Podcast Episode #45: Women, Body Image, Emotional Eating & Real Health

LIZ WOLFE: Hey everyone, I'm Liz Wolfe, nutritional therapy practioner and the woman behind the curtain at CaveGirlEats.com. That's a little Wizard of Oz joke for you to start the podcast. I'm here with Diane Sanfilippo, certified nutrition consultant and CHEK Holistic Lifestyle Coach and pretty much a million other things that I can never remember to reel off in one sitting. She is also the winning personality behind BalancedBites.com. Welcome all to episode 45 of the Balanced Bites podcast.

DIANE SANFILIPPO: Woo hoo!

LIZ WOLFE: I took a little break last week. Diane was super cool and let me take the episode off. I had to wash my hair.

DIANE SANFILIPPO: I normally…wash your hair? I'm normally a slave driver, so I'm pretty rough on my, you know, my little commies here. We all get together and everyone has to work 24/7. No, I'm kidding.

LIZ WOLFE: You're the bossy friend. You're like Christy from the Babysitters Club.

DIANE SANFILIPPO: Yeah.

LIZ WOLFE: And I'm Claudia, the free spirit. Hayley is more like Mallory..

DIANE SANFILIPPO: I do have a friend who gave me…heh. I have a friend who gave me one of those Little Miss Bossy t-shirts once.

LIZ WOLFE: Sounds about right.

DIANE SANFILIPPO: Yeah. You know, whatever.. Sometimes you just have to like kick people in the butt and I don't know, the rest of the time, I pretty much just lay low, so you know, anyway.

LIZ WOLFE: You can take it as much as you can dish it out, and I respect that.

DIANE SANFILIPPO: Yeah, well, you know, you have to have friends who can also put you in your place, so…what are we even talking about? What are…

LIZ WOLFE: I don't know.

DIANE SANFILIPPO: What's going on? Luckily we have listeners who, yeah, they just like to hear us jibber jabber about who knows what. And the ones that don't like to hear that obviously have dropped off the pole.

LIZ WOLFE: It's not like they didn't build a fast forward button onto the iPod.

DIANE SANFILIPPO: That is true. And I will tell you this. See, you and I, people may or may not know, like very often we're talking kind of all week, and then we've been so busy lately that this is like the first time Liz and I have spoken in a week. Or for the most part, yeah, so I got another…you know who you sound like, the other day, I was like yes. Yes, I do.

LIZ WOLFE: Was it [xxx]?

DIANE SANFILIPPO: He was like that girl on New Girl. Yeah. L

LIZ WOLFE: Did you see the Saturday Night Live skit where they do, “See I'm quirky with Zoey Deschanel” [laughs]

DIANE SANFILIPPO: Jimmy Moore's going to be laughing at this one. I know that. It's all I can think of, is him tuning in. Yeah, so anyway…

LIZ WOLFE: Jimmy, yeah, anyway. So remember that the materials and content in this podcast are intended as general information only, and not considered to be a substitute for professional medical advice, diagnosis, or treatment. Got a couple updates. [laughs]

DIANE SANFILIPPO: In case anyone was confused…

LIZ WOLFE: Yeah, in case you all were confused that we're not like super serious people here. I'm going to be at the CrossFit Games coming up this weekend. I will be representing Steve's Club National Program and PaleoKits. The two kind of go hand in hand. So please stop by the booth. We're doing a little tent awareness drive for Steve's Club National Program. We're super excited. I actually just got back from a meeting at PaleoKits/Steve's Club HQ, and it's really exciting. They've just opened up their second local Steve's Club affiliate, and it's actually…some of the older kids from Steve's Club, and for those folks that don't know what Steve's Club is, it's basically a nonprofit that provides CrossFit training, mentorship, nutritional guidance to at-risk kids. Any economic background. Any kid that just needs that extra boost. Something to do, something to look forward to, something to perform well at. Steve's club is for them. So I'm involved with them on the nutrition side, and I just came from a meeting there about this second Steve's Club, local club that we're starting or that they're starting in Camden, New Jersey, and the kids of Steve's Club, of the original Steve's Club are actually taking the leadership role, coaching and working with the new kids that are coming in, which is amazing. Through Steve's Club National Program, we've been able to get a lot of these kids actually CrossFit Certified and they're just doing phenomenal things, mentoring other kids from their areas and it's just amazing. I'm going to put a little video that they sent me out there about it on my blog and on the Cave Girl Eats Facebook page. It's pretty cool. Pretty cool stuff. I'm really excited about it. So I totally forgot what…why I was talking about that. Why was I talking about..? Oh.

DIANE SANFILIPPO: Because you're going to be at the Games?

LIZ WOLFE: Yeah. So watching the fittest on earth do apparently…apparently a triathlon on a military base. I don't know if you heard about that.

DIANE SANFILIPPO: Yeah.

LIZ WOLFE: But that's the…

DIANE SANFILIPPO: I don't think…I don't think you can watch though.

LIZ WOLFE: No.

DIANE SANFILIPPO: I don't think you can watch, though, right?

LIZ WOLFE: Mm-Nn.

DIANE SANFILIPPO: No.

LIZ WOLFE: You can't. Got a quick refresh on xxx], I guess.

DIANE SANFILIPPO: I just..yeah, I just was talking to one of my friends and she said, oh my god! ‘Did you see? There's a triathlon? I said, no, I haven't seen it. I'm trying to avoid all of the updates because I'm like really bummed that I'm just too exhausted to go, and I've got so much travel coming up that…

LIZ WOLFE: Yeah.

DIANE SANFILIPPO: I had to kind of extract myself from that weeklong trip that I was really excited about. But yeah, we were just talking about it. I was like, holy jeez, like these athletes probably all were told to show up by today and then boom, tomorrow, triathlon.

LIZ WOLFE: It was like, here's your coat…

DIANE SANFILIPPO: Yeah, so is it like, it's like a dirtbike or a roadbike or what? Did get anything about this?

LIZ WOLFE: Yeah, Sand, mud. [xxx] I don't even know.

DIANE SANFILIPPO: I'm nervous that people are going to get hurt. Yeah, I'm nervous about that bike ride, to be honest. That was the reason I never did any triathlons. I had a lot of triathlete friends years and years ago, like right before I did my half marathon, which was like my first bout with adrenal fatigue. So that was kind of my like, Diane, you are not made for endurance athletics. But I almost did a triathlon. But I was scared of the bike, and I'm actually scared for people to get hurt on the bike, especially because it's not their bike. Like what they're showing up and here's a bike? It's not like here's a pair of sneakers. I'm nervous for them.

LIZ WOLFE: Yeah, that's totally why I never did a triathlon, too. Because I was like, actually because I had way too many episodes of the Bachelorette like backed up on my TiVo and other stuff, too.

DIANE SANFILIPPO: Look, I was like, wrapped up in that world for awhile, you know. I had some friends…

LIZ WOLFE: I was practicing my Kristen Wiig impressions of Kristen Wiig doing impressions of other people. The Target! [laughs]

DIANE SANFILIPPO: [laughs] That's my favorite.

LIZ WOLFE: This is what happens when my husband deploys. I allow myself like one hour of television on the weekends, and it's just no good. I'm like a sponge. I absorb everything, but all ridiculous. Nothing worthwhile.

DIANE SANFILIPPO: It is pretty much absolutely my favorite impression that you do, so it's kind of, like if Diane's in a bad mood, get Liz to do the Target Lady impression and we're all good. [laughs] All right, now we're going to have to link to a clip of the Target Lady because they're like, what are they talking about? It's the best.

LIZ WOLFE: Classic Liz.

DIANE SANFILIPPO: Classic.

LIZ WOLFE: For real, though. So let's get down to brass tacks here. So we're pretty excited today to talk about a subject that we're both pretty passionate about. Something that I hope to keep talking about more in the future. But I want to preface this episode with a little bit of context. This podcast is intended to speak to much more than food. This podcast in general is about more than just food and more than just nutritional input. We believe that food is a part of the equation, but surely not all of it. While we clearly think that, you know, food is of extraordinary importance, I don't want to, you know, understate that. Both Diane and myself have really gone through enough struggles with body image and self-criticism to know that the interaction of health, happiness, and body respect is intricate and it's deserving of much more attention than it generally gets. And for that reason, we really do our best to focus on mindset and those challenges of thought that are too often put on the backburner in favor of quite honestly neuroses about body composition or minuscule flaws that, too, a lot of individuals that reach out to us have become mountains rather than molehills. So we're really excited to lend our voices to this conversation as consistently as we can, as well as to hear from our listeners and readers and anybody in the community that has something to share. And we're also really excited to have the opportunity to talk to some really great thinkers in this community and hear what they have to say and share on the topic. We're really, really excited, over the moon today because one of the most bold and eloquent voices, I think, on this topic, Stefani of PaleoforWomen.com is joining us today. Stefani is a huge inspiration. She has a fascinating background. She's also got a podcast of her own called Live, Love, Eat that I love. We'll have Stefani introduce herself a little more in just a second. And actually I think we're going to shake things up a little bit. Diane, have you ask the questions and kick them over, play a little Freaky Friday, like switch our Freaky whatever day it is.

DIANE SANFILIPPO: Opposite day? [laughs]

LIZ WOLFE: Opposite day. So I think we've actually got Stefani on right now. Stefani, are you here?

STEFANI RUPER: Yeah, I'm with you, Liz. Hi.

LIZ WOLFE: Awesome.

DIANE SANFILIPPO: Hi!

LIZ WOLFE: Thanks for coming on. We appreciate it.

STEFANI RUPER: Yeah, of course.

DIANE SANFILIPPO: Awesome, so…

LIZ WOLFE: So do you want to tell us a little bit about your background and a little about your podcast as well. I know you're…Are you about 3 episodes in at this point? I know I've listened to 3 of your episodes so far. Do you have a 4th in the queue?

STEFANI RUPER: Yeah, actually, I am recording. We are recording the 4th episode tomorrow evening. I'm really excited about, yeah. I'm really excited about the forthcoming podcast. I'll be doing it with a woman older than my past guests have been, and she's a mother, and so there is a new perspective. Dealing with disordered eating is interesting because there are different populations and of course different ways that people can have different relationships with food, but particularly in a Paleosphere, it goes down in a pretty common kind of way, and so many of our guests have…or many of the people who want to be guests have somewhat similar stories, which is really great because the more we can talk about these similar stories, the more we can help all of the people who share in this struggle. But I also really love expanding that vision, and expanding that story. So yes, so I am really excited that episode 4 is coming up soon. My life has been a bit of a mess recently, as I was dealing with some things with my family back home, and I just made it back to Boston in the last couple days, and so my production on my blog and with the podcast will hopefully be speeding along like it was before. I'll continue to sleep as much as I can in the meantime.
In terms of an introduction to myself and my work, I began my work in the Paleosphere in the first weeks of 2011, so I guess I've been at it for 18 months now. And when I started, I began because I felt that there was a dearth of women's voices in the movement despite the wonderful work that you, Liz and you, Diane, have been doing and Sarah Frogoso and many others. But very quickly, I realized that what we should all be speaking to are our strengths and our own experiences, and I ended up doing most of my work on disordered eating, and being pretty upset about the fact that at the time-this is not the case anymore. I would like to think that I have helped this effort in some way, but at the time, people presumed that like eating a Paleo diet would make their problems with food go away. Like eating a Paleo diet would make your problems with everything go away. So clearly, you're going to stop binging when you're on your Paleo diet. But that's ridiculous. It's ridiculous. And so I spent a lot of time working on that, and I developed myself throughout that time. And so if you go back and read my blog, you can see how my own acceptance of my body evolved throughout that time period. I was very thin when I started writing. Very thin, and I knew that it was possibly a part of my health problems, but I didn't really understand the extent to which it might have been a part of them until maybe 7 or 8 months ago, when I deliberately decided to put on weight, and I witnessed the great, you know, health benefits that came from that. And so my work recently in the last few months, I've decided to solidify my work. I used to…I worked at a different blog, it's called PaleoPepper.com.

LIZ WOLFE: Yep.

DIANE SANFILIPPO: Yes. And now I am…I feel confident speaking about women's hormonal and health issues, at least to an extent, and I feel well experienced working with women and writing for women in disordered eating, such that I started my new website and have been pretty committed to it and it's been a wonderful, if tumultuous, few months, trying to build this notion of community and this notion of a movement. It's really silly because I'm starting a movement. Follow me. I feel like I'm leaping on a horse in the French Revolution and no one's following me, though there are many thousands, actually, and it's stirring and it's exciting as hard and it's challenging as taking these steps and thinking about these issues.

DIANE SANFILIPPO: So…this is Diane, I just want to…sometimes people confuse our voices, myself and Liz. But I just wanted to have people maybe get a little bit of a feel for what your background is educationally because it's pretty different from what you're doing now, but it does…you know, we each kind of come from a different background and then also a different set of personal experiences, so can you let people know a little bit about your educational background and then how you know, just maybe what made you decide to kind of make these changes and really go full force for what you're doing now.

STEFANI RUPER: Sure. I'm enormously underqualified. I have never settled on anything in my whole life, and as a matter of fact, I have 4 jobs right now. I consider my blog one of them. But I have 4 jobs right now, and I…my…it's having my hand in many different pots, and so in my undergrad, I studied biogeochemistry, which is equal parts inorganic chemistry, such as studying iron and minerals and rocks, and equal parts biochemistry, and organic chemistry, and I was an organic chemistry tutor, believe it or not, I managed to excel in that course. And so I have…like I have a strong scientific background. I did very well in course. I went to Dartmouth College in New Hampshire, which is wonderful. And I did well, and I learned science. I worked for NASA for a bit; they gave me a grant to study some stuff. I worked on one of the Rovers actually which is on Mars right now.

LIZ WOLFE: Wow.

STEFANI RUPER: Which is pretty cool. Yeah, pretty cool stuff.

DIANE SANFILIPPO: Very cool.

STEFANI RUPER: And yeah, I actually…my senior thesis was on, I can't believe I'm talking about this on a podcast about disordered eating, but my undergraduate thesis, I worked on the viability of life existing in the interior planets, so right. So that's my scientific background, but I always really loved talking about people and ideas and health and all of these things. So I'm currently studying philosophy at Boston University, and I also study Unitarian Universalist ministry at Harvard Divinity School. So those are two things that I'm interested in. It's be interesting…So much of it plays out together…my desire and ability to counsel women, coupled with my academics and philosophy and science. I'm stuttering a lot because this is a huge story and I'm trying to make it very short. I also, of course, battled food for ages and ages and ages as a ballet dancer from a very young age, and that played a part in me being like the chubby dancer, even though I was of course in decent shape the whole time. And that persisted throughout college, and so I became an eating disorder counselor, and I read about it, and I jumped online and I started talking to women about it. And it's in the last several years I believe that I have read widely and experienced enough talking with women and of myself to speak to these issues. I make no claims at being a professional or having professional training. I am planning on perusing degrees in this field as well in eating disorders, I think. But I can't be in more than a handful of degree programs at a time, so they're all further down the line, and eventually I would like to pursue my doctorate in psychology. So…anyway…

LIZ WOLFE: That's awesome.

STEFANI RUPER: That's my hugely varied background.

LIZ WOLFE: I think that's amazing. I think it's so…I think it's so cool how so many people in this community bring all of these different perspectives that we've all kind of come together on similar topics. This is Liz speaking, by the way. But I did just want to say real quick before I'm sure Diane has a lot in her arsenal, but I just wanted to say there's such a need for this conversation, and I'm so excited about having you here, Stefani, and just continuing it here.

STEFANI RUPER: Thank you.

LIZ WOLFE: And wherever we are. You know, like you said, this is something that was in the back of my head when I got started with this, this feeling like I was supposed to be fixed and also look a certain way, have a certain level of leanness in order to be healthy and/or Paleo. And without that accomplishment for a very long time, I felt like I had failed. And a lot of things have happened since then that have really shifted the way I think, and part of that is this enlivening conversation that this community is having about these things, so I'm just super excited, so thanks a lot for being here.

STEFANI RUPER: Thank you.

DIANE SANFILIPPO: Yeah, I think…Now, this is Diane. And I think what is really cool. I thought it was really funny what you said about, you know, maybe not being quote unquote qualified to talk about this or help people with it, but I actually think that having your own experience and then being willing to talk about it is a certain level of qualification to at least extend an offer of help to somebody else. It doesn't mean any of us are stamping ourselves, you know, as medical doctors or even, you know, psychiatrists or psychologists or whatever. But I think there's just an element of we're willing to talk about this stuff, and you know, we have our own experiences to share, and that's really, you know, it's like 80% of the game at a certain point. It's just, can we talk though it; maybe what have we've experienced, what have we helped some other people with, and what can people learn from that, you know, and apply to themselves and there's definitely an element of different types of therapies that people I think do need to go through, and we'll look at some questions here in a minute, and have recommendations for people, things that have helped me, and I've seen help other people. But, you know, I think us being able to talk about this stuff really is what helps people. I think it's funny that you mentioned, Stefani, that you were studying to be a Unitarian Universalist minister. I grew up Unitarian Universalist, so it's very…

STEFANI RUPER: Oh, what a…

DIANE SANFILIPPO: Yeah, isn't that funny? I was like, smiling when you said that because I'm sure a lot of people have no idea what that means, but I'm like, that's how I grew up. You know, we have this whole kind of different perspective on, you know, what religion means or morality or just how we treat people and I think that's really interesting that that's what you're kind of going for now. So very cool, and I think we're glad, too, because you know, Liz and I talk about this stuff a lot. We get a lot of questions from women, and we wanted to continue our conversation, and just sort of invite you in as, you know, a third perspective. Just you've got a whole different point of view, growing up as a dancer, and so we just want to be able to get through some of these questions and then just continue whatever conversation, you know, whatever comes to mind that you think might be additionally helpful for people and we'll just kind of share that all over the next hour-ish. Sounds good?

STEFANI RUPER: Sounds great. Yeah.

DIANE SANFILIPPO: Cool. Okay, well, I have a handful of topics that I want to make sure that we cover at some point during our talk right now, but what I want to do is just get to the questions and then we'll see and make sure that we are covering some of these things because I think, you know, I think the women who are tuning in, I'm sure there's going to be men tuning in as well. Either they just want to understand this stuff better; maybe they've got a sister or girlfriend or a wife or what have you who's dealing with this stuff, and I do think that would be a great idea for men to listen because, you know, you can hear these perspectives that are really difficult for us to explain this stuff to men, and we don't…we don't often do it because they just don't always get it, although I'm sure we could probably do an equal podcast with a bunch of guys talking about what they're dealing with.
But let's just get into the first question here. We got one from Jennifer, and Jennifer's asking: “How can I get myself to stop overeating and just eat enough? How can I get myself to stop overeating and just eat enough? I have this tendency to eat until all the food is gone, regardless of what I’m eating: veggies and protein, or a treat. Then I feel sick, in my stomach and in my head, for doing it. I of course tell myself that I won’t do It again, but I end up doing it anyway. The worry and fullness won’t let me sleep and it’s getting hard to achieve the last of the fat loss I want to accomplish. Worst of all, I feel out of control. I’m not losing fat regardless of my efforts. I feel tired often because I can’t sleep because of the over analyzing and panicking what I've done and thinking I'll do things better “starting tomorrow”. What tips or thoughts can you share with me to regulate myself and be balanced? I seriously want to feel content and in control of my mind, body, and choices.”
And she's got a little bit of extra info here. We tend to ask for this because we get the question and then we like to look at some of the background, so she says, “I’m 33, I weigh 142lb. I CrossFit 4 times a week. I used to run some mornings, but in the last few months I’ve been too tired for running. Could be the lack of sleep. I eat Paleo and really enjoy it! I used to weigh 170 2 yrs ago, 220 at age 19. I try to eat clean, and I don’t regret it, but peer pressure from my friends that just seem to never gain weight makes me think sometimes it’s ok to indulge in sweets. For the most part I’m staying away, and I mostly do because eating them is a slippery slope for me.” For her she says, “Sweets are like Pringles.” Get her started and it’s hard to stop. It says she'll just overdo it if she has anything. She's tried to complete my 21 Day Sugar Detox, but she feels like her mind isn't balanced enough to kind of get through it, so yeah, hopefully that is enough of a background. Liz, what do you think about this? about what Lauren's dealing with, or sorry, Jennifer's dealing with?

STEFANI RUPER: You were asking Liz, right, Diane? Did I hear that right?

DIANE SANFILIPPO: Yeah, Liz, did you…or did you want me to just throw it to Stefani first?

STEFANI RUPER: I definitely have ideas if Liz is…

DIANE SANFILIPPO: Yeah, go ahead Stefani.

STEFANI RUPER: So one of the things that she didn't quite specify is whether she only overeats when she has sweets or if she overeats anything. I know that it varies and that most people have both, but it's helpful to know. I, interestingly enough, this is the most common question that I get, and I'm sure..

DIANE SANFILIPPO: She did say she has a tendency to eat until all the food is gone regardless of what she's eating.

STEFANI RUPER: Right, okay.

DIANE SANFILIPPO: So veggies or protein or treats. So I think she's doing it even with like good food.

STEFANI RUPER: Right.

DIANE SANFILIPPO: You know?

STEFANI RUPER: Right. So I actually…I wrote a post about this and put it up this morning. Many women, many…and men…mostly people who are concerned about their body image and such participate in cycles of over and undereating, and always want to learn how to stop binging. And the problem really, from my perspective, is the desire to control and to restrict and really the fact that we're thinking about food at all. Like self-negativity, she says that she's spends a huge amount of time worrying about this, and I understand that. Goodness, do I understand that. But you know, she has also lost a massive amount of weight, and I am certain that her body image is important to her. And for many people who have lost a lot of weight, there's a lot of fear of gaining it back, and there's a huge effort involved with maintaining weight because we're all so conscious of the way that we look, and in my opinion, the effort to…it's unfortunate, but the effort to stay thin or to be fit, it is always, almost always coupled with self-flagellation and with guilt. You know, instead of using positive motivators, we use negative motivators and we're constantly thinking about food because we always want to be eating less, and just the merest thought of food triggers an obsession and we all know that the healthiest relationship with food is one in which you don't think about it, and so there needs to be a transition, in my opinion, for many women between this hypercontrolled, hyperviligilant form of eating because they're afraid of, you know, their body image, they're trying to keep it in mind, a transition from that into something more intuitive. In my opinion, and I just wrote about, and what people who've read my work know very well is that my opinion is all about self-love, and about forgiving ourselves, and it's understanding that it's not our fault that we overeat. You know something..we all have these demons deep inside of us that have been planted in us by society and by norms, and we have physiological drive to eat these foods, especially the sweet food she's talking about, and they claw their way to the surface, and they come over us, and we have to recognize that it's not our fault, and we have to forgive ourselves, and to kind of just roll the binge off of our shoulders, and to stop trying so hard to restrict because the restriction mentality almost necessarily begets overeating. Because we're trying to restrict ourselves, and it's negative, you know, our willpower is a limited resource, it only lasts so long, and so it's absolutely crucial to forgive ourselves and to love ourselves, and to think about eating in terms of nourishment and giving our bodies what they need ‘rather than how little food can I get away with eating today.
I think one really concrete step she can take is when she approaches meals, to not think how little can I eat? but rather, I'm going to eat and when I stop, I can have more when I'm done. And for a lot of women that's very scary because they feel like their body weight's might run away with them. They feel as though their appetite might run away with them. But over time, and with practice, and with forgiveness, we can come to trust those drives because they are there. It just takes time. We have to relearn trust and intuitive eating, and I've been talking for way too long. But it's a huge and complicated issue, so I'm sorry and that is, I feel, like…

LIZ WOLFE: I'm just sitting here nodding my head. I'm like, yes!

STEFANI RUPER: Right. So I feel, I feel very…I feel passionately about this, and I've been articulating it and struggling to get it in a popular form for a long time. So I'm glad to speak to it, and I am…of course there's a whole lot more there, and if you guys want to speak to it what else is sitting there, I'd be more than happy to hear your insights.

LIZ WOLFE: I want to touch on something that you said, and something also that I kind of plucked from one of your podcasts was the idea of forgiveness, and that's something…I can't remember, Diane, if I've talked about this on the podcast before, or just in our personal conversations, but there was a time probably 5 or 6 years ago where I sought some outside help with just things that I was really struggling with in my life, and one of the phrases that I took away from that was one of the things the woman I worked with said, was you just have to forgive yourself that. And the notion of just alleviating that weight voluntarily, I think a lot of women don't realize that the burden they're carrying is something that they can shed of their own accord. It's not something that someone else has to lift for them, and to just forgive yourself that. And this is actually kind of juxtaposed, not even juxtaposed, but actually kind of said in the same breath in one of your podcasts, Stefani, with the idea of laughing something off, or having a sense of humor or lightheartedness about it, and I wanted to kind of ask you if you feel like forgiving one's self and having a sense of humor are one and the same, or if they're kind of different approaches to the same kind of result that we're going for.

STEFANI RUPER: Yeah, I'm really glad you brought that up. I was thinking about that, but I was-I had-I was talking a lot, so I didn't say it.

LIZ WOLFE: [laughs]

STEFANI RUPER: [laughs] So the…yeah, I think that that's interesting to ask if they're the exact same thing. I don't think so. I think you can forgive yourself without laughing, but I believe that the laughter piece is pretty crucial, and I don't mean laughing at. I don't mean scornful. I mean just letting what your behavior roll off of your shoulders, you know. It's just, like I said on the podcast, it's like “Holy crap, I just ate 8 pounds of sweet potatoes. There I go again!” I mean, there's nothing necessarily that we can do, you know, about this, and we can't…the whole piece of the laughter is about learning not to obsess about it, and just to shrug it off because the self-flagellation and the guilt and all of these things, they're super heavy, and we have to put a counter-balance against that that is powerful and loving, and also just…that just dismisses it, right? It's a really powerful thing. Okay, so I'm really glad that we're talking about this because it's one thing to make a concerted effort and to, you know , make yourself forgive yourself, and to perhaps journal to yourself and write letters and convince yourself that it's not your fault. This is an important step; I believe that a lot of women have to do this, and to practice positive self-talk actively. But I think that another step, the next step is to say, okay, great, I'm not going to think about it because that's where we eventually need to get, and so we need to be both positive and dismissive of overeating, of binge eating, of negative behaviors at the same time because if we were constantly thinking about negative behaviors, I don't think we can ever get rid of them, and so if we can positively, lightly laugh them off, you know, and then perhaps go to the placeholders that they have, you know, deep in our souls and in our hearts and whatnot, perhaps their placeholders will just become less strong and less capable of getting grips into us.

LIZ WOLFE: Kind of denying them power.

STEFANI RUPER: Yeah.

DIANE SANFILIPPO: Yeah.

STEFANI RUPER: Yeah, just deny it, yup.

DIANE SANFILIPPO: This is…so I mean there's so many things to talk about in this one question, and I've got my kind of…I've actually got my touchy-feely approach to this, and I've got my really practical side approach to this because I've gone through what Jennifer's talking about, more times than I can count, and I don't know that, you know…this is Diane. I don't know that where I'm at now is like completely past it for forever, but I feel like I've gotten to a really good place with the way that I approach food. And it's funny because somebody just asked me this morning about the balance of macronutrients in my breakfast and like that I didn't really have a lot of carbs in my breakfast, and I just said to this person, or replied to the post that, you know, right now, I'm in a place where I'm eating what I feel like eating, within the realm of what is whole food, and not stressing about how much or, you know, did I do the right thing or not? I'm just eating what I know to be good food and I know for myself, whenever I take…I have two kinds of extremes that I go to, and the one is like a lot of rules, and I feel really comfortable with a lot of rules because I feel like my own consciousness around the choices is relieved, and so I just know here are the foods that I'm “supposed to eat right now,” so if I stay in this, you know, whatever these rules are, I'm comfortable and calm, you know. And what Jennifer's talking about, anxiety, whatever, for me, it goes away if I'm sort of following some kind of very rigid plan…

LIZ WOLFE: Mm-hmm.

DIANE SANFILIPPO: And then to the opposite extreme if I just allow myself to eat whole foods naturally, whatever I feel like eating, then I also have that relief where like, right now, I'm just not stressing about it. I don't think about it. I don't worry about it. I just think, what do I feel like having? What would be fun for me to cook because that's what I enjoy doing? And then, how do I feel when I eat that? Is that the right balance just because you know, am I hungry an hour later or not. And the reality is, it's all about kind of a self-talk around where you are right now with your body and your body image, and so after, you know, months of a lot of stress for me, I got back to a place where I wasn't really thrilled with what my body was doing, and I've had to start saying no to a lot of things, which, you know, I get the feeling that women who land in this place, they're pretty overwhelmed by other things going on. Like, I think, Stefani, you were saying, you know, if it's a little element of control and the conversation that we have with ourselves around like, well, if our body is doing this, what can we control or change to fix it? And of course, the first thing we look to is what's on our plate. And the reality is we need to start changing how we're thinking about things because the stress that we're feeling, whether it's just emotional or, you know, physical stress, the physiological and emotional side of it becomes physical. Like we stress ourselves into holding onto body fat. So like…

LIZ WOLFE: Yup.

DIANE SANFILIPPO: the more we think about it, the more it becomes a problem that's self-fulfilling, so basically when you stop feeding those thoughts and negative, you know, thought patterns and negative emotions, you can release some of the pressure, and then you do come back to naturally eating a balanced amount of food. But I don't think it's something that people can learn of themselves immediately or just because they hear us say it. I don't think you have to go through that process a few times, like the same way when somebody goes to give up gluten or grains. Like how many times do you backslide before you stick with it? And I think this emotional stuff sort of needs that, too, to a degree, so that each person understands their own tolerance for the negative self-talk before they snap themselves out of it or decide to go to somebody for help and work on it. And so, those are the kind of…this may lead to the practical side of things, so I've worked with somebody personally and as a colleague and a friend of mine now, but originally, you know, as a practitioner, I worked with on Emotional Freedom Technique. Have you ever heard of that or done work with it, Stefani? EFT?

STEFANI RUPER: Yes, I have never done EFT myself, but I am familiar.

DIANE SANFILIPPO: So people can look it up. I think I've posted about it before; I may have posted about it in an adrenal fatigue podcast. I can't remember. But EFT can be a really effective tool for people who are dealing with these very isolated, acute incidents where they just…it maybe isn't manifesting for something huge and in their path, or it may be, but the reality is, you just want to deal with the emotions you're having around physical actions right now, and I found it to be really effective for me because it's almost like it doesn't matter what I grew up with, whatever may have pushed me to this way of coping, like as a coping mechanism. It doesn't really matter, all of that, like you could go to talk therapy for 10 or 20 years and try to deal with that, or you can work on, you know, behavioral modification that really sticks now. And for me, I like that really hands-on stuff, so I think EFT is really effective for people. It really helps you just detach those negative emotions from certain actions, so that you can do that forgiveness step of sort of laughing things off.
There are really, and this is something that people need to research on their own, Julia Ross has written a book called The Mood Cure, and The Diet Cure. I honestly think that…I've had personal experience with this, and it's probably something I'll write more about, but working with different amino acids and different neurotransmitter support and some vitamin and mineral support…

STEFANI RUPER: Yeah.

DIANE SANFILIPPO: For people who find themselves in these mental states, I mean, I found that, like I mean, I've taken like different kinds of supplement combinations that really take my appetite down, and not to a place where I'm not eating, but to a place where I don't find those spiraling thoughts ever happening. And it's really interesting to learn, that there's a way to maybe rebalance your brain, so if you're in a place where you're so stressed that like, you just can't talk yourself out of it, there are ways to help support your body, and it's not about anti-depressants and all that stuff, but it's really just some sort of, you know, natural support that maybe your body is a little deficient in something, and it just supports your brain chemistry to bring you back to that equilibrium. Have you worked with neurotransmitter stuff or amino acid therapy at all?

STEFANI RUPER: Yes. I am a huge proponent of amino therapy.

LIZ WOLFE: Nice.

STEFANI RUPER: That isn't to say that I do…I don't do testing for myself or with women that I talk to, and I refer people to their doctors to figure out a good plan for them. But there are also some general recommendations. I mean, I know the field and I know certain things that are good for others, and I myself have been struggling, not with my relationship with food recently, but with…with some other emotional things, and I'm currently taking some supplements that I think are really salvific-I think it's a good word. And amino therapy, I have seen help many women, very many women. On the other hand, I do know people who have tried it and been like “that's great, but I'm still…like something's still not right.” I absolutely believe just 800 million percent that these issues have to be tackled from both angles. I think that it's a shame that when we talk about health, by default, we mean physical health rather than, you know, talking about mental and emotional and spiritual health and all of that. And I think it's a shame that so many of the people who work in eating disorders these days only focus on one or the other. That's partially why I feel so passionate about the work I'm doing is I feel so strongly about holistic health and needing to tackle issues from all angles. And yeah, it's unfortunate, but that's not a popular viewpoint in disordered eating circles, at least not in the wider kind of way, and so yes, amino therapy I think can be really helpful with all therapies.

DIANE SANFILIPPO: Cool, well, we're going to shift gears just a little bit and get into the next question, which touches a little bit more on some fertility and hormonal issues. So Jordain asks: “Hi Ladies! I’m desperately seeking advice on how to handle something that I have been struggling with for three years now. I’ve stopped menstruating, and at 17 years old this is frightening because I very much want to be able to have a family of my own one day. A little background: My entire life I was overweight, inactive, and ate less than stellar choices when it came to nutrition. However, I finally saw the light and decided to take charge of my health. To make a long story short, I began exercising more and eating less. It worked! I lost 50 pounds in a healthy manner in about a year and couldn’t have been more proud of myself. Here’s the bad news—in the process I stopped having a monthly cycle and developed an unhealthy relationship with food (more on that later). I researched my dilemma and assumed my period would return after my body had “adjusted”. However, it’s been 3 years and still no Aunt Flo! About 6 months ago I had my first gyno appt. to discuss the matter. To my disappointment I was put on a birth control pill, but not given a clear reason as to why I wasn’t having a cycle. I feel as if I was only given a band-aid. The pill hasn’t worked and all I want is to be fertile and healthy. ”
Quite noble for a 17 year old. I like this.

LIZ WOLFE: Smart.

DIANE SANFILIPPO: She says: “I am 5’2 and my weight stays between 108-110. I guess you could say I’m very petite, and admittedly I’m very lean. I’m a huge perfectionist and I’m easily stressed. For the last three years I have been dealing with family and body image issues. It seems as if all I see is the notion that less food and more exercise is better. SO frustrating. I’m sick of comparing myself to others. In an attempt to regulate my cycle I’ve recently cut back on my strength program —4 days of lifting and on off days I may do a conditioning circuit or run sprints depending on how I feel. I’m never really hungry, and my appetite is very sluggish. Do I need to eat more? Exercise less? I already feel as if I do the bare minimum compared to others I see while eating more. As a teenager, what is your opinion on the best way to go about a paleo diet (more carbs, less fat, etc.)? Thank you SO MUCH for taking time to read over this loaded question. I truly look up to both of you as healthy role models in a world so consumed by aesthetics. I feel so helpless, and I want my health and fertility back!” Phew! This is a big one.

LIZ WOLFE: This is definitely a smart, smart gal. I mean, she asks about whether she should eat more or exercise less. Just so what I'm hearing here from her is that she's pretty darn aware that there are some things going on within that are probably going to be as they are for many women, including myself, greater in breadth and depth than what is actually eating and physical activity has actually done. If she were my client, I would totally refer her out to someone like Stefani and try and work in conjunction with her, as I plan some kind of nutrient strategy and engage in that kind of inner, reflective process. She touches about-on something that we talk about in our workshop or that I talk about personally, Diane and Stefani, which is kind of choosing your priorities. Mine is fertility because I know my husband and I won't be ready to start a family until likely later into our thirties, much later. And I know how important it is to get my body what it needs so that when we're ready, we can move forward. I just really respect this gal, and I want her to know how impressive her eloquence is. I just hope she's not undervaluing herself on the whole, so I'm just excited to hear what Stefani has to say. I'll let you take it, Stefani. [laughs] I'll shut up.

STEFANI RUPER: Thank you. Yeah, so I don't want to go ahead and diagnose her over the podcast without having spoken to her or in public [laughs], but I would encourage her to think about and to read about, and maybe she's heard about hypothalamic amenorrhea, which is a condition that many women experience, and it is in fact, it's been important in my life. It's been important in many other women I work with. It's been important for them. So this is the condition women find themselves under when their bodies detect themselves in a too stressed or too hungry, too starved state, and when…and this happens via a number of mechanisms. It happens primarily by being in an energy deficit, but this is through, you know, extreme…this is through exercise. You do exercise a lot. Not too much, but you do exercise a…this happens through exercise. This happens through caloric restriction. This can happen through macronutrient restriction. If women are not eating carbohydrates, this can be a significant factor. The body can detect that as a starvation response. And this also happens when women are at a low body weight, and so very often, people consider, you know, the loss of menstruation due to this type of problem as a factor of just being a low body weight. And so some women will, you know, drop to 18 or 19% body fat, or in my case, I'm currently sitting at 22% body fat-ish…probably more…and they're not menstruating. And much of the literature talks about how it's actually women who are at, you know, 12 and 14% body fat who stop menstruating. But it's different for every single woman, and it is a particularly concerning for women who have experienced weight loss. I
It's my opinion, and it's not everybody's, so you don't have to believe me, but it's my opinion that a woman's body sets a sort of hormonal set point, a nutrition level set point early on in her life, early in puberty, etc, and that…when the two hormones that are particular to think about in this regard are estrogen and leptin. Both of these hormones are produced in fat stores, and both of them are crucial for telling the hypothalamus, the part in the brain that dictates all of this, both of them are crucial for telling the hypothalamus that the body is fed, and that it should go ahead and reproduce normally. And so when we lose a lot of weight, for some women, it's hundreds of pounds and for some women it's 20, but if we experience a significant change in these levels, then the body will, you know, detect this as a starved state, and stop reproducing. You at 5'2 and 108 pounds, you said, that's quite thin, and given that you exercise so much, I would anticipate that you have a lot of muscle on you. And so when you're talking about your ability to menstruate, all of these things become of concern. I'm not asserting that you can only menstruate and only be fertile overweight. That is, I believe, wholly incorrect. Wholly misguided. I believe that women menstruate at healthy weights. I believe that women can be within the normal range and both fertile and healthy, but some of us cannot go that low. You know, we have this acceptable range…I'm using air quotes right now, “acceptable range” of body fats for women, and doctors recommend that women be within 15 and 25%, but in my opinion, the women who do well at 15, you know, 16, 17, 18% are women who were born that way. Women with those genes. Women who have grown up eating low leptin, low calorie diets. You know, many women around the world are extraordinarily thin, but still manage to have babies because they grew up in these environments. But many of us did not, and so if we have a more nourished body, and we have higher leptin levels when we're growing up, then our body is going to want to have higher levels once we mature. And so it becomes…it is not an issue of an absolute body fat level, but rather a relative body fat level for those of us who struggle with this.
And so body fat is one important part. Your body may never adjust to being at this low body fat, no matter how nourishing and how much you eat, etc. It may require it, I would say, probably would, but again, I have no idea about your life. I have no idea about your history or your doctor. You know, your lab tests and whatnot. But when things walk like a duck and quack like a duck, they tend to be ducks, and so and I mean, it's tough because myself….So this problem happened to me. I lost 30 pounds in 3 months, and I stopped menstruating. And I was diagnosed with PCOS, which is a different hormonal problem, but what triggered it was the, you know, the low body fat, etc. And my way of moving forward was to try every single solution I could possibly think of first before I put on body weight because I was so excited to be thin, and I was so terrified of putting on weight. And I did try everything else, and I kept looking for a nutritional solutions for like the proper diet and I didn't find anything. I did that for a few years, and then I got on drugs, secondarily, to see if that would help. And that was a large mistake because they were very bad for me, and they messed up my neurotransmitters, which is why I'm dealing with some issues right now. But all that being said, I tried everything before I tried putting on weight, and it ended up being a duck. It was quacking like a duck, and it ended up being a duck.

DIANE SANFILIPPO: Mm-hmm.

STEFANI RUPER: And I had to finally own that and to put on some weight. So I won't tell you that that's what you have to do, but in my experience myself and with many people, that is generally, you know, is a real condition and it's a real phenomenon that stops us from being fertile. That being said, the primary health concern with that is that your estrogen levels might be too low and might weaken your bone strength. And there are also a number of mental health problems that can accompany such a dearth in estrogen relative to other hormone levels. And a dearth may be possibly, depending on your condition of all hormone levels, and so if you end up….if you find that you're experiencing depression or anxiety or insomnia, acne, any kind of disturbances, poor memory, etc., those might also be a factor of something…a hormone imbalance that may be present in you that clearly is at least a little bit because you're not menstruating. That should be addressed. Birth control put a band aid on it, like you said, but it will not get at the underlying cause, and as a matter of fact, I would argue that it can exacerbate the problem because getting off of birth control, then, in the long run, has only crippled us further in terms of our hormonal development, and so again, I spoke for way too long, but I think I covered the science of it as thoroughly as it needed to be covered. What do you think?

DIANE SANFILIPPO: Yeah, I think…yeah, this is Diane because I'm the other long-winded one here. [laughs] Heh, no.

LIZ WOLFE: [laughs]

DIANE SANFILIPPO: No, I think…no, I was again, you know, nodding along and I think what you touched on is something that we started talking about this whole adrenal fatigue or adrenal exhaustion issue in a couple of different episodes. So when you mentioned a hypothalamic amenorrhea, the first thing that comes to my mind is whatever is happening, you know, the hypothalamus as the command center in our brain, whatever it is, it's some kind of stressor.

STEFANI RUPER: Right.

DIANE SANFILIPPO: So what we tend to do today is look for things to do rather than things to stop doing. So, you know, if we're restricting this, restricting that, adding exercise, etc., and we think, you know, very, very wise 17 year old, should I eat more, exercise less? You know, kind of take away restrictions, take away rules, add back some fun, and some way of relieving stress in her life, and this is a lot of where the holistic lifestyle coaching and the whole CHEK practitioner universe comes into play a lot because we see a lot of people with these hormonal imbalances, and quite often, as we're seeing with her, it's a woman who on the outside and who other women appears an ideal shape, right? Or she's got some level of “perfect body “or “great body” or “lean,” and then they come to us as practitioners and they tell us that they're not menstruating or they have irregular periods or painful, or hormonal imbalances that we're seeing in this question, and it's very, very common. So I love that this question is addressing a whole picture that we have of, you know, what we think we should look like to be healthy, when really, as much as I love the athletic community because it's giving us a positive mindset around strong women, I think it's coming with, you know, the flipside, the Catch-22,and then we're also seeing uber-lean women who are performing at a very high level and are very strong, and we may aspire to some of those achievements as well, but we hopefully aren't aspiring to this state of amenorrhea, where we're no longer menstruating because it's not a healthy place to be. And so it may be something where competitive athletes get there for short periods of time, hopefully, and can come back from it, but it's a pretty base bet that a lot of competitive athletes are not menstruating and hopefully, that's not something they do for long period of time. So if this is us as kind of like the regular folks, and I've been there, too. I stopped menstruating when I was at my lowest body fat. I think, Stefani, you said around 18% we can get there? I was probably around 18 or 19% when it happened to me, and I don't know that it was just this situation of low body fat for me, but just the severe, severe stress that was right around when I had my first bout with really bad adrenal fatigue. And so, I mean, it could be any or all of those things feeding into each other, but we really need just to look at it as a holistic picture of like what are all the things that I'm doing that are adding stress to my life and adding stress to my system, as opposed to what can I remove that's a stressor, and you know, as she mentioned, maybe exercising less because, you know, exercise is a stressor, and it's a positive one if we're doing it with the right dose and duration, but when we take it over that ledge, and it's different for every person, what that ledge may be, where it becomes too much, and becomes a negative.
So I think, you know, I think it's an amazing point to get people to realize that that imbalance and stopping the menstruation may be the low body fat, or it may be some sort of just a stress signal in your body-that could be the low body fat, it could be any other number of things, right? Like these hormonal imbalances causing it. So it sounds like she really should find like a naturopath or, you know, some other kind of practitioner who can work with her, maybe do some salivary adrenal testing and female hormone testing, right, and try and maybe get back on a course of supporting proper hormone balance as well as kind of looking at what she's doing in her diet and lifestyle, just take the stress away. What do you kind of think about that? Before we get to another question here, do you think that's kind of a good next step for her or…?

STEFANI RUPER: I do. So women can actually, as you said, can actually stop menstruating just from mental stress. Most of the time, both factors are at play. And this is…I'm not speaking just from my experience, but from the vast, vast number of medical practitioners and journals that I've read, that women often experience both at the same time, and so both do need to be tackled and I think she should be wary of her stress and she should work on stress reduction. But also again, the duck issue…please don't use the stress as an excuse to not pursue diet and lifestyle modifications because a lot of us end up doing that. We, you know, grasp at the one variable that doesn't make us have to put on weight or something, and so move forward with caution and with all possibilities in mind.

DIANE SANFILIPPO: Coo. Well, let's head to…well, we have actually…Stefani, do you have a little bit more time? Can we get to a couple more questions here?

STEFANI RUPER: Yeah. Absolutely.

DIANE SANFILIPPO: Okay, I didn't want to hold you up if you had a [xxx]. Okay, so we've got another Jennifer, who's asking…she said. Oh wait, no with that. Is that our Jennifer here? No, we've got some really similar questions here, so…Okay, here we go. Now here's another one…a lack of menstruation that maybe we might have a couple more notes for her. So this one's Jennifer: “I recently had a check-up with my gynecologist due to a lack of menstruation. I have been eating a Paleo diet for almost a year and a half and my periods have been sporadic for the last year. When I do have a period they are 40-50 days apart and only last a day or so; they are not true periods in that I haven’t been ovulating. My doctor completed a sonogram of my ovaries, uterus, etc. Everything checked out fine. The next step was bloodwork. She informed me that my TSH was high; hence, hypothyroidism. Her next step is meds, of course. I had read Chris Kresser’s Hypothyroidism Series even before this bloodwork was done, and I just don’t think that could be the cause of my missed periods. I feel healthy otherwise – I don’t lack energy – it’s only the missed periods that concern me. I know this is somewhat of a blanket question as there are so many factors that play a role in a woman’s cycle, but any advice would be appreciated. Perhaps there are other common causes, us Paleo women encounter, that can cause amenorrhea that I am overlooking? As far as my diet is concerned I am fairly strict. I get good amounts of meat, veggies, and fats. I do minimize the fruit; maybe a few servings a week, and include starches like sweet potatoes post work-out. Fish oil is the only supplement I take – not on any meds. Periods have been regular in the past, although, I spent several years on birth control. Since I gave up on the birth control (over a year ago) my period has yet to return. I exercise about 5 days a week, usually 20 minutes. Some days are for heavy lifting and others include sprinting or plyometrics. Sleep is decent, but could be better — usually 7-8 hrs a night, but I wake up often. Oh, by the way ya’ll are fantastic! I listen to you two every week and I just know that you’ll give me some sort of information I can put to good use. Appreciate everything you do!”

LIZ WOLFE: Aw. Super sweet. Well, let's kick this to Stefani directly because it's kind of what we've already been talking about, but I also wanted to just throw in, and Stefani, you can commentate on this or not, if you want, but just thinking about some of the work from Dr. Kate Clancy. I believe she's not doing context and variation anymore; that was her old blog. I believe she's working out of the Scientific American now, talking about kind of “normal cycle lengths” quote unquote “normal cycle lengths.” I don't know if that's anything you want to talk about, Stefani.

STEFANI RUPER: Yeah, so it's not something that I am hugely, widely read in. Normal cycle length is a bit of a modern invention.

LIZ WOLFE: Mm-hmm.

STEFANI RUPER: Women, so far as we can tell, can experience a wide variety of cycle lengths and can, you know, experience varying degrees of fertility throughout the year, throughout her life, and still be healthy. You know, looking at history and looking at traditional cultures and you know, looking at women within our own cultures, and so it may be possible, and it certainly is possible for women to have outliers, for women to experience something significantly different from the norm, and still be fertile. That said, Jennifer is not ovulating, so she's not fertile, and she's concerned about that. And she's asking about common causes of the missed periods and I'm interested in the fact that she didn't test to have…that she didn't have cystic ovaries. I had anticipated that she would have because she's right, and I think in some ways in that hypothyroidism, it can contribute. It can be a very significant contributor to dysregulated hormonal cycles. Usually, it's accompanied by cystic ovaries, but not always. So I would encourage her to, you know, to actually consider that seriously. Taking T3, I think, is a decent way to correct that in the meantime. I think upping carbohydrate intake and calorie intake is a good way to do that. Stress, as we mentioned, is another…it's kind of a silent, you know, a silent killer of fertility, but that can also be shown through decreases, you know, really low output from the HPA Axis hormonally, which would come out in terms of low LH and low FSH in particular. A final cause, and I think I would hang on my hat on this one, if I had to, and perhaps coupled with everything else, is the fact that she was on birth control for so long. I've worked with women who have gone several months if not years recovering from birth control. This because birth control produces…you know, we take hormones in birth control, and our body detects these hormones in our blood stream, and so it downregulates the production, and it can take a really long time for that production to come back. So those are my few thoughts on what could possibly at play in this woman. And with regards to, you know, the normal cycle, I'm not sure…I'm not sure about what she would fall in that spectrum and how she would know what she's experiencing is normal, and I'm not very familiar with the work you spoke about, Diane, so maybe you should take a minute to speak on that.

DIANE SANFILIPPO: Well, there's one other thing I was thinking, and you know, I definitely have colleagues…I knew some women in school who had come off of birth control and for well into a year, maybe two years, still not getting their period. You know, that didn't happen to me, so I wasn't as familiar with that experience. I'm pretty sure I was menstruating regularly anytime…I did take the pill maybe on and off for 10 years. So I was pretty lucky to come out that pretty unscathed, I think. But I know a lot of women who it does take them a long time, as you said. I also know women who are hypothyroid who don't get a period or who have worked with practitioners for about a year now or almost a year to basically on this notion of I want to get my period back, and so have been doing a lot of different supplement protocols and lifestyle approaches just focused on how can I get my period back. And, really, I don't know. That's what I recommend for Jennifer. Like I have one colleague who I send a lot of women to who works primarily on female hormonal issues. Her name is Mary Vance, and, you know, I know she's pretty experienced with different issues around hypothyroidism, so if that was happening, she would run a lot more, you know, sort of salivary panels and different types of tests, and just kind of see what's going on with you. Because it really does become sort of the priority, you know, to have a regular period, a lot of times women will come to us with, you know, sort of weight loss goals or weight loss resistance or just energy levels, which you know, Jennifer's not having that issue with energy, but whatever the issue is, if your hormonal balance is out of whack, we kind of can't really know if what we're going to do will work. It's like, if we don't have an even playing field, the horizon line is not even, we just don't know, and I say the same thing to women who are even on the Pill. Like I just don't know that everything I might do with you will work the same way, and you know, it's one element, right? The person's constitution, their history, everything feeds into it, but if somebody's got a known hormonal imbalance or a known hormone medication that they're taking, we just don't know that what we do to effect change will work in the same, expected way with them as it would otherwise. So I would just make that her primary focus, and again, you know, like this is what I said for the last question is, you know, find a practitioner who will work with you on bringing your period back because I don't know that this is something that you can just do. I definitely think making sure you're not restricting carbohydrates, making sure you're not restricting calories or, you know, with that comes nutrition, so not restricting nutrition because that's stressful to your body.
I think that those are really important things, but I don't know that this is something that you can just, you know, turn a couple of knobs and fix. I think it might take a long time, and it might take a bunch of supplement support for a period of time to get you back there, to reset, like you said, Stefani, the HPA Axis, like, a lot of the stuff that we do with supplementation, things like pregnenolone or DHEA or to work on resetting that axis, and so what those signals are, you know, are being sent from our brain to the rest of our body. If we can't, you know, consciously change the signals, we're eating well, we don't have some kind of infection, etc., that's pushing that balance off, just helping reset that signal, that might be, you know, what needs to happen. So I would get in touch with Mary. I mean, I just…I've had a lot of…people have really good success with her, and we'll put a link to her blog and website on the show notes here, but it's just MaryVanceNC.com. I was long winded there. Liz, did you have anything else? You're muted if you're trying to talk. No?

LIZ WOLFE: No, I'm not muted. [laughs]

DIANE SANFILIPPO: Okay.

LIZ WOLFE: Just listening, just soaking it up. You guys…you guys are awesome. What's next?

DIANE SANFILIPPO: Yeah, where we were? We've got one more question here. Kate asks: “I went back through your Women’s Health Podcasts and you briefly mentioned that women who have recently taken themselves off of birth control should be much tighter with their diets. Can you expand upon that? What part(s) of coming off birth control after 12ish years makes you vulnerable to metabolic/insulin/hormonal issues? I thought that my body would immediately be better but now I understand that it can take up to 6 months or maybe more for my body to normalize. For additional info, I was in a pretty bad car accident almost 2 weeks ago. No broken bones or major injuries (thank God) but trying to be easy on myself in the way of exercise. By the way, I love love love the show and you both have inspired me to enroll at Bauman so I can attempt to help myself and other people even a fraction as much as you help your listeners.

LIZ WOLFE: We actually chose all of these questions to make ourselves feel good. They're…everyone's…just kidding. [laughs]

DIANE SANFILIPPO: [laughs] So she says, she “went on Paleo approximately 1 year ago. Stress/hormones/willpower have been [her] biggest issues. As most, I started out great and petered out. Today, I’ve started the Sugar Detox (again) to really shore up my issues. Sleep is good most nights. Occasionally have to cut it short due to work scheduling but otherwise I aim for 8+ hours. As I said above, exercise is slow right now. The last few months of last year were great and I was very dedicated to a weight lifting routine I made up for myself. This year has not been consistent. I plan on building back up to hitting the gym by walking a lot and doing a lot of weight bearing exercise at home. I can't do CrossFit but I have a nice 24 hour gym with weight equipment, barbells, and dumbbells available that I go to.” She's saying her “Biggest non-paleo vices right now include tons of cheese, corn tortillas, and sugar. I have these items 3 times week. I am not drinking alcohol right now at all as I know it won’t help. I haven't had any gluten exposures in the last….oh, have had recent gluten exposures probably 1/week for the past 3 weeks.” So that's little extra details we like to get from people, so, yeah, another one who's not getting her period. Stefani, do you want to jump in on this again with just a little bit more info from Kate here?

STEFANI RUPER: Yeah, so I could, but I also…I am unfamiliar with the recommendations that you've made for women coming off of the Pill, and she was asking for a bit more help on how to dial in. The only piece that I would assert is that you just…I would…personally, I don't like dairy all that much for hormones. It's a pretty hormonal food. And I just encourage people to be as nourishing as possible and to practice as little restriction as possible when they're trying to right their hormone balance. And that's about as specific as I think I can get, and then I would love to hear what you have to say in terms of the diet. Oh, and don't restrict carbohydrates. I don't feel like you can do that much of the time

LIZ WOLFE: Yeah. When we say, when we say being tighter with the diet, and I think this is a really important distinction that we should be making is we're talking about being a nutrient-seeker. We're not talking about making sure you eat chicken breast, broccoli, and coconut oil every day. We're talking work in bone broth. Work in some good liver, you know. Some good really nutrient dense food as much as possible, just to really give your body that foundation, so it can kind of, you know, reach equilibrium, kind of rebalance a little bit. Usually, women, at least the clients that I've worked with, when they're coming off birth control, they're extremely willing, and that's when I can have the most fun with folks, and we can talk about working organ meats into the diet, getting a variety of really good, nourishing fats and Stefani, you keep using the word nourishing, and that's like 100% my soapbox. Like I want women to be well nourished first and foremost. So that's what we're talking about when we say being tighter with the diet.

STEFANI RUPER: Right.

LIZ WOLFE: We're not talking about, you know, macronutrients or anything like that.

DIANE SANFILIPPO: Yeah, we're really not big proponents of…I'm a…I don't know. I'm really big on making sure that people are eating enough because I look at a lot of food logs, and I see this with men and woman, and I know sometimes if I post a picture of a meal, and someone's like, that's all you're eating? I'm like, well, maybe today, I didn't post all 3 meals, and you didn't see how big the next meal was. [laughs] You know, it's like, you don't know everything, so when I look at food logs, often I'm like, this is not enough food, and it's not just about the calories. It's about, what are the micronutrients doing to replenish you, and I think the other thing we had talked about, Liz, is like replenishing micronutrient stores, and I think birth control…I can't remember exactly, but I think we have seen that they are known to deplete like B vitamins, possibly vitamin C. Really anything that has to do with stress in the body, so vitamin C and B vitamins. So it's not necessarily about taking tons of supplements or doing anything specific other than when we're looking at the “tightening up,” we mean, really not messing around with much with garbage food that makes its way in. And it's not about feeling badly if it does make its way in, but it's about recognizing that those foods are continuing to deplete your body when we're trying to build it back up, and we're trying to fill in the holes of any possible nutrient reserves that have been depleted by taking these exogenous hormones. And the same really goes for taking any kind of medication that might deplete your body or any type of depleting activity, like exercise.
We're always trying to replenish nutrient stores, and I love that idea, too, Liz, of like a nutrient seeker, because I think the whole macronutrient, and Stefani, you touch on this, like not restricting carbohydrates, I just think the whole macronutrient question is getting way too much attention and it's valid, and it has its place, especially when we talk about athletic endeavors and making sure people are well fueled for different types of activities, but the reality is we are really just like driving ourselves crazy, and we have a lot of questions, even in our queue of, you know, what macronutrient ratio should I be eating, and I'm like, I don't know. What do you feel like eating? You know, you get to a point where you just don't want to be that prescriptive with people, and of course, we have different prescriptive approaches we can give people to try. They're all just recommendations. Like we have this field for you, write it down. We want the qualitative information as much as if not more so than the quantitative because we want to know how you feel. And I think that that's really the important point when you're coming off of birth control or just any time you're looking to get hormones regulated, it's replenishing more micronutrient stores, getting very nutrient dense foods in, and making sure you basically crowd out the garbage food with the nutrient dense foods in the opposite way we pretty much all grew up eating, right? With our Pop-Tarts and our Cheerios crowding out any possibility for things like liver and bone broth.

LIZ WOLFE: LIVER!

DIANE SANFILIPPO: And scoffing at them, you know, and it became like this societal thing that those are crazy, ridiculous foods, but we're bringing them back.

LIZ WOLFE: I love liver.

DIANE SANFILIPPO: Making them normal, if we can. Yeah, so that's kind of what we meant by those things, and please by all means, if it stresses you out to try and be on the Sugar Detox, like please don't do it if it's stressing you out. I don't want anyone to feel about bringing more negative stressors into their life. But if you feel like you're having trouble with sugar and that might help you, then do it. So that's what we have in, but I think, Liz, did you have anything else that you wanted to kind of touch on here with Stefani or ideas to roll around?

LIZ WOLFE: Yeah, I have one -I have one last question…yeah.

DIANE SANFILIPPO: Okay.

LIZ WOLFE: One quick thing, Stefani, just get your take on it quickly, and we'll let you go. On the, you know, coming up the CrossFit Games here, just I think what's been on a lot of folks' minds is the idea of ideal body composition. I want to get your take on-does that exist? Is that something women should even occupy themselves with? Is that toxic? Is it benign? What do you think?

STEFANI RUPER: [laughs]That's a loaded question. It is a bit of a loaded question. I mean, not intentionally, but it's a heavy question because I do…I get a lot of people protesting my recommendations and I want to be clear that I do not advocate that women just accept being overweight and deal with it and love their bodies, etc, etc, etc. That's a common trope in society, and I understand why people feel that way. But I advocate health, and I do believe that the “normal range”, and again I'm using finger quotes, but I do believe that the normal range of body fat is the healthiest place for women to be, and I believe that there is a window where both health and fertility are present and maximized, right? And so I believe that women should live, should strive to be in that women, and I don't even believe….many people say that we should have personal ideals, body sizes, and not one relative to society, but rather as our own. And I agree kind of, but the whole notion of “ideal” really breaks my heart, and I think doesn't quite do us justice. Something that I advocate is loving our bodies as physical bodies, as the platforms off of which we spring and live and exist and love and all of these awesome, powerful things. And so we love our bodies and we treat them well, but not wholly dependent on size. I believe that being in a range is great. This is my ideal range. I like being between 20 and 23% body fat. Or I like being between 24 and 26, and it feels good, and I'm eating intuitively, and I look sexy because everybody like in the 20% to 29% range, whatever, looks sexy. Please, women, please internalize this. You can have fat on your body. Not necessarily in your abdomen, which can be unhealthy, but fat on your hips and your thighs. That is totally attractive. It's totally sexy. It's fertile. It's awesome. I just put it on. I was super rail thin, and recently in the last year of my life, I put the weight on, and it was difficult doing so, but once I got there, I loved it, and you can own it. And so I do not think that a notion of ideal is helpful for anybody, but rather I think that emphasizing our bodies as these wonderful, lively things that can give us life, and trying to nourish them that we can help them do that, without worrying about what they look like, it does not make sense to me.
I did-I recently wrote a post that was posted at the Whole9's website, entitled, “How Perfect is the Perfect Body?” And I did, I addressed this very question, saying that there were so many different things that are more appropriate markers for health. Like this is one of them. You should be in a good range, absolutely, but what is what body fat is indicative of is the hormone levels that we have within us, and if we could all like walk around with a little chart that showed people what our different nutrient statuses were with our blood count, and then we could be proud of that and call that sexy. That would be really great, but we don't because we have what our body looks like as a presentation, and so being in that range is important. But being healthy and empowered and confident and loving and comfortable in our own skins in that range, I think that that's-I think that that's definitely the way to go, and the way to have health in all of the realms that are important.

LIZ WOLFE: I love it.

STEFANI RUPER: Yeah.

DIANE SANFILIPPO: Awesome.

STEFANI RUPER: Thank you for asking.

DIANE SANFILIPPO: I think that's a really good place…yeah. I think that's a really good place for us to wrap up and you know, we'll leave this maybe a little bit open-ended if we seem to get a ton of response from this, and maybe in a couple of months, we want to kind of touch on it again at some point, we'll get in touch and see what kind of other questions people have. And we didn't put out feelers for questions for this episode because we already had so many lined up that we just basically roped you into talking with us. And nobody even knows until we release it. So you know, I wouldn't be surprised if we get a big response from it, and you know, I'd love to leave the door open for potential to do another follow-up on this in the future, and yeah, I'm really, really glad that you came and talked with us today, Stefani. It was really fun, and yeah, it's awesome to have another like-minded female come on and dish with us, basically.

LIZ WOLFE: A like-minded female who worked for NASA. [laughs]

DIANE SANFILIPPO: Exactly.

STEFANI RUPER: I'm really-I'm embarrassed I said that. I'm so sorry. I wasn't…

LIZ WOLFE: No, love it!

STEFANI RUPER: Oh my goodness…

LIZ WOLFE: Own it, girl!

STEFANI RUPER: I didn't mean to name drop…you know, I'm sorry.

LIZ WOLFE: No, and it's awesome. Stefani, it's awesome. I love it. I love hearing about these intelligent, fantastic, just well-educated women just all coming together over this stuff. Probably not myself included. Rock Chalk Jayhawk! I went to school so I could watch basketball, but I just so appreciate your background and your education, and it's awesome, so thank you so much for being here with us.

STEFANI RUPER: Yeah, I thank you of course as well, and I would like to respond to what you just said, and to say that something else that I believe very strongly in is I like humility, but I actually not all that much, and you're a total bad ass..oh, I don't know if we're allowed to say that word. You're totally awesome, too. And please, you know, own that. I think everybody should own their gifts and should own how powerful and beautiful they are, so yeah, go for it.

LIZ WOLFE: I always think of that line, really really tiny segment and that's actually a good, good little call out there, Stefani, because that's actually something I'm working on is really, working on that who am I not to be, successful…

STEFANI RUPER: Right.

LIZ WOLFE: or whatever. We're all…we are all in need of that kind of voice in our lives, so I just totally appreciate it.

STEFANI RUPER: Okay, well, be my friend and I'll throw it in at you.

DIANE SANFILIPPO: Awesome.

LIZ WOLFE: [laughs] You got it. Good luck at getting rid of us now, Stefani.

DIANE SANFILIPPO: Cool.

LIZ WOLFE: Thanks.

DIANE SANFILIPPO: All right, well, thank you.

LIZ WOLFE: Bye. Bye-Bye.

STEFANI RUPER: Thank you ladies. Thank you so much.

LIZ WOLFE: Thank you.

DIANE SANFILIPPO: All right, bye bye.

STEFANI RUPER: Bye.

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