Why body image and food choices are more connected than you think [PODCAST]




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We dive into the intricate world of food choices, body image, and the science behind nutrition myths with psychologist and author Charlotte Markey. Charlotte unpacks the sometimes overwhelming dietary information people encounter daily, offering insights into making food choices that promote both physical and psychological well-being. From debunking popular nutrition myths to finding body acceptance in a social media-saturated world, this conversation empowers listeners to take control of their food choices and develop a healthier relationship with their bodies.

Charlotte Markey is a psychologist and author of Adultish: The Body Image Book for Life.

She discusses the KevinMD article, “How to build a healthier diet without overthinking.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at kevinmd.com/podcast. Today we welcome Charlotte Markey. She’s a psychologist and author of the book Adultish: The Body Image Book for Life. There’s an excerpt from that book on KevinMD titled “How to Build a Healthier Diet Without Overthinking.” Charlotte, welcome to the show.

Charlotte Markey: Thank you for having me.

Kevin Pho: So, let’s start by briefly sharing your story and journey.

Charlotte Markey: So, I’m a psychologist, as you said. I’m a professor at Rutgers University, and I am the author of a number of books at this point. The last few are part of a series, The Body Image Book series. This most recent one is meant for teens and young adults.

Kevin Pho: And there’s an excerpt from that book on KevinMD. It’s titled “How to Build a Healthier Diet Without Overthinking.” Now, for those who didn’t get a chance to read this particular excerpt, tell us what it’s about.

Charlotte Markey: Well, I think a lot of people get confused in terms of what they should be eating because there’s a lot of conflicting messaging, whether it be a news story or influencer posts on social media. We get a lot of conflicting information about what a “healthy diet” should look like. As a psychologist, part of what I’m interested in is not just that people eat nutrient-dense food, but that they have a healthy relationship with food—that they’re not consumed with anxiety and worry. And, you know, I always say, don’t make eating a homework project, right? It’s not a math problem of counting and adding and solving. It should be an enjoyable experience.

Kevin Pho: On social media, and you know, my daughter’s on social media a lot, I see so much information on different diets, what you should eat, what you shouldn’t eat. So, just give us a sense of that world of conflicting information and how a patient or consumer is just overwhelmed by that and confused as to what to do next.

Charlotte Markey: Well, I think most of us want to do what’s best for ourselves, for our bodies, for our health, and so we often seek out this information. Once you seek it out in today’s algorithm-driven media landscape, you will receive it—all sorts of conflicting messages, right? So you get messages like “avoid all carbohydrates,” “avoid all sugar,” “avoid all fat,” “avoid meat.” They are usually very cut-and-dry, like “avoid a whole food group” messages. And if you pay attention to all of them, you’re left with no foods to eat. And I think for a lot of people, then they feel like, “Well, what am I supposed to do?” Most registered dietitians, nutrition scientists, and psychologists who study these issues don’t think you should cut out any food. We think that you should eat all foods, enjoy all foods, because every food fits, and that’s a much more psychologically healthy way to approach eating.

Kevin Pho: So, tell us some practical tips that people can use when confronted with conflicting information. From your perspective as a psychologist, what can consumers do?

Charlotte Markey: One concept we talk about is “protective filters,” and what that means is you need to protect yourself by filtering out information that is not helpful to you. So, if you are following some sort of diet guru on Instagram or TikTok and realize that this is not for you—this is not going to be helpful, which, frankly, it is very unlikely to be, as most diets fail and result in more weight gain than weight loss—you need to unfollow. You need to disengage, or you need to protect yourself by filtering that out of your world. That is the nice thing about the current media landscape; we do have some choice, and we can get rid of some of those harmful messages.

Kevin Pho: And in terms of asking questions to see whether a particular influencer is right for them or not, what kind of questions can a consumer or patient ask themselves to determine that?

Charlotte Markey: Anytime the message is too clear-cut, too simple, and too absolute, it’s not going to be evidence-based. So, anyone who says, “This will work for everybody,” or “All you have to do is this one thing,” those are red flags, right? Because we all have different appetites, body sizes, nutritional preferences, and nutritional needs. So anytime you get the message that everyone should be doing one certain thing, you know that is not actually evidence-based messaging, and you should avoid that.

Kevin Pho: Can you tell us a story or a case study of that practical advice in action, where someone may have taken that advice and made some appreciable change and moved that needle? So, what would be a story of that?

Charlotte Markey: Well, I interview people when I work on my books, and I have worked with people in recovery from eating disorders for many years. I see very often that once people disengage from what we call “diet culture” or this messaging about, “You have to do this,” “You can’t do this,” “You must eat this,” “You must not eat that,” they feel a huge sense of relief. They feel like a weight is lifted off their shoulders because think about it—we have to eat every few hours, optimally, for the sake of our health and survival. So if every few hours, and oftentimes a lot of the time in between, is consumed by worry or shame or angst about what we’re eating or trying not to eat, that can really destroy your day, one meal at a time, one hour at a time. And when people feel the freedom to disengage from thinking about food in this way, from unfollowing the messaging that would suggest it’s imperative, it really can be life-changing.

Kevin Pho: As I mentioned earlier, that excerpt is from your book. It’s called Adultish: The Body Image Book for Life. So, tell us what this book is about. What are some of the key messages from the book?

Charlotte Markey: So, the book is really a guide for mental and physical health for teens and young adults. And body image is sort of the thread that weaves all of these topics together. I conceptualize body image very broadly, in that it is really essentially how comfortable we are in our own skin. How well are we taking care of ourselves? And I try to integrate some of the latest science with personal stories, questions and answers, myths, and expert advice. It’s really a different approach in that it is evidence-based, but it’s also self-help. So, it’s meant to be really accessible and kind of fun. You can look through a chapter at a time. My goal is to help young people. All we hear about, it seems, these days is that young people are in crisis, right? The pandemic was really difficult for all of us but especially for young people who were in middle school and high school during the start of the pandemic. And many of them have delays, whether it be socially, academically, or interpersonally, and problems in terms of mental health. And so this is meant to be a comprehensive resource for that group of young people who can really use, I think, some evidence-based and reliable information, right? TikTok is fun, but it should be viewed much more as entertainment than as a source of health information.

Kevin Pho: So, tell us some evidence-based examples that these teenagers can glean from your book as it relates to healthy eating and body image. What are some misperceptions that they may be seeing on social media that you can clear up?

Charlotte Markey: Well, I think some of what we were talking about already—the misperception that dieting is a clear-cut path to weight loss and that our bodies are infinitely malleable. We don’t try to change our height because we know that’s about 80 to 90 percent genetically determined. Our weight, depending on the study, is 50 to 80 percent genetically determined. So, there’s really only so much we can do to shape ourselves into the beauty ideals many of us aspire to. A lot of this book is about treating yourself with care, compassion, and acceptance because we are not all going to be supermodels or celebrities or even influencers.

Kevin Pho: And from a psychological perspective, you talk about acceptance, that body image is already somewhat genetically predetermined. What are some techniques that readers in your book can use to gain some of that acceptance?

Charlotte Markey: Yeah, so there’s a whole bunch of strategies I talk about to improve body image. One of them is something we’ve already mentioned, which is to limit social media use and be careful with media engagement more generally. But we can also work on practicing gratitude. Gratitude has been found to improve mental health in general and body image in particular. So, focusing more on what we actually like about ourselves is important. I run through how we can do that. There’s a lot of commercials and messaging about fixing ourselves because that’s how people make money. If we’re convinced we need to be fixed and need products and plans to make ourselves acceptable, that makes money for others. But if we are more self-accepting and appreciate things about ourselves, we’re not going to buy all those things. There’s an inequality in the messaging we receive because of consumerism. I try to talk more about gratitude, acceptance, and appreciation, and how we can nurture those things to be the best version of ourselves without feeling discontent, shame, or insecurity.

Kevin Pho: I’m an internal medicine primary care physician, and as you can imagine, this topic of healthy eating comes up frequently in the exam room. So, in a limited-time visit, do you have any high-yield tips that I can share with my patients in terms of improving their relationship with food?

Charlotte Markey: Yeah, I mean, internal medicine physicians are often the first point of contact, as you know. People come to you with every problem they have, and a lot of them have to do with eating and how they feel about themselves. We know that even for primary care providers, a majority of visits are actually driven by mental health, not just physical health. So, I think some really great advice is, if someone is really struggling, to refer them to a registered dietitian. An expert in food can actually help think through what they’re eating and whether that’s really what’s best for them. But also, I think what people need to hear from doctors sometimes is not to worry about the details so much. People need to eat regularly to function as human beings. Don’t worry about deprivation. We’re so used to thinking doctors are going to say, “Don’t eat sugar, don’t eat fat, don’t eat this,” and those messages become counterproductive. If people hear from medical professionals, “Don’t worry about the details, nourish yourself,” they may feel less shame. Ask them, “What’s possible for you right now? What can you afford? What do you have time for? Do you want to talk to an expert? Let me refer you to an expert. Do you have questions?” There’s a lot of shame surrounding food and eating, and in order for people to do well, we need to remove that shame.

Kevin Pho: We’re talking to Charlotte Markey. She’s the author of Adultish: The Body Image Book for Life. She’s a psychologist, and today’s KevinMD article is titled “How to Build a Healthier Diet Without Overthinking.” Charlotte, we’ll end with some take-home messages for the KevinMD audience.

Charlotte Markey: Yeah. None of us are going to be perfect when it comes to how we look or how we eat. Yet, we can be compassionate towards ourselves and do the best we can within our means to take care of ourselves. The books I write are all about how to do that in an effective way without feeling oppressed or as if it’s a homework problem we can’t get away from. Self-acceptance is a big piece of the puzzle, but there’s much more in the books.

Kevin Pho: The book is called Adultish: The Body Image Book for Life. Charlotte, thank you so much for sharing your perspective and insight, and thanks for coming on the show.

Charlotte Markey: Thanks for all the work you do.


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