Nutrition is not a Diet: Promoting Food Acceptance and Inclusivity

Nutrition and dieting are often confused in our culture, each reduced to an “eat this, not that” mentality that sees “healthy” eating as food restriction and deprivation. Think “clean eating” and fasting. Calorie counting and detoxes. Setting certain foods off-limits and strict times for when and when not to eat. Mainstream ideas about nutrition are rigid, often extreme, and heavily influenced by diet culture and our society’s obsession with weight.

But nutrition is not a diet. Dieting, in fact, can be a form of disordered eating—not healthy eating—and contribute to eating disorders of all types. Regardless of the nutritional content of food in any given non-medical diet, the act of dieting often compromises a person’s underlying relationship with food.

At The Emily Program, we approach nutrition from a different, more inclusive perspective. It’s a philosophy where all foods fit, one that removes judgment from food and encourages flexibility and variety with eating. Key to this broader understanding of nutrition is food acceptance and inclusivity. Along with the aspects of eating flexibly and meeting individual needs, this concept is a cornerstone of our approach to nutrition in eating disorder treatment.

What is Food Acceptance and Inclusivity?

Food judgment clouds many eating decisions. It categorizes food in black-and-white terms: good or bad, right or wrong, healthy or unhealthy. It sets strict food rules: “I can only eat at certain times of the day.” “I shouldn’t be eating this.” “I can only eat this if I do that.” This judgment underlies most non-medical diets—and their characteristically strict rules about what, when, and how much to eat—and breeds disordered eating of all types.

Alternatively, food acceptance strips judgment from eating and allows all foods to fit. Instead of the “eat this, not that” mindset, it says: It’s okay to eat this and it’s okay to eat that.” Apple and cupcake. Salad and pizza. Fruits, vegetables, nuts, bread, candy, crackers, desserts—all foods fit. No one food holds superior moral value over another.

This neutral approach to food acknowledges that while foods have different nutritional profiles, these differences don’t make some items permissible and others off-limits. Foods of all types provide some form of nutrition: the energy our bodies need to stay alive and maintain vital processes. But food is also much more than nutrients. It is rooted in culture and identity and a means for connection, community, expression, pleasure, and satisfaction. Eating and sharing food for reasons beyond its nutritional content is part of a peaceful relationship with food.

Food acceptance and inclusivity also respect and reflect diversity in food types, preparation and serving methods, and other eating practices. Food is an expression of cultural heritage and to appreciate the identity and preferences of a given culture, we must look beyond the dominant images of what constitutes “healthy” eating to include traditional meals and ingredients. How often do we see ingredients like plantains, cassava, lychee, or okra featured in mainstream conversations about nutrition? Dishes like tagine, paella, pierogi, or tamales? Excluding world cuisines only perpetuates the idea that some foods are not as “good” as others.

How to support your patients in practicing food acceptance and inclusivity

1. Be aware of the ways you talk about food and eating.

We can positively influence each other’s eating behaviors and thoughts by being aware of the ways we talk about and act around food ourselves. To support your patients in practicing food acceptance and inclusivity, consider integrating these strategies into your practice:

• Avoid labeling foods as “good” or “bad” or in other moral terms (e.g., “guilt-free,” “cheat meal”)
• Adopt words like “satisfying” instead of “healthy” and describe food in terms of taste and flavor (e.g., “savory,” “tart,” “tender,” “bitter”)
• Notice the phrase “should not” in conversations about eating (e.g., “should not be eating that”)
• Include your patient’s cultural food preferences and traditions in conversations about food

2. Ask your patients about their relationship with food to recognize eating disorder warning signs.

Providers play a valuable role in recognizing early warning signs of an eating disorder. Look for these signs of an unhealthy relationship with food:

• Categorizing foods as “good” or “bad”
• Shame, guilt, stress, or fear about the foods they eat
• Avoidance or restriction of certain foods
• Frequently talking about food, weight, and shape
• Purging, restricting, or binge eating

3. Connect your patients with specialty eating disorder care.

If you are concerned about your patient’s relationship with food, connect them to specialty care for a full assessment. The earlier an eating disorder is detected and treated, the better the outcomes are likely to be.

The Emily Program keeps nutrition in the foreground when helping people with eating disorders develop a more peaceful relationship with food. As part of a multidisciplinary treatment team,registered dietitians provide nutritional assessments, education, and support in developing meal plans that not only meet energy and nutritional needs but also support food variety, acceptance, and flexibility.

The Emily Program’s vision is a world of peaceful relationships with food, weight, and body image, where everyone with an eating disorder can experience recovery. The Emily Program was founded in 1993 by Dirk Miller, PhD, LP, after his sister Emily recovered from an eating disorder. Recognizing that one size does not fit all, The Emily Program provides exceptional, individualized care leading to recovery from eating disorders, incorporating individual, group, and family therapy, nutrition, psychiatry, medical care, yoga, and more. If you or someone you know is struggling with an eating disorder, call 1-888-EMILY-77 or visit emilyprogram.com.