Dismantling Diet Culture: How Naturopathic Doctors are Helping Women Improve Relationships with Food

Dismantling Diet Culture Pexels

When Naturopathic Doctor Sylvi Martin noticed her female patients often expressed guilt or shame about the foods they ate, she was inspired to help them break free from old patterns. We sat down with Dr. Martin, ND, to learn how she combines naturopathic care with intuitive and mindfulness-based eating to help women develop better relationships with food and improve overall health.

When Eating Brings Guilt and Shame

Martin’s naturopathic patient base is about 90% female-identifying.  With a focus on mental health, she works with women experiencing anxiety, depression, other mood disorders, and hormone fluctuations. 

But in her first decade of practice, she noticed a troubling pattern. When she asked her female patients to write down what they ate, certain phrases came up time and time again— like, “‘I blew it; I ate a row of cookies,’ or ‘I had pizza, and I feel terrible about it.’ Many women expressed guilt and shame for the foods they ate and passed judgment about how they thought they should be eating. Many thought I was going to judge their eating!” Martin recalls. “But I don’t bring judgment into the room; I assess. I’m not there to pass or fail patients about their eating.” 

As an evidence-based practitioner, Martin knew she had to dig deep into the research. “Why are we associating guilt and shame with eating? These patients didn’t meet the criteria for eating disorders, but they were not ‘OK’ with their relationship with foods,” Martin explains. 

Benefits of Mindful and Intuitive Eating

Her explorations first led her to the field of mindful eating—a practice of slowing down and using the senses to connect with our food and our bodies to create a more positive relationship with food.   

She was so impressed with the research that she undertook further training to become a mindfulness-based eating facilitator. “It helps people get rid of the guilt and shame narrative and pay more attention to their hunger, fullness, and satiety. I loved incorporating that into my naturopathic practice,” says Martin.  A 2021 study published in the international research journal Appetite concluded that even one short mindfulness exercise could substantially improve the ability to feel hunger. 

As she continued to explore weight-inclusive approaches to wellness, she noted the power of intuitive eating principles (such as challenging our internal food police and rejecting the diet mentality) to change eating behavior effectively. She undertook yet more training to become a Certified Intuitive Eating Counselor. A 2021 study published in the Journal of Nutrition Education and Behavior revealed that intuitive eating could boost fruit and vegetable intake. 

Over time, Martin got to the heart of the issue. “Meal plans don’t matter if you don’t have a good relationship with food and you label certain foods as bad. I love poutine. I don’t eat it five times a day, but when I do, I don’t feel bad about it,” Martin explains. “What’s the difference between me and someone who feels bad when they eat poutine? We need to explore that more.”

Racism and Diet Culture

Our cultural norms have significant impacts on racialized women who may have darker skin and a different body type than the Eurocentric thin, white ideal. Martin points to the roles of racism and colonialism. “It came from this white Puritan approach of European immigrants coming to North America and deciding that an ideal, pure woman with good morals looks a certain way,” Martin explains. “It stems from racism. Someone that likes to eat or has a larger body is criticized and automatically deemed lazy.” These issues of intersectional care are discussed in the book Fearing the Black Body: The Racial Origins of Fat Phobia by Sabrina Strings, Ph.D., a book that Martin highly recommends to anyone wanting to understand the racist roots of diet culture and fear of weight gain.

Over time, Martin got to the heart of the issue. “Meal plans don’t matter if you don’t have a good relationship with food and you label certain foods as bad. I love poutine. I don’t eat it five times a day, but when I do, I don’t feel bad about it,” Martin explains. “What’s the difference between me and someone who feels bad when they eat poutine? We need to explore that more.”

For Martin, this additional training supports the naturopathic approach of getting to the root cause. “I don’t want patients to come to see me, lose weight, and then be on their way without building a better relationship with food,” notes Martin. “I want to get to the underlying concern. These two avenues have really helped me do that with patients.” 

How Diet Culture Impacts Relationships with Food

Diet culture is about pursuing the thin ideal. And this approach paves the way for diet trends aplenty. “At first, it was the Atkins diet. Now everyone is doing the Ketogenic diet, intermittent fasting, or full days of fasting,” Martin explains. “And it’s not necessarily for health reasons. It’s to try and control our body, shape, and weight. It’s really toxic.”

Drawing on her background as a mental health nurse, Martin understands the importance of learning where unhealthy relationships with food begin. “Most women start dieting before their 20s. I see women in their 70s who were put on diets at 11 years old. They were shamed by their family for putting on weight in times of grief and despair or for eating more after a period of food scarcity,” Martin explains. “What are we doing? Puberty-aged women should not be dieting. We’re teaching women that it’s unacceptable for the body to change—that’s what diet culture is.” Instead of celebrating the natural changes that come with pregnancy and aging, women are expected to maintain this unrealistic, thin ideal throughout their lives. 

Focused on Outcomes, not Numbers on a Scale

Although Martin’s non-diet approach is crystal clear on her website, some patients fear that she may recommend a restrictive diet. Patients soon learn that Martin focuses on outcomes rather than numbers on a scale. Outcomes could include managing cholesterol and high blood pressure or simply learning to incorporate movement and get outside more. 

Her first step in assessing a patient’s relationship with food is prioritizing the red flags. “Often with binge eating, somebody has been restricting food during the day. Or, they don’t realize they haven’t been letting themselves eat regularly because they feel that food is bad,” Martin explains. “Then they get hangry and binge eat. When you stabilize food intake by having them eat at regular intervals, they realize that they’re binging less (or not at all) because they feel satisfied.”

Martin’s patients often comment that they no longer overthink their food. “Women spend so much time wondering if they should eat certain foods. Should they avoid all canned tuna because of mercury? If they’re eating 50 cans of tuna a week, we have to talk about potential exposure. But I want them to have a satisfying protein meal first before we worry about what else could be in that meal,” notes Martin.

For many women, it comes down to giving themselves permission to eat certain foods. “A patient may come in to never want to eat sugar again. But if you don’t let yourself have some sweet things, you’re going to give into a craving which turns into a binge, and then you’re going to feel awful about yourself,” Martin notes. “It’s about correcting that relationship with food and getting to their pain points. Let’s break that whole cycle and give permission.” A 2022 study published in the journal Current Opinion in Psychology observes that ‘giving in once in a while’ can help simplify relationships with food. 

Carving out the Time for Mindful Eating

Another common struggle? Many women don’t carve out the time to mindfully eat the foods they enjoy. Martin finds that her patients squeeze in meals when they can, grabbing hurried mouthfuls in the car between errands. “Even five minutes of sitting, enjoying food, and being present while eating can make a big difference. That’s one of the key components of mindful eating—just slowing down for even a few minutes. It doesn’t have to be an hour, and you don’t have to meditate before you eat.” 

At the first appointment, Martin asks patients to walk her through their day to learn when they typically stop for meals, snacks, and beverages. She then works with patients to figure out where to fit food into their day to keep them energized. According to a 2017 Dalhousie University study, women are three times more likely to skip breakfast than men. 

Group Program Benefits

Martin’s training in mental health nursing, naturopathic medicine, mindfulness-based eating, and intuitive eating gives her a unique clinical perspective. But in her virtual group treatment program, Nourish Wellbeing, she regularly sees the value of peer support. Women get support from other women who are struggling with similar issues. “A recent group noted that they could share things that they never talked to friends or family about because they didn’t know how to support them in a nonjudgmental way,” says Martin. 

Martin sets safety parameters in her groups to ensure no one accidentally judges someone else. “A major way that the groups are supportive is knowing that there are other people cheering them on. Everybody wins from everybody else’s success. And they’re there to hold space for each other when things get tough.”

Martin also builds self-compassion into her groups, so they can learn to truly love themselves. A 2021 study published in the journal Nutrients noted that higher levels of self-compassion among mothers are linked to healthier eating habits. Some participants are initially uncomfortable with this concept, thinking that self-compassion means being selfish. “But is it selfish to take care of yourself, so you can better care for others? No! Self-compassion is really just allowing ourselves to be comfortable with where we are in life, to be nonjudgmental, and to love ourselves as we would our best friend,” Martin explains. “It’s so important to be kind to ourselves and support ourselves as we learn new skills. It’s been really helpful for people to practice this in a group setting.”

Martin recalls one patient who wouldn’t stop for lunch and the impact of her implementing a 10-minute lunch break. “Permitting herself to eat in an uninterrupted way dramatically changed her life. Not every meal will be like that; sometimes, we eat on the go. But it’s so important for women to fit in uninterrupted eating daily.” 

Reconnecting with Feelings of Hunger and Satiety

When our gas tank runs low, we don’t hesitate to fill it up. But it’s not as easy for women to know when to refill the tank when it comes to food. “For women with a history of dieting, their hunger and fullness cues might not be as reliable. For decades, they may have been skipping meals or using diet pills and laxatives,” Martin explains. 

Martin helps patients reconnect to their bodies by using a variety of sensory-based activities. Some patients bring a snack to their appointment, and she guides them through a few eating activities. She also provides additional activities and resources to explore between appointments. “It’s about developing new patterns and new relationships with their bodies, food, hunger, and fullness. It’s where mental health counseling meets mood, and bringing it into the relationship with food.”

Ultimately, Martin wants women to know that they don’t have to struggle alone. “The answer isn’t in an online diet. It’s in working with clinicians who are trained to assess them and help them in a non-diet way that supports them as a whole person.” 

Martin also educates other Naturopathic Doctors on how to help patients improve their relationship with food. She recently spoke at the American Association of Naturopathic Physicians (AANP) Convention and the Ontario Association of Naturopathic Doctors (OAND) Convention.

Disclaimer: This article does not refer to patients with eating disorders. If you suspect that you have an eating disorder, talk to your doctor or contact the National Eating Disorders Association (NEDA) in the U.S. or the National Eating Disorder Information Centre (NEDIC) in Canada. 


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Carbonneau N, Holding A, Lavigne G, Robitaille J. Feel Good, Eat Better: The Role of Self-Compassion and Body Esteem in Mothers’ Healthy Eating Behaviours. Nutrients. 2021;13(11):3907. doi:https://doi.org/10.3390/nu13113907

Christoph MJ, Hazzard VM, Järvelä-Reijonen E, Hooper L, Larson N, Neumark-Sztainer D. Intuitive Eating is Associated With Higher Fruit and Vegetable Intake Among Adults. Journal of Nutrition Education and Behavior. 2021;53(3):240-245. doi:https://doi.org/10.1016/j.jneb.2020.11.015 

Fragmented food habits: New Dal study explores how Canadians eat. Dalhousie News. Accessed February 17, 2023. https://www.dal.ca/news/2017/05/19/dal-study-explores-eating-habits-across-canada.html 

de Ridder D, Gillebaart M. How food overconsumption has hijacked our notions about eating as a pleasurable activity. Current Opinion in Psychology. 2022;46:101324. doi:https://doi.org/10.1016/j.copsyc.2022.101324

Kristeller JL, Jordan KD. Mindful Eating: Connecting With the Wise Self, the Spiritual Self. Frontiers in Psychology. 2018;9. doi:https://doi.org/10.3389/fpsyg.2018.01271

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For more resources on healthy eating, check out the Way app for iOS. This article is provided by the Institute for Natural Medicine, a non-profit 501(c)(3) organization. INM’s mission is to transform healthcare in America by increasing both public awareness of naturopathic medicine and access to naturopathic doctors for patients. INM believes that naturopathic medicine, with its unique principles and practices, has the potential to reverse the tide of chronic illness that overwhelms existing healthcare systems and to empower people to achieve and maintain their optimal lifelong health. INM strives to achieve this mission through the following initiatives:

  • Education – Reveal the unique benefits and outcomes of naturopathic medicine
  • Access – Connect patients to licensed naturopathic doctors
  • Research – Expand quality research of this complex and comprehensive system of medicine

INM's team is made up of naturopathic doctors and health journalists.

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Debra Hubers is a serial entrepreneur and has started seven businesses; ranging from an advanced genomics to an employer health care purchasing cooperative. Deb has over 35 years of experience in healthcare finance, education, technology, and pharmacogenomics.

Ms. Hubers has dedicated her career to measuring and improving healthcare outcomes. Her expertise is leveraging technology to deliver personalized, preventative medicine. Ms. Hubers co-founded La Vita Compounding Pharmacy in 2007. Collaborating with her business partner, physicians and strategic partners, Deb has grown La Vita to be one of the most respected and sought-after personalized medicine providers on the west coast. She is also Co-Founder of EpigeneticsRx, a leading provider of precise, personalized, prevention which positively impacts genetic expression.

Alex Keller, ND

Dr. Alex Keller, ND, AFMCP is a graduate of the University of Ottawa with an Honours Bachelor in Health Sciences and Psychology. Although originally intending to attend conventional medical school, following a three-month volunteer internship at a rural Kenyan hospital where he observed how doctors used local food to treat patients, he shifted his career goals and pursued a degree in naturopathic medicine at the Canadian College of Naturopathic Medicine in Toronto.

After one year of practicing with the esteemed Dr. Chris Pickrell, ND, RH in a community acupuncture setting, in 2015 he and his wife Dr. Jenn Keller, ND moved to rural Ottawa, Canada where they started an organic farm and retreat center. In the same year, Alex and his athletic therapist sister Jess Keller combined their practices to form Keller Active Health, an integrative physical therapy clinic.

Ever curious and passionate about the education of evidence-based natural medicine, in 2017, Dr. Keller joined a fledgling Ottawa-based health tech startup named Fullscript. He serves as its Medical Director and oversees the development of medical education content for practitioners across North America.

Prior to medicine, Alex worked in the renewable energy sector, where he developed a deep passion for sustainable agriculture and environmental stewardship. This connection between medicine and agriculture now drives Alex to focus much of his energy on bringing awareness to the quality and sourcing standards in the supplement and organic agriculture supply chains.

Today, he splits his professional time practicing as a clinician, working for Fullscript, and expanding the farming operation while chasing his kids with Jenn and occasionally running ultra-marathon trail races. He is also currently completing an Executive MBA through the Quantic School of Business & Technology with a focus on supply chain innovation.

Pamela Snider, ND

Pamela Snider, ND, is Executive and Senior Editor for the Foundations of Naturopathic Medicine Project, producing a first of its kind international textbook of Naturopathic medicine through a series of international retreats and symposia. A nationally recognized integrative health and policy leader, she is active in both national and regional integrative health initiatives. Dr. Snider serves on the Board of Directors, was founding Executive Director and co-founder of the Academic Consortium for Integrative Health (ACIH/ACCAHCa consortium of the councils of schools, accrediting agencies and certifying bodies of the licensed, traditional and emerging integrative health professions, and is currently Vice Chair and co-founder of the Integrative Health Policy Consortium (IHPC).  Dr. Snider served as a founding Board Member of the Academy of Integrative Health & Medicine from 2014-2016. Her public policy work includes completing a two year appointment to the DHHS Center For Medicaid and Medicare Services (CMS) Medicare Coverage Advisory Committee (MCAC); serving as a Steering Committee Member for  the HRSA funded American College of Preventive Medicine NCCIM Integrative Medicine in Preventive Medicine Residency program, co-directing in USPHS Region X the Building Bridges Between Provider Communities Group, an exploration of interdisciplinary collaboration and common ground between public health and CAM; serving for 22 years on Washington State’s Health Professional Loan Repayment and Scholarship Program Advisory Committee (HPLRSP); providing technical assistance to and developing key language for the enabling legislation for NIH Center for Complementary and Alternative Medicine (NCCIH/NCCAM); and staffing Joseph Pizzorno ND during his appointment as Commissioner on the White House Commission on CAM Policy.

From 1994-2003, Dr. Snider served as Associate Dean for Public and Professional Affairs and Naturopathic Medicine at Bastyr University, dividing her work between academic and public affairs activities, including chairing the Naturopathic Medicine Program Curriculum Review Committee.  Dr. Snider has been teaching, publishing and lecturing widely on Naturopathic philosophy, theory integrative health, public policy, and other topics for over 30 years. Currently, an Associate Professor at National University of Natural Medicine (NUNM) in Portland, OR, Dr. Snider also continues at Bastyr University in her 22nd year as a faculty member teaching naturopathic medicine history, clinical theory, and global context. Among her Naturopathic medicine professional roles she serves on the Institute for Natural Medicine’s Leadership Council.  In 1989, she co-led the naturopathic profession with Dr. Jared Zeff, in developing a unifying definition of naturopathic medicine and its principles of practice adopted unanimously by the American Association of Naturopathic Physicians (AANP) House of Delegates. She was a co-investigator in the 2004 NIH NCCAM research study, the North American Naturopathic Medical Research Agenda and CAM Advisor in NIHCCAM’s Financing Integrative Health Care (University of Washington).  Her areas of experience include healthcare education; naturopathic and interdisciplinary clinical theory, curriculum development; clinical practice; government and legislative affairs, public policy, interdisciplinary collaboration, and community organizing.  Dr. Snider has received the Ontario Naturopathic Physician of the Year Award, the Physician of the Year Award from the AANP, the President’s Outstanding Vision Award and Distinguished Alumnus Award at Bastyr University, AANP’s President’s Award, an honorary Doctorate of Naturopathic Philosophy from the Canadian College of Naturopathic Medicine (CCNM), the William A Mitchell Vis Award from the AANP and The Gathering – NMSA’s Beacon Award. She received her ND degree in 1982 from Bastyr University of Natural Health Sciences and is a licensed naturopathic physician in the State of Washington. She lives with her husband and children at their homestead in North Bend Washington, in the beautiful mountain to sea landscape and home of The Revival – Restore the Vis, an annual student-led community gathering.

Susan Haeger

Susan Haeger is Founder/Principal of Transformative Health Solutions Inc. She has applied her twenty plus years in executive leadership to help shape and drive adoption of progressive health policy for whole person healthcare. She was a section contributor to the 2021 INM/AANP published professional white paper, Naturopathic Physicians as Whole Health Specialists: The Future is Whole Person Health Care that provides supporting evidence for the profession’s significant and unique contributions to preventive, whole person care and models of integrative clinical practice.

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In the late 1980’s Bruce became passionate about how health could be dramatically improved with Flax Oil Supplementation. Bruce along with his entrepreneurial parents saw the potential to improve the lives of many people and in 1989 they began selling Flax Oil under the Barlean’s name. From 1989 – 2000 the business grew an average of 40% year over year. While most companies saw a decline in business in the 2001 recession, Barlean’s continued to grow and soon became America’s #1 selling flaxseed oil and continues to be to the present. The brand has since expanded to include additional oils, green food concentrates and other premium supplements. Bruce continues to drive innovation and over the years his products and company have won countless awards including: Eight consecutive Vity Awards for #1 EFA, Six consecutive Vity Awards for #1 Greens Food Supplement, Natural Choice Award for Best Specialty Supplement, Best Product of the Year, Best New Product, Gold Medal Taster’s Choice Award, Gold Medal American Masters of Taste Award, #1 Health Food Store Brand for Consumer Satisfaction by Consumer Lab, and Manufacturer of the Year.

In 2013 as the company was on the eve of celebrating the 25th year in business Bruce and his parents decided to take their desire to help people to a new level that they call Pathway to a Better Life – which is now seen in the Barlean’s logo. Bruce and his parents had always been generous in their giving and support of charities, but as part of the Pathway to a Better Life they decided to increased partnership with charitable organizations such as: Vitamin Angels, Compassion International, KidsTown International, Autism Hope Alliance, Engedi Refuge, Project 92, and others. And because so many people are unable to meet basic nutritional needs, Bruce created a comprehensive Omega-3 and multivitamin formula that he distributes free-of-charge to local food banks. In addition, Bruce decided the company would supply food banks with organic coconut oil to provide people with a health alternative to standard cooking oils.

Always generous with his time Bruce has served as a youth leader for his local church for several years and continues to mentor youth. He has been on several not for profit boards including; Whatcom County Pregnancy Center (2003-2006), Natural Products Association (dates?), and the Institute for Natural Medicine Leadership Council (presently).

The Barlean family have been avid supporters of Bastyr University since the 1990’s and in 2013 were given Bastyr’s most prestigious honor, the Mission Award, which recognizes their leadership over time in improving the health and well-being of the human community.

Bruce currently resides in Ferndale, WA with his wife Lisa and their two dogs: Heinz & Shadow. When he’s not helping others he can be found fishing (catch & release).

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Michelle Simon, PHD, ND

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As president and CEO of INM, Dr. Simon brings her passion for working with organizations dedicated to improving the quality and delivery of healthcare. This desire stems from her years of practice as a licensed naturopathic physician. In addition to holding a Naturopathic Doctorate from Bastyr University she also holds a PhD in Biomedical Engineering from the University of North Carolina at Chapel Hill.

She has served on boards for the American Association of Naturopathic Physicians (AANP), the Naturopathic Physicians Research Institute (NPRI), and several advisory boards. Dr. Simon served nine years on the Washington State Health Technology Clinical Committee, as Ambassador to the Academy of Integrative Health and Medicine (AIHM) and was recognized as 2018 AANP Physician of the Year. Dr. Simon shares with her husband a passion for adventure travel, preferably by boat or motorcycle. She also enjoys teaching a women’s off-road motorcycling class.