Learn the three red flags of mindfulness and mindful eating so you can unpack it from diet culture. Get clarity on how mindfulness relates to mindful eating. Learn how mindful eating can unpack internalized bias surrounding diabetes distress, burnout, as well as disordered eating, weight, body image, and oppression.
Welcome!
My name is Megrette Fletcher, MEd, RD, CDCES and I am delighted that you are joining me for this course. Mindful eating is near and dear to me because in 2005 I wrote my first book, Discover Mindful Eating. It is the book that started my mindful eating journey. In 2006, I became a co-founder of The Center for Mindful Eating, TCME.org.
I went on to write The Core Concepts of Mindful Eating, Discover Mindful Eating for Kids, and Eat What You Love Love What You Eat with Diabetes with Dr. Michelle May. All of these books focus on being and returning to the present moment when eating. Since 2006, mindful eating has become a term used in weight-centric programs. In fact the term mindfulness is used in everything and it seems like you can be mindful of your financial situation, diet, exercise, mood, in short of everything. Yet is it true? This program will help you learn what are the red flags to mindful eating and how can you include mindful eating in your diabetes training without reinforcing diet culture? You know diets don’t work, but how do you separate mindful eating from dieting, especially when your client says, “I heard the trick was to eat mindfully and I won’t crave sweets,” what do you say?
Learning Objectives
Identify two red flags surrounding mindful eating
Identify three ways mindfulness and mindful eating are related
Engage in counseling role-play
Megrette Fletcher has no conflicts to disclose.
Timed Outline
1-5 minutes: Defining Mindfulness, and mindful eating.
5-10 minutes: 3 Common Red Flags of Mindful Eating
11-20 minutes: Understanding the root of mindfulness. How to dismantle the belief that Mindful Eating is an instruction instead of awareness building practice.
21-30 minutes: How Mindful eating helps unpack internalized bias for people with elevated blood sugar.
31-40 minutes: How to avoid the binary either/or choice regarding food, and mindful eating in diabetes care.
41-50 minutes: Case Study: Working with a client with diabetes
51-60 minutes: Question and Answer comparing mindful eating with other nutrition teaching models.
1 CPE from The Commission of Dietetic Registration is available for purchase for $29.00.
EMR Swipe File
Generic EMR Swipe File
The patient presented expressing concern about their past/current eating behavior. Patient was able to see how present moment awareness can interrupt habitual patterns of acting and thinking. Explored -/+ of change using mindful eating to increase awareness.
Affirmed the need for space and grace when engaging in behavioral change.
Affirmed the need for personal reflection. Reviewed how mindfulness and mindful eating may support this desire.
Affirmed the need for self-compassion.
Affirmed the understanding that diabetes is unique to each person.
After education, the overall plan is for the patient to focus becoming more aware of eating. Patient feels help him balanced his meals.
The goal that the patient will work on between sessions is:
[Use your systems SMART goal format]
Examples of Weight Inclusive Smart Goals:
To create balance I am going to decrease distractions when eating. My goal is to eat something mindfully for breakfast every morning.
OR
I am going to practice enjoying eating. My goal is to have some enjoyable carbs in my meals, while keeping my total carbs between 30-75 grams for breakfast.
This might include: List of options
OR
My plan is to cook food I love, and give myself time to eat it. My goal is to give myself 20 minutes to eat my dinner daily.
Case study
Meet Bob
He is interested in mindful eating to improve his diet and blood sugars. He read that when you eat mindfully, you stop eating sweets. He has been craving sugar recently.
He is a retired military construction worker (welding).
He has had diabetes for 12 years. He has noticed that since he stopped working 2 years ago, his blood sugar and A1C have increased but not his weight.
A1C 24 months ago 7.1 Current 9.8
Medication: Lantus 40 units at night, Farxiga 5 mg
He is monitoring his blood sugar daily (fasting) They are consistent with an A1C of 9.8 230 ish)
Anthropometric: 6.1” and has a BMI of 30. Weight has been stable.
He is physically able and walks the dog 3 times a day (about 1 mile).
He has seen you for years (about 10) and understands that diabetes is progressive. He mentions that his wife of 43 years is being treated for breast cancer. His mother of 91 just passed away. In your conversation, you mentioned that Bob is going through many changes: his job, wife, and mother passing away. He explains (in a comforting way) that death is part of life at his age, 71 years old.
OUR RESPONSE
Hi Bob,
Good to see you again. I am sorry that you are dealing with all that and I wanted to acknowledge your grace in the face of all this. [Appreciation and small talk in response]
Bob: “I heard the trick was to eat mindfully, and I won’t crave sweets.”
"You are concerned that eating more sweets is driving up your blood sugars." [Bob nodes his head]
"Tell me more."
[Bob reviews his diet]
"What changes are you imagining making?"
[Bob reviews his changes]
"How could you become more mindful?"
Bob: I am not sure. I think I am eating because of the stress and because there are a lot more sweets in the house.
"Being more mindful might help you separate your needs from your wife's."
Bob: "Yes, but I don't want her to eat alone."
"Eating is social. It is something you can share, and you are thinking about your wife's health."
Bob: "This is hard." You nod. "This isn't what I thought I would be dealing with." You nod. Silence. "I see it now. I think I know what I can do."
"Please share it with me! Maybe I can write a NY Times best-selling book with your wisdom!"
Bob: Only if you split the profits!
"Done" [Laughter]
Bob: "I think I am using Mary's illness as an excuse. We have been together so long…[Bob continues to explain the relationship]
"Your wife's illness is bringing many big issues to the surface. Do you have anyone you can talk to about these?"
Bob: "Like a therapist?"
"Sure, a pastor, friend."
Bob: "I never thought about talking to my Rabbi.
"Might that help?"
Bob: "Just telling you helped. I think I will talk to Mary first.
[Silence] I really want to learn more about mindfulness and mindful eating.
"That would be helpful."
Bob: Yes. I am in my head, and as you just found out, it isn't the best place to be! [Laughter]
“I am always suspicious when people talk about ways to trick ourselves, especially something as yummy as dessert. There are a lot of benefits of mindful eating, and many might help your overall blood sugar. Is that what you like to explore today?”
Bob: What is it exactly?
[Instruction]
What, if anything, was helpful about Mindful Eating?
Bob: "I really like focusing on the joy. I am still in my head when I am eating."
"Worry can do that."
Bob: "Agreed"
"How might you use this information?"
Bob: "I'm not really sure. I think I need to play around and explore the topic more. I would like to meet with you again and between appointments can you send me some good resources to review?"Absolutely. I will send you some links in your EMR."
Prompt #1 How would you teach Bob about mindfulness and mindful eating without reinforcing diet culture? Read: Consider Eat What You Love, Love What You Eat with Diabetes. Other resources include Diabetes Counseling and Educational Activities - CPE program, Skelly Skills. Or Discover Mindful Eating - CPE program Skelly Skills.
What books/podcasts or resources might you suggest for between sessions to learn more about diabetes? (Feel free to promote your own)
Possible other prompt #2
What would you focus on? How he is dealing with many emotional situations that can distract and overwhelm a person.
What is your biggest concern? Depression
What would you NOT talk about? Dieting and weight loss would distract Bob from being with and processing his emotions.
References:
“Mindful Eating Questionnaire Sample - Fred Hutch.” Mindful Eating Questionnaire, https://www.fredhutch.org/content/dam/www/research/divisions/public-health-sciences/nutrition-assessment/mindful-eating-questionnaire-sample.pdf.
Winkens, Laura H.H., et al. “The Mindful Eating Behavior Scale: Development and Psychometric Properties in a Sample of Dutch Adults Aged 55 Years and Older.” Journal of the Academy of Nutrition and Dietetics, vol. 118, no. 7, 2018, https://doi.org/10.1016/j.jand.2018.01.015.
Center for Mindful Eating, The. “The Center for Mindful Eating.” The Center for Mindful Eating - Principles of Mindful Eating, https://thecenterformindfuleating.org/Principles-Mindful-Eating.
Neff, Kristin. “Self CompassionCompassion.” Self-Compassion, 23 Sept. 2022,
https://self-compassion.org/.
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