Guilt Around Eating – Interview with Esther Tambe MS, RDN

Esther has spent her career working in underserved communities providing nutrition education and counseling to individuals with chronic illnesses such as diabetes, hypertension, chronic kidney disease, and HIV/AIDS. In addition to being a clinical dietitian, Esther volunteers and serves as a mentor for Complete Girlz Inc, a non-profit organization dedicated to educating, motivating, and empowering young women, as well as Diversify Dietetics, a non-profit organization whose mission is to increase the racial and ethnic diversity in the field of nutrition by empowering nutrition leaders of color.  Check out her work and learn more here.

Seeing how people were happier and healthier after shifting movement patterns to align with their natural structures, gave him the deepest sense of reward he’s felt professionally. Having built impactful and successful businesses in consumer health as well as clinical laboratory, his passion and mission have led him to founding Way. Check out his work and learn more here.

This is an interview with Esther Tambe MS, RDN, CDCES, hosted by Bentley Adams, Founder/CEO of Way, discussing the feeling of Guilt Around Eating. How “Guilt” can really be Shame Eating, Body Image, and many other thoughts and feelings. These can adversely influence the relationship with food, the body, and mental health.  Full recording is available directly below on Way’s YouTube Channel. And, we’ve turned the Transcript into a Blog Post below. Enjoy! (Recorded live on December 27th, 2023.)

Opening – Guilt Around Eating

Bentley Adams: Hey, Esther! Good to talk with you, and really excited to dive into this subject around guilt around eating. And I think the first question is really around, when we say guilt around eating. Is that really what we mean? Is it about guilt, or are there other emotions that people feel, that you see in environments around diabetes? And, just generally out in the social media landscape, around this feeling of what we would call guilt. Is it guilt, or is it something else?

Esther Tambe: I feel like it’s part guilt, but I think the guilt is rooted in shame. And the overlaying message of this all is about shame, and that’s where this guilt is coming from. I think that shame playing a lot into food, diabetes management, really anything. Overall, it’s like wanting to follow a “certain” thing. I believe that’s where a lot of the shame is coming from, and that’s where the guilt comes from at the same time.

Bentley Adams: Yeah. And that feeling of shame really, distinct from guilt. Shame, being the feeling of unworthiness, of belonging, or of love even, or of connection. Different than guilt. The guilt is usually based in values, right? And so, the difference being – are people really upset about what they eat because it doesn’t align with their values? Or is it really – and what are some of the examples, that you see – of people who are feeling bad, and they don’t know how they feel. Maybe they call it guilt. But maybe it’s shame, actually right. Is what you’re saying you see? How do you look at that?

Exploring How “Guilt” is Really Shame Eating – The “Should” Word

Esther Tambe: I see it in many ways. I think a lot of times, people feel that like they should have done better, or they didn’t do enough, or they’re not good enough, and they will use – whether that be their food choices [or, other parts of their life] – as justification of that. They are trying to follow something. They might feel bad that they didn’t eat this, or saying, they have guilt about eating, maybe fruit [for example]. They think fruit is “bad” for them, or it may cause diabetes because of the sugar or that there’s too much sugar in it.

Whereas, we know that there’s gonna be sugar in [fruit], but at the same time with fruit, we do get fiber, we do get vitamins, we do get antioxidants from it. So why are we guilting ourselves or having shame for eating something that is potentially providing us nutrition?

Same with other choices, which could be the other way, where, you may actually like that “diet” type product, but now you have guilt, [thinking] “Am I bad for liking this?” And, all those thoughts start to come in. So, think about like diet soda – some people might just actually enjoy diet soda. But, there’s that “guilt” level, {thinking] “Am I dieting because I’m drinking diet soda? Am I restricting because I’m drinking diet soda?”

Or, cauliflower rice – it tends to get a wrap of being a replacement for rice, but there might just be some people enjoy it due to the fiber provides. Or, it just might be the texture [of the cauliflower rice], but now you have people questioning themselves, [thinking] “Well, am I dieting?” or “Am I not this person?”, or “Am I still following diet culture, because I do like this diet replacement type meal?”

So there’s a lot of guilt and shame that comes in, because of this whole, you “should” eat a certain type of way, or these rules that continue to be put out there, even though they may not come out as rules. That tends to happen a lot.

Give Unconditional Permission to Eat What You Want

Bentley Adams: Yeah. And it becomes kind of a social culture, these rules do, right? Some of them are indoctrinated, right? And that’s goes back to our parents, or people that were around [us when we were little]. Those are the rules they absorbed. But largely, it’s in our environment still – it’s an everyday thing. So, I think that the examples that you laid out are perfect. In the sense that they really explain and connect with this overarching feeling that people have of what they “should” eat.

Like, “Oh, if I don’t eat the brown rice, then I’m not eating what I am “supposed” to eat, or ‘should’ eat”. And if I have the cauliflower rice in that case, it’s like, “oh, there’s something ‘wrong’ with me because I didn’t eat the brown rice and I ate the cauliflower rice, or that I replaced the brown rice with cauliflower rice.” It’s like I’m wrong either way.  And so I think that this question is going back to [the point] – what happens to people’s sense of their relationship with food [from these thoughts]?

And how do we get [people] to start to listen to their body when they already are at this place. Where they feel there’s something wrong with them. As a result of all of the messages that have said what you’re “supposed” to eat. And, what you’re “not supposed” to eat. And then, if you want to be “non-restrictive”, this is what you’re supposed to eat, and these sorts of things. Like, what you “should” eat foods, and they how they make this chronic pattern that people get into a feeling like there’s something “wrong” with them.

How do we break that [pattern] and help people start to listen to their body? And really, heal their relationship with food? Is it just giving themselves unconditional permission to eat? Or what is it?

Esther – Give Unconditional Permission to Eat What You Want

Esther Tambe: I think it’s giving unconditional permission to eat. I think it’s really asking, “What is it that you’re eating? Why are you eating it? Because you genuinely enjoy it? Or are you eating it because this person on the Internet said, ‘If you eat this, you’ll achieve this’? Why are you eating?” There are many reasons for food – food is pleasurable, food provides nutrition, so what are you eating for? But at the same time, if you’re worried that “Oh, I need to eat the brown rice for fiber”. Then, let’s think about how else can we get fiber? What else are we adding into our meal?

If you don’t like brown rice. Don’t eat it. If you don’t like whole wheat bread, don’t eat it. You can still get fiber in there without having to now make this substitution, or go buy something else that you don’t necessarily enjoy. So, I think it goes back to asking, why are we doing this? Is it for “health”? If it is for health, what does health mean to you, and what are ways to achieve that without restricting ourselves? And now getting hyper fixated into behaviors that don’t serve us.

How “Lose Weight” and “Body Image” Goals Are, Really, The Same

Bentley Adams: Right – I think that’s a beautiful point, because what we’re getting down to here is, why do you want what you say that you want? Is it actually something that comes from you, from your own values? Or, is it really from the outside? Is it really this external, stigmatized area?

And this question of like, what I always say is, whenever I walk into even to like your classic center of fitness facility and talk to some people, amazing people [who work there, as trainers, etc.]. They can see it immediately when you ask, what’s the number one/what are the top reasons why people come in here? Their “goals” [quote-unquote], when they come in? And it’s always the same thing – the first goal people say is, they want to lose weight, right? “I wanna lose weight.” And then the second one is – “oh, I wanna look great” or “I want an aesthetic.” And anytime we come back to that, we {ask}, “Why?” Right?

Because at the end of the day when most people say they want to “lose weight”, what they’re actually saying is, “If I weigh ‘x’ amount, then my body’s gonna look a certain way.” So, if [they] go from being 200 pounds to 180 pounds, then, all of a sudden, I’m gonna look a certain way.

And then, really, when you ask them “why” – why is that body image so important to you? Because that’s, at the end of the day, of the people that say they wanna “lose weight”, for 25-50% of them, it’s really for a body image. And then the people, the other people say [their goal is] “body image”.

So, it’s really 50-75% of people who are trying to go after a body image, but when you get down to it, usually comes back to this question of, “What do you actually value?” They believe – really, they’ve been taught and indoctrinated and reinforced to believe – that if I have this [“perfect”] body image that looks a certain way, then everything in my life is gonna be so much better. And oftentimes, that’s not the reality.

And the path to getting there scars them, even worse than wherever they’re at currently. So this question of, like you said, “What do you value?”

Root Questions Behind “Lose Weight” – Joy, Happiness, Access

Bentley Adams (ctd.): Also, what are some helpful ways that people can start to identify what they might value, and/or how to explore what they actually believe is “health”? Like, what is “health” to them? Curious how you think of those [questions].

Esther Tambe: I think those are excellent questions. So even if it’s like [asking yourself], “What is that body weight? What was it about that body weight? Was there joy? Was there happiness?” For some people, did that provide you more access to the world? Whether that be sense of belonging, better jobs, social status? So for some people, it can be more about accessibility to things that someone else hasn’t had access to. Just being able to explore those type of questions, I mean, even just asking them.

But you know, at the end of the day, understanding that what they believe and what they want to achieve, it’s still their choice. So I think that comes up along with it, too. Just being able to explore those questions, knowing that you know the guilt and shame they feel, and where that’s coming from. To acknowledge what they’re feeling at the same time, and not to feel bad about having those feelings, too. Right?

So we just need to also emphasize that shame doesn’t motivate behavioral change [long-term]. If we can come from that viewpoint to begin with, that can be [really] helpful.

Psychological & Emotional Safety – How to Reframe Negative Self-Talk

Bentley Adams: [Nodding] And just finding, to whatever extent, some feeling of safety, of the ability to just be yourself, like you said. Allow your choices to exist, and that sort of thing.

There are some interesting parts here where we get into how this affects people on a mental health basis, especially people who are going through a diabetes journey, or something like that, right? When they think that they’re they’re motivating

themselves through shame, like you said, and shame is not a good fuel for motivation. I personally felt that in my own life, early in my life. It’s just not a good way to push ourselves forward. It may be temporarily, but what happens on the back end of that is usually catastrophic or disastrous, or at least significantly more painful than if we would have just started the right way to begin with. Even if it feels slower to go down this line of what are asking – what my values are, and that sort of thing.

But how are ways that you, in practice, help people with this concept of – when they’ve been motivating themselves through shame. And really this concept that we have talked about, which is they feel like there’s something quote-unquote “wrong” with them. Because they’re not able to do what they quote-unquote “should do”? These shame oriented external standards that exist, that are over-emphasized, definitely.

The concept of how do we help somebody look at their deeper root judgment that they’ve made of themselves? Like, how do we stop along the way and start chipping away at that? Because it usually starts from a small [thing], every day, they do one thing. And then that one thing adds up to 2 things, and then 3 things, and then 4 things that they did “wrong”.

Then, they start to believe this bigger picture, that “there’s something ‘wrong’ with me”. Is it really just these small little moments of like saying, “Hey, my body just likes the cauliflower rice, and it tastes better.” “So I’m just gonna have that. And, I’m okay with that.”

Self-Acceptance and Dismantling Stigma

Esther Tambe: Right – I think it’s a small moment, but I think it also depends on the individual and what the situation may be. Also, celebrating those small wins. Acknowledging the small wins, or [of course] if they’re big wins.

More so, [say to yourself] I ate today. You ate cauliflower rice, cool – you ate cauliflower rice. You ate white rice [cool], you ate white rice. You ate a sugar-sweetened type snack. Okay, you ate that. You did something more. So it’s more about, can we actually focus on the strengths versus the weaknesses? And as providers, practitioners, can we come in with more so of – it’s definitely person-centered, but less of a deficit approach.

Like, let’s look at this person – watching our language, but just understanding the shame that results leads to that, that’s part of stigma. Stigma leads to exclusion, rejection, blame. But that also doesn’t help with one’s outcomes in their health, most of the time.

If someone’s feeling some type of stigma or shame, they’re actually avoiding their appointments, they’re actually doing a little bit worse with their self-image, their mental health. There’s lots of negative impact to stigma and shame overall. So just being able to provide that positive space and a safe space. Shame and stigma can be dismantled like that.

You can “cure” that. Cure, in that you just have to realize – what does your practice look like? What does your environment look like? There are ways to help decrease, stigma and stop stigma.

How to Practice Little Reframes on Negative Self-Talk and Stigma

Bentley Adams: Yeah. And I love that because I think that what you’re talking about lines up with so much of what behavior scientists say, from a different lens than a dietitian like you, that’s specifically working with the nutrition of somebody. And, I think because your background is also, too, you’re both a diabetes educator and a dietitian. You’ve seen a lot of things.

I think that there’s this consistent theme of effectively reframing. I think that’s kind of what you I heard you describe right is like reframing the little things as like, “That’s okay, that’s good.” It’s just little reframes that happen. And the ability, the skill set that we want to help people develop, which is to be able to reframe on their own. To be able to look at it from a perspective that’s actually self-affirming, not self-destructive right?

Esther Tambe: Yep. The ability reframe, just resisting the urge to blame and shame the individual. And instead unpack, so you know, we tend to use the word “compliance”, “adherence”. But those are just negative connotations. If the patient or client ate 3 times a day – they ate 3 times a day. Why does it have to be that they didn’t eat XYZ? Let’s focus on what was done.

So, just figuring out ways of how we can resist the urge to blame and shame, but also reinforce the strength of what was done – that can help increase engagement with people.

Closing

Bentley Adams: 100%. And I think that’s a really good summation of how we can look at this concept of guilt around eating that people oftentimes think is, quote-unquote “guilt”, but it’s really shame, right? And what they can do to lessen the influence or the impact of that [shame] on them.

It has been a really helpful conversation, I think it will actually help a lot of people as they go through this [process]. So I’ll say thank you so much. I know it’s all the time that we have and we could probably talk for another 3 hours on it. But thank you as always, Esther, and we’ll look forward to talking more about it soon!