One dietitian's perspective on how macro counting ("flexible dieting") helps her clients make peace with food and say goodbye to "yes" or "no" foods.
(This is part 2 in a series of posts about my experience trying out "macro counting." If you haven't read part 1 yet, you can find it here. I suggest reading that before you read today's post.)
By now you know the back story and the back-back story of what got me to try 60 days of macro counting through the IIFYM program. I could leave it there, but instead of simply recapping my experience I wanted to share more of the overall "macro counting" story. Specifically, I wanted to take a deeper dive into understanding if there are any RDs who are incorporating this type of "flexible dieting" into their own practices and what types of results they're seeing with their patients.
Identifying a "macro counting" RD wasn't exactly easy. I know TONS of RDs. But I don't recall a single one ever mentioning to me macro counting or flexible dieting (or reverse dieting as you see it referred to occasionally) as a part of their practice. Luckily, through the magic of Facebook (it's really Mark Z's world and we're all just living in it) I was able to post a query in a closed RD group and through a colleague found Emily Field, RD (*see bio below).
I emailed Emily and asked if she'd be willing to answer a few questions about macro counting and the popularity of IIFYM (the online program I tested out.) She was kind enough to agree and provided some great insights as to how she uses "flexible dieting" in her practice. Here's what she had to say:
Emily: I’ll use the term “flexible dieting” throughout this interview, but it can be used almost interchangeably with “macro counting/tracking”, “if it fits your macros” and “iifym”.
Regan: Macro tracking isn't exactly "mainstream" among RDs right now. But so many fitness professionals are using it and it's popularity seems to be growing. As an RD, why do you use Macro Tracking with your clients? What type of results have you seen? And how do these differ from approaches you might have taken in the past to achieve weight loss?
Emily: I’ve found that offering flexible dieting in conjunction with behavior change coaching to be the perfect recipe for my clients to achieve their goals. Most people seek nutrition professionals after they’ve made all the changes they know to make but are still not seeing the results they want: maybe they’re not able to lose that 10-15 pounds sitting around their midsection, or they constantly struggle with digestive issues or highs and lows in their mood and energy.
We all need a certain amount of proteins, fats and carbohydrates to feel vibrant, energized, and to support a healthy metabolism. Your body is counting macronutrients whether or not you are. In my experience, my clients are typically struggling to meet their protein and fat needs, which means they’re proportionately eating too many carbohydrates - though they don’t realize it. It’s also very common to see people eating far too few calories, and again, they don’t really know it. These typical eating patterns lead to the common complaints (like I mentioned before) we see as nutrition professionals. I’ve found that tracking macros offers a way to help clients see how much protein, fat and carbohydrates they need. When they’re able to start eating enough of the right macros in the right balance for them, they see almost immediate positive results.
Regan: What type of results have you seen?
Emily: I typically work with my clients for 3 months, but sometimes up to 6 and 9 months. In that amount of time we are able to see drastic improvements in body composition; primarily dropping body fat while maintaining or gaining lean muscle. However, I am always most excited to see my clients make peace with food for good (Sidenote from Regan. I LOVE what she says here. It hits home).
Flexible dieting is the only method I have found which offers the structure that people need, while also promoting choice and autonomy. I think it’s incredibly powerful to help someone achieve the “look” or aesthetic they want while living the life they enjoy at the same time. I’m interested in setting my clients up for success and essentially, I’d like to be the last nutrition professional they seek out. When clients “graduate” my services, they’re armed with the sustainable tools and approaches to make them feel empowered to take things into their own hands long into the future.
Regan: And how do these differ from approaches you might have taken in the past to achieve weight loss?
Emily: I’ve been using flexible dieting as a part of my coaching services since I went into private practice so truth be told, I haven’t tried other approaches to help clients make the lasting improvements to their body composition and athletic performance like I do these days. In my practice we focus on the relationships between nutrition, exercise, sleep and stress and I help my clients start to recognize the behaviors and patterns that support or inhibit them from reaching their goals. So while macro tracking is certainly a part of my methodology, it’s not always the dominating feature that leads to desired results.
When I’ve worked in more traditional RD roles, I felt that using meal plans, the food guide pyramid or MyPlate as tools for clients were never super helpful or applicable to different food preferences or cuisines. Whether you prefer vegetarian or Paleolithic styles of eating, Mexican or Vietnamese cuisines, for example, flexible dieting allows you the freedom to eat the foods you prefer while meeting your nutrition needs and delivering the body composition results you want.
Regan: Along those same lines, are you only using Macro tracking for "weight loss" with patients? A quick social media assessment shows that many people are macro tracking to actually "gain weight" to bulk up and start a "cut phase." I'm curious about your thoughts on this as an RDN and how this may/may not fit into your practice.
Emily: Some of the biggest proponents of flexible dieting on social media seem to be athletes and bodybuilders- so yes, a quick glance would definitely reveal language about how they eat to gain lean muscle or to lose body fat. I use flexible dieting to help my clients achieve a variety of different goals so their macros would reflect weight gain, weight loss, inches gained, inches lost, etc. I work with weightlifters, Crossfit athletes, endurance athletes, and regular people who generally want to feel healthier - and quite frankly just want to look good naked.
In my experience, flexible dieting is one the of the most calculated and efficient methods to go about shedding unwanted body fat to reveal a lean, strong physique. So whether or not you’re a fitness enthusiast or a “regular person”, you can see how adopting a flexible dieting eating pattern might be attractive.
What you might not see on social media is that it can also be one of the most cathartic and rewarding experiences for someone who has a history of trying to lose weight with traditional methods: gone are “yes foods” or “no foods”, short, bland and limiting food lists or a canceled social life. No more “chicken and broccoli life” - I like to say.
I typically stay away from using words like “weight loss” because I think it’s largely misleading. Many people couldn’t care less about the scale weight when they’re tightening notches on their belt, experiencing higher energy, sleeping soundly and attacking their workout routine with gusto. So while weight might be one measure of progress in our work together, I am typically using a mix of lifestyle factors, body measurements, and quality of life commentary from my clients to measure success with the program.
Regan: How do you determine the Macro ratios you're using with patients? Is there a set formula you use with all patients or does it vary based on their goals?
Emily: I use the Mifflin-St. Jeor formula that takes into account gender, age, height, weight and activity level as a starting place. From there, I have learned through professional practice and client preference, how to tweak macro ratios to get us closer to their individual goals. Based on a client’s preference for fat-containing foods or past medical history indicating possible blood sugar issues, I might opt for a higher percent of calories to come from fat macros than for someone who participates in longer endurance activities, for example.
Regan: Do you only macro track the big 3 - CHO/PRO/FAT? Do you have any concerns that in a flexible diet model clients can meet their CHO through simple sugars and not focus on complex carbs?
Emily: I only ask my clients to track the three macronutrients, but I do know some coaches that ask their clients to track fiber as well. By keeping an eye on fiber and setting targets for it, clients are mindful to eat their whole fruits and vegetables, as well as whole grains often.
(Regarding concerns about simple sugars) Nope, no concerns at all. Simply put, it’s very hard to hit your protein, fat and carbohydrate prescription with junk food. My clients have health, body composition and athletic performance goals that are clearly established so while I encourage them to work simple sugars, junk foods, “bad foods” (however they want to label it) into their macro prescription without guilt, they find out very quickly how hard or uncomfortable it is to “eat around” those types of foods with plain chicken and broccoli, for example, because they decided to chow down Krispy Kreme donuts.
In order to get to the place they want to be, they’ll need to prioritize meal planning, food prepping as well as restructure their environment in order to be conducive to the lifestyle changes they’re making. What kind of RD wouldn’t want their clients to struggle through the muck with the right tools and come out the other side having decided on their own to eat whole, real foods over processed, packaged or refined ones?
Regan: Some of the commentary I've seen about programs like IIFYM indicate the calories set by their "blueprint" often feel really high for the average person who has maybe been trying to "lose weight" in the past. IIFYM's info seems to indicate the reason "why" their calorie/macros are so high is in an attempt to "reset" a person's metabolism. Any thoughts on this and/or IIFYM in general?
Emily: There are typically one of two things going on when someone comments that their macro prescription feels really high - as in the calories feel high and they feel like they’re eating “so much food”.
One is related to chronically undereating in an attempt to maintain a low body weight or to lose weight prior to starting flexible dieting. We’ve been told that “eating less” and “moving more” are the keys to losing weight, and our clients hear this messaging loud and clear everywhere from our food advertising to health organizations. Quite frankly, I think this advice should be buried right alongside margarine on the island of mis-fit health recommendations. Eating less and moving more makes you tired, cranky, hungry, frustrated and, if done chronically, will slow metabolism. So when someone starts on a flexible dieting eating pattern and they’re encouraged to eat 1800 calories, for example, up from the 1200 they might be used to, yes, that’s going to feel really high!
Second is related to the types of food they might start to eat when they begin flexible dieting. Eating whole, real food proteins, healthy fats and carbohydrates is certainly more filling than processed, packaged and refined foods. Imagine switching from a granola bar for breakfast, low-calorie microwave meal for lunch, soup or salad for dinner with a few light snacks between meals. Suddenly while with flexible dieting you’re eating substantially bigger meals: 2-3 eggs in an omelet with vegetables topped with cheese, large salad for lunch with a full breast of chicken, sunflower seeds and avocado, maybe a stir-fry with ground turkey and rice for dinner - even some macros leftover for a bit of full fat yogurt topped with slivered dark chocolate.
It becomes almost easier to reach for foods in their most natural form because most people want to be in control of all the ingredients and portion sizes in order to hit their prescribed macros for the day. So while they might work in some treats and sweets during the day, most people are eating more real, whole food, feeling full and energized between meals, and enjoying their fat loss journey.
I really appreciate Emily taking the time to share her perspective. Being an RD practicing outside of the traditional "eat less, burn more" mentality provides a whole new perspective to consider. As I said yesterday, I still support the "non-diet" approach to healthy eating that many of my peers promote. But I think for people (like me) who have perhaps struggled with borderline undereating or need to "make peace with food" in a structured format, macro counting may be a viable option.
And still, the story doesn't end there either. There were a lot of things I personally learned, both about myself and my food choices through this experiment. I'll share those with you in my next post.
'Til then, drop me a comment and let me know what you think about what Emily shared, what you think about this experiment or simply tell me what's on your mind when you think about "dieting and achieving a healthy weight."
*Emily Field is a Registered Dietitian who primarily works with women feeling stuck in their own bodies by nonsense dieting behaviors and outdated food rules. She helps them achieve the confidence they’ve been looking for with eating strategies that work for the long term. Typically her clients eat more, ditch the scale and develop the lean, strong body that matches their powerful, vibrant selves. You can find her at www.emilyfieldrd.com and on instagram @emilyfieldrd
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