I 100% agree with you that it can be challenging if someone's listening and saying, “I'm trying to get a child, a teenager, a young adult myself into finding someone that's qualified in my area.” And I love the idea of utilizing health coaches. I think in many ways health coaches can be a bridge. They can work in partnership with clinicians. In many instances, they're working in their offices already. My functional medicine physician, who's our friend, Dr. Aaron Hartman, he has health coaches in his practice, and they bridge the gaps in between appointments. And so, I think that in many instances, these health coaches are providing a much needed service that clinicians themselves can't provide. They either don't have the amount of time they need with a patient to be able to go through the nutritional history, talk more about lifestyle. They may be able to do a cursory discussion, but I know when I was still working in clinical cardiology, I couldn't spend an hour talking to a patient about the nutrition piece.
[00:46:56] But we know from experts like Dr. Chris Palmer and Dr. Perlmutter, both of whom have been on the podcast, we know there's this complex interrelationship between the foods that we eat, the types of neurotransmitters that our body produces, the bulk of which are produced in the stomach in the gastrointestinal tract and not our brain. So when we start talking about medical therapy and pharmacotherapy and talking about selective serotonin reuptake inhibitors, helping people understand that there is a place for medication, but in many instances, a lot of lifestyle changes can make an enormous impact on our mental health. And I would actually argue that should be frontline therapy. Obviously, if someone is in crisis that is different, they may very well need not only medication, they may also need hospitalization to be in a position where they're safe. And certainly, many years ago, when I was a nursing student, I worked on the eating disorder unit during my psych rotation, and you better believe those poor patients got. I remember they would try to hide their food in just about anything, but it was almost inedible looking food.
[00:47:56] So I thought to myself, even if they wanted to eat, there's no incentive to eat mushy vegetables and overcooked meat and probably way more carbohydrate than they probably had any interest in eating. So, thank you for bringing that to our attention and certainly we will make sure that we put links to the health coaching program that you are actively involved in. And I applaud you for understanding how important it is to have that level of support for patients that sometimes we can't solely depend on the provider to provide all that level of support. This is where I think health coaching is so impactful.
[00:48:30] Last but not least, I'd love to kind of touch on Mind-Body medicine. I know some people may think they know what that is, but helping people understand that our psychological wellness impacts symptoms that we experience, whether they be positive or negative, and how a lot of what I consider to be symptoms of bigger issues where, like chronic headaches, chronic diarrhea, chronic constipation, sometimes low-level anxiety or panic attacks can be a byproduct of this mind-body connection and also our lifestyle. Let's wrap things up today, because I think this is an important point that I want to make sure we make today, is that working diligently on our mental health can help support our physical health quite significantly.
Dr. Sandra Scheinbaum: [00:49:18] Absolutely. Well, I have been doing Mind-body medicine since the 70s, before we called it Mind-Body medicine, when it was just breathing, not breath work. And I had a saying when I would give lectures back in the day, and that is, “What's real in the mind is real in the body.” And the only difference between back then when I was saying that, and now is that we have the imaging techniques, we have the data, we have the research that is showing, just as we talked about earlier, that science is evolving. So what does that mean? What's real in the mind is real in the body. So if you think of a sorting system, think about, you are sorting laundry, darks and lights. There's no grays in between, it's just two buckets. And you have to make a decision. Every thought, every image is either going to be stark light, safety, danger. If it's safety. If I am saying right now, “Oh, this has been so great to talk with you, I'm really excited when it airs. I'm really enjoying this,” or even if I'm saying like, “Oh, we're nearing the end,” that's a neutral thought that would go in the light basket. But if I am saying, “Oh, I was so inarticulate, oh, I didn't do a good job, you're not going to like what I'm saying” for example, and I was at a loss for words. I didn't answer that question really well. So now you are judging and you are then putting that thought into the danger category, very low level.
[00:50:49] So it's not like I'm shaking with fear, but there's some muscle contraction that's starting to take place. There's a distortion. You're shifting over into the sympathetic from the parasympathetic nervous system. There's some sense that there's some danger and it affects everything and then it can escalate from there to a higher level, which would be like “Oh, this is the worst I've ever done. This is awful, this is terrible.” And you might start getting into even a panic state like, “Oh, I can't breathe. I'm so stressed. I'm such a screw up. Why can't I do these podcast interviews?” Well, so now you're extending it. Now you're at a higher, higher level. So how do you intervene? “Well, it's integrative. It's not one size fits all. It's not one method, it's not, oh, all I'll do is breathe or I'm going to meditate for 5 to 10 minutes. That'll take care of it.” It often starts with the thought change, like, “So what if I didn't answer that question that well, my life will still go on.” And so there are many strategies that comes from cognitive behavior therapy, where you're actually reformulating those thoughts.
[00:51:51] And if you blend that with, I'm going to take a breath and oh, wait, my shoulders are up to here, I'm going to let that go. So it's a physical process of muscle relaxation and looking at-- so that in essence in a nutshell is the Mind-Body medicine. And then there are approaches like you can go to get a massage, you can do yoga, you can meditate. Those are practices that are coming from Mind-Body medicine but the actual theory is how our mind and body travel together. They cannot be separated.
Cynthia Thurlow: [00:52:23] Well, thank you so much for that. I think that it is without question, the more that we understand about this interrelationship, the more we can do to support our bodies. Please let listeners know how to connect with you on social media, how to listen to your podcast, get connected to the health coaching program, etc.
Dr. Sandra Scheinbaum: [00:52:10] Sure. So, on social media, I am on Instagram @drsandi, @functionalmedcoach is our Functional Medicine Coaching Academy's Instagram page and functionalmedicinecoaching.org. This is a wonderful time to consider being a health coach because you can, especially if you are dissatisfied with your career. If you have a strong sense of having a mission to serve others, then this profession is growing. And our podcast is Health Coach Talk. And that is where we talk all about health coaching. Whether you want to work with a coach, be a coach or hire a coach if you're a practitioner or company wanting to improve the health of your employees.
Cynthia Thurlow: [00:53:23] Awesome. Thank you again for coming on, my friend.
Dr. Sandra Scheinbaum: [00:53:25] Oh, thank you. This has been delightful to talk with you.
Cynthia Thurlow: [00:53:30] If you love this podcast episode, please leave a rating and review, subscribe and tell a friend.
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