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Being half-in is a disservice

Last year I was talking with a friend about health coaching and how I work with clients. We talked a lot about the mental health aspect of health and I said it was important to help them navigate some of the tough questions and then refer when things go out of your scope.

She told me that she wanted to do what I do. She explained that she wanted to help people with their eating and their diet, but she didn’t want to “deal” with people’s problems.

I told her bluntly, she shouldn’t be allowed to help people if she was just going to half-ass it – that’s a disservice to them as the client and her as a professional. As a professional, it puts you in a tricky spot, but it quickly becomes clear that the work isn’t about the client then.

Last week, I attended a bariatric nutrition conference. The room was full of health professionals (primarily registered dietitian’s) who work with people pre- and post-op of bariatric surgery.

We talked about current practices in surgery methods, possible future methods and what that could mean for patients and clinicians. We talked about exercise post-surgery, and I was pleasantly surprised to learn that my background already has me prepared and that I’m already implementing what the physical therapist recommends.

I also loved how she incorporated some information to help professionals better identify when to refer. I refer clients to physical therapy, massage therapy and chiropractic care a lot via encouraging them to speak with their primary care provider about what we’ve discussed so they can get the appropriate referral if needed. For those who don’t need referral from their primary care provider, I suggest they reach out to someone in their network for their insurance (if they don’t already see someone) and in some cases I help them navigate the in-network database to find someone because healthcare can be tricky. At this point, I haven’t worked with anyone who didn’t have insurance.

There were discussions about nutritional guidelines and where they come from. I was shocked to learn that many of those in attendance said that the standards they use aren’t necessarily used across the board. For example, I had assumed, and I’m sure many do, that there are recommendations for a starting point for an individual post-op from vertical sleeve gastrectomy (VSG) with the ability to make modifications unique to the patient. However, I learned that this is individual to the surgeon’s beliefs, and in some cases there’s no clinical research, but instead anecdotal evidence they utilize to determine their practice’s protocols.

The conclusion I came to – health must be individualized and the person must be humanized. I say client to you all because that’s easy, but I call them by their names. I know a lot about my clients and it’s because it helps me see the bigger picture – it gives me the tools to individualize every single thing.

We talked about mindful and intuitive eating. I’ve talked about my beliefs about those concepts and their principles. They’re similar, and like everything else – they’re not for everyone. Many of the principles I utilize with clients, but I use different language and like I’ve explained it’s because EVERY DAMN THING GETS TURNED INTO A DIET. Neither one of these approaches is meant to be a diet, but they are meant to help navigate the food relationship better, but we all know that is not how these concepts are discussed – at least not online where many people spend time…like I do, and clearly you do too.

I raised my hand and asked the presenter about her thoughts on language and how social media has played a role in how these concepts are interpreted and how they can stray from their original intention. I’ve talked about HAES and how this has been misinterpreted online as well. You can read about that here.

I also mentioned that I have experience working with some who have diagnosed eating disorders either currently or in their history and how I only work with them if they are concurrently working with therapists.

Her responses was “clients who come to me don’t come from the Internet.” She reinforced “I don’t go anywhere near eating disorders.”

Two things.

  1. Every age group uses the Internet for something.

Here are some demographics for those who like numbers:

Facebook has 2.23 billion monthly active users. 1.74 billion users are considered mobile monthly active users, with the rest being considered desktop active users.

Facebook is 53% female, 47% male.

62% of online users categorized as seniors 65+ years of age are on Facebook. 72% of those users are between the ages 50-64.

Twitter has 326 million monthly active users. 500 million tweets are sent daily. 80% of users are mobile.

24% of all internet male users are one Twitter, whereas 21% of all female users are on Twitter.

37% of twitter users range between 18-29 years old. 25% of users are 30-49 years old.

Instagram has 1 billion monthly active users. 500 million users are actively on a daily basis. 50 billion photos have been shared as of September 2018. 25 million business were on Instagram as of December 2017 and we know that number has greatly increased.

68% of Instagram users are female, 80% of Instagram users come from outside the US. However, 77.6 million users are still in the US.

32% of all internet users are on Instagram. 72% of teens use Instagram. 59% of internet users on Instagram are between the ages of 18-29. 33% of internet users on Instagram are between 30-49 years of age.

To not use the Internet is a HUGE disservice because it gives us a chance to reach more people, but to also provide good information, correct poor information and break down barriers surround conversations even though we’ve seen growth in areas of mental health, body image, eating disorders. The Internet helps us also create access by connecting to those around the world for minimal cost.

My goal is to work within my community, but it’s irresponsible to not participate in multiple spaces where information can be provided.

As I’ve thought about her statement, I thought it’s possible that those she works with don’t connect with her online socially or like many others in health are starting to, but I’m sure they have found a web site that has discussed the kind of work she does or maybe they found information about her work specifically.

2. You don’t have to dig deep or get messy, but recognizing a problem that needs to be addressed and then making a recommendation or referral is so powerful.

We can’t ignore unhealthy and negative behavior just because it’s outside of our scope. It’s irresponsible to say that you don’t deal with or you stay away from those issues because it gives the impression that it can’t be brought up – there’s a barrier or potential judgement.

Normalizing therapy is so important because like going to the doctor for a yearly check up, talking to someone about your mental health keeps you healthy. It’s about prevention, not just treatment. So, by stating that you won’t deal with them it’s possible that those issues will be hidden, which means the cyclical nature of ignoring them will continue.

Humanizing health and wellness and fitness, and all of the other super cool trendy words out there is important. It’s multifaceted. It’s why I find public health so fascinating – it’s not just about what you’re eating, it’s about access to that food financially, geographically. It’s about the emotions surrounding that food, and how you physically feel when you eat it. It’s about how you can or can’t move your body. It’s about your support system – or lack of one, and then it’s about how you support yourself. It’s about community including the role of religion and culture. There are more angles than I ever realized when I decided I wanted to do this work.

If we’re going to be in the business of helping people, we can’t dissect them and pick the parts that are pretty or are interesting.

I don’t know everything. I can’t fix all the problems of the world – even though I want to some days, most days. But I can listen and I can help guide someone to a better person when I can’t do things. That network, that team – that’s going to help a person be successful.

It’s also going to reinforce humility, collaboration and creativity, which I think we all need.

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