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.
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.
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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