Unlocking the Secrets to Sustainable Nutrition: A Deep Dive with Erin DeMille

You're listening to the PT Profit podcast, episode number 343. Today, Erin DeMille is back on the show for a return appearance and she's going to be doing a deep dive on unlocking sustainable nutrition. Are you ready? Let's get started.

Hi, I'm Beverly Simpson, former fitness manager turned online personal training business owner. And this podcast is where smart fitness professionals, including trainers and clinicians. Clinicians discover how to increase client performance in movement, package and position their products and services and get out of their own way so that they can increase their revenue to live a life that they love without sleazy sales. Welcome to the PT Profit Podcast.

Welcome back to PT Profit Podcast. My name is Chris. I work behind the scenes here at B. Sims and Fitness. And this is an extra special episode because not only has Erin been on the PT Profit Podcast before, but she's also been on the podcast that I host. And I truly believe that she makes our industry better through the work she does and how she does it. So Beverly and I are both incredibly excited we were able to get her back on the show. She's very popular and Aaron is a renowned dietitian with a rich background in nutrition biochemistry and clinical practice. In this episode, we dive into the complexities of metabolic health, emotional eating, and the often misunderstood journey of sustainable nutrition and fat loss. Erin shares her unique approach to helping clients rebuild their relationship with food and achieve long term health goals. So get ready for an extremely valuable conversation that challenges conventional diet wisdom and offers practical strategies for lasting change. Are you ready? Let's get started.

Aaron, it is so amazing to have you back on the show. I was just saying I better hit record, otherwise we're just going to start doing the podcast before we do the podcast because honestly, the reason Erin was a guest on our show previously and we'll make sure that we link that up so that that we. I don't try to ask too many repetitive questions, but I was kept dming her these crazy things that I've been seeing on the Internet and I was like, I just need to bring her back on the show and ask publicly. So that's what brought on this episode because I kept seeing all these crazy things on social media. So with that said, Aaron, can you please share with us a little bit about who you are, who you serve, in case anybody is new to you and hasn't heard our previous episode.

Absolutely. Thank you so much for having me. It's always good to be with you. So I am a dietitian. My name is Aaron DeMille. MSRD is the technical situation over here. I went through grad school studying nutrition biochemistry and, and got my degree in dietetics so that I could treat medically. I really wanted to have the scope of practice so that it wasn't just lab work. And so my background is treatment, being with people and also being in the lab. So I try to kind of hold those two things in harmony with one another. And sometimes there, there is a gap. We have research that's not quite there yet and we're seeing things like anecdotally in our case studies and vice versa. So kind of trying to hold space for both of those is a big part of my work. And now I have a private practice where I see people in the Boston area and kind of primarily online though I kind of see people from a wide variety of, of places and with different situations going on. My husband and I own free PT and wellness clinics, so we work a lot with physical therapy trainers, doctors. We kind of like see everybody and integrate across many different disciplines. We. I work closely with a lot of cardiologists as well, so metabolic diseases are a big space for me. But really primarily who I work with is, well, there's a variety, but it's primarily with presentations of emotional eating or binge eating disorder. So some really ruptured food relationships or feelings of disordered eating. And often in the setting also of some metabolic disease or metabolic concerns. So we like to be preventative. But sometimes I also do catch people at the beginning of something or at a late stage of something. And my background, after grad school, dietitians have to do a year of clinical work. So I had like residency was basically like a way to think of it. And I had a long term residency in critical care and icu. So I really like that space. And I always saw metabolic diseases at their very young stage in the icu. And so I really am passionate about preventing them. And they're really kind of like a major, major, major disease of our time, a cluster of those metabolic diseases. I'm really passionate about trying to cool those off and get them to the curb, so to speak. So I really like working with people with that kind of a variety of things going on. So that's usually what I'm doing on a day to day basis.

I love that. And honestly, your approach is so unique and unlike so many other traditional experiences or traditional approaches that we have traditionally seen. So I'm excited to really dive into that. But just for further clarification, when you mentioned metabolic diseases, what specifically are you talking about question?

So we're looking at kind of like a cluster and depending on who you talk to and what research you're looking at, what is included in that cluster can vary slightly, but overall we're really looking at basically varieties of blood sugar dysregulation and insulin resistance, which we commonly know as pre diabetes and type 2 diabetes. And where in that stage a body is, is actually like a pretty big spectrum, but that blood sugar dysregulation. And then we also look at the cardiovascular diseases. So heart disease basically and risk of heart attack, plaque buildup, high cholesterol, hyperlipidemia, things like that is also what we're looking at. And, and depending on who you're speaking to, we also often include in their neurodegenerative diseases and really trying to prevent those as they're, as we're learning so much about the way they relate, they relate to metabolic health. So they, they certainly cluster together. And then we also have basically body composition, bone density, muscle versus fat ratios on the body. So we're also kind of looking in that as well. And then there's a lot of things in that pocket like non alcoholic fatty liver disease and a variety of other things that can present. But we're basically looking at metabolic health from top to bottom. How dense are my bones, how much muscle is on board, how's my blood sugar regulation, how are my lipids, visceral fat deposition, so fat deposit around the organs and those risk factors. But primarily the two really big ticket items are going to be diabetes and heart disease.

And honestly it's a pandemic. It's something that we, we struggle with, that people don't actually realize how big of an importance this, our health actually is as opposed to the look of a body. Because the look of a body isn't a measurement of health. And I think a lot of people get that twisted, especially in the day and age of social media, right, where it's just everything is photoshopped and everyone's highlight reels. So we're actually, don't we have a very skewed perception of what health actually looks like?

Exactly. It's so true.

And so I'm, I'm curious for you, you know, how are you. And you also mentioned, and I'm, I'm just curious, do you put this in the neuro, in the neurometabolic health. You talked about disordered eating and I know that there's a difference between disordered eating habits and eating disorders. So I'm assuming that you Are including those components in the neuro, in the neuro category of metabolic health.

Is that right? So with the neurodegenerative diseases, when, when we're thinking of prevention, we're very much also thinking of dementia, Alzheimer's, Parkinson's. And then certainly in the psychology of food, we have disordered eating. Eating disorders. And, and really also what I'd use like a soccer term for in general, which I really love, which is so important, which is our food relationship. And I, I think that's probably an underrated, probably the most underrated thing that we have brewing on at the core of all of us. So it's a term we don't first think about, we think so much about our macros and even, yeah our lab values and how's my, my blood sugar and how's my cholesterol? And we're, we're starting to have those be a little bit more known like they're in the conversation. But I am still not being that piece of what's my food relationship. I'm not seeing people talk about that yet. I'm still not, I don't think we're there. And actually that is the nucleus of, of all of it. So I'll be curious over the years to see if that can start permeating the conversation a bit more.

Okay, I love this. And then I also. Okay, so I'm curious, right? So when we're, when we're, when you.

Get a new patient. Okay.

I mean there's just so many things to talk about because there's so many levels of how experience the food relationship and nutrition and eating and so on and so forth. And what I mean by that is, right, we've got, we've got. And, and honestly I build my business on social media so I'm, I have no shade. But with every, there's the law of polarity for everything that's good about it. There's also the counter, right? And so some of the things that we have experienced in terms of the negative experience of social media is that, you know, some of this stuff gets really exacerbated our food relationship and our perception of self and really taking a look at like what is healthy versus like what is hating ourselves. And it's just a very pressure cooker experience. And so one of that is a part of that is the conversation around fat loss and this idea that like wanting fat loss is bad when in reality we have to really look at like well, fat. Having excess fat has a very detrimental component depending on the fat to your Body.

Right.

So there's so, it's so nuanced and intertwined. So I'm curious for you when you are bringing a new patient, can you walk me us through your methodology and how you get to the root of their food relationship, how you get to what it is that they're dealing with and then how do you build your approach out around helping this patient?

Such a great question. So big. That's a big question too. So there's a lot there a lot of good stuff. So when, when I just to like define our terms, when I think of food relationship, I'm really thinking about the way a brain is relating to food, viewing food, the language it's using around food, how it includes food in its life and what it means throughout the day, throughout the week, throughout the month, throughout the year and even what that can mean socially, psychologically, emotionally and physically. So when I think of my food relationship, especially if I'm, I'm viewing like a new client as, as you mentioned, I'm going to start with the, the 30,000 foot feed first with them and then start zooming in. So we're going to start with how's my food relationship right now. And I start understanding that by looking at how are you feeling in your body, how's the state of health in your body, your physical health, how's your psychological and emotional well being as it relates to your body and food. How is food in your life now? Like just what, what does that look like? And that food relationship is going to be unique as a thumbprint. Like I really like to think about like this is the fingerprint for you. What are early memories with food and the. There's a lot of universality here. But I like to focus on the uniqueness because the way it will present is going to be unique to an individual. But we could have something like, like to give examples. Okay. New client might say to me, I'm in a place where I feel like I have some health concerns. I'm starting to get labs coming back that are flagged. I'm not feeling so good and I have dieted so many times, it's simply not working. I really don't know what to do next. I'm not feeling at peace with this. I'm super stressed about it. And that's kind of like, all right, there's so much to begin with there. And we really start pulling back the layers. And something that's so important is health history, diet history. Because that is going to infuse the food relationship. If we've been dieting for. Many of my clients have been dieting for 10, 20, 30 years. That's going to change our food relationship, right? There's this story of restriction, trying to get rid of things, trying to eat less, trying to get smaller on tools. Beer can start appearing inside of that architecture. Our food culture infuses our food relationships so much so there could be all these foods we're scared to eat. I have clients, it's almost like they're like timestamped. I have clients who are in their 50s and 60s who were teens during the low fat craze. So that got baked in. So they still try to eat low fat. I have people who, low protein and, and, and red meat were, they were told it was going to cause cancer. So like that generation always trying to avoid protein. Then we've got the low carb generation. Like it's literally timestamp. You can almost track when they were a teen and a young person and, and whatever, whatever. And then now people, if I have clients in their 20s, late teens, 30s, they're very much like, I don't even know what to eat. Like everything almost is in trouble now. So we look at like how I'm viewing nutrition and what I know about it. And then that story that began so long ago. Did I learn how to cook? Was I watching parents diet all the time? Did we always do takeout? Did everyone eat in front of tv? Was someone always trying to be good and then falling off the wagon and then they were being bad? And I'm using lots of the 90s. Oh, you just described the 90s. Oh yeah, all the wagon. There's always a wagon, right? Or south beach, like frozen meals and all these different things. And, and all of that is going to infuse how someone views food. And, and just to clarify, let's juxtapose that with a very different example, which might be someone who grew up in Italy or Brazil or France or somewhere where there's a strong food culture. It's, it wasn't about dieting. Things were cooked at home. And there's actually a cultural distinct cuisine that is healthful, appropriate, delicious meals are eaten with others and that's just what they eat. They're, they're not thinking, oh, I gotta swap this, oh, I shouldn't have. Those beans, those carbs, you know, they're actually just eating to their food culture. And so that's a whole other food relationship. And imagine the differences there in peace regulation, nutrition quality, so on and so forth. So we, the food relationship really is that story of how I've learned to literally think about food and even my words around food, like wagons and good and bad and restart and things like that, it's just, it says so much and it literally becomes the, the scaffolding that our entire health is built upon.

Okay, great. And, and so it's like getting to the, the psychology of food. Essentially. It's getting to the root cause of whatever you're experiencing.

Right.

So now when someone comes to you, you know, there's just so many different approaches in, you know, when it comes to like unwinding and relearning.

Right.

So we've got a habit based approach.

We'Ve got keto, we got macros, we've.

Got counting, we've got no dieting, we've got like, you know, how, how do we, once we have, you know, gotten to the root and we're starting to build, build new foundation and building from the ground up. Right. How do we undo all the damage that has, that we've done?

Right.

So, you know, for years past, like let's say you have visceral fat on the body that needs to be released. What do we, how do we do it? Because the thing that's interesting that I've been hearing a lot recently and kind of how I've just been living my life is that, you know, is that.

We'Re not meant to die to.

You know, everyone says, you know, we need to, you know, it has to be sustainable. But like losing fat isn't supposed to be sustainable. You need to. The magic's in the maintenance. Everyone knows how to diet, but no one knows how to maintain. So I'm just curious, like, how do you build someone's, how do you rebuild someone's food foundation and help them release visceral fat?

Yeah. So we'd have almost two. I kind of think of them as two tracks that need to be running at the same time, which is we have the behavioral track, which is going to encompass also our emotional state and response and skills to food and our psychology with food. And then we do have a second track, which is our biochemistry and our biology that, that we can't get away from that. If we need to create a change in our physical health, then we gotta deal with the biochemistry too. So we've got behavior and we've got biochemistry and those tracks need to be running at the same time. And yes, to your point. Absolutely. Fat loss. If we have someone where we know that blood sugar labs, lipid labs, things like that, we can restore those to normal ranges, usually by losing about 7% of body fat. So once we kind of achieve a bit of that, we often see labs come back into range if a disease progression is not far, far advanced. So we can restore a lot of metabolic health by reducing overnutrition. And when we create that setting, that ecosystem, we have a energy deficit and we will liberate fat from the cell. So we'll, we'll see some body recomposition if all that's done properly. There's obviously a lot more to that, but if all that's done properly. So fat loss, yes, is going to be deficit, that's different than maintenance. But inside of achieving that deficit there are a bunch of and many, many, many basically skills that also must exist for maintenance to be achieved. Because to your point, we actually don't have a dieting problem. And if we look at our best research on, on high quality fat loss, which is different than low quality weight loss, these are, these are distinct terms which I'll really quickly define. High quality weight loss, as we define in our nutrition studies, is when a body slowly loses fat tissue and preserves lean mass and therefore mostly preserves a nice chunk of their metabolic rate. Low quality weight loss is when someone quickly loses a bunch of weight and they're also losing a lot of lean tissue along with some fat. And we see some issues with metabolic rate. The loss of lean mass will kind of basically set them up for a, the not as much wiggle room in their diet and they're going to be highly likely and highly prone to weight regain. So we actually view those as distinct options. A lot of diets are low quality weight loss, which is a huge problem. Very smaller amounts of high quality diets can create high quality weight loss, but that's actually less common because it's not the extreme dieting, it's very behavior based. But even in our best studies with high quality weight loss, behavior based change, literally RDs, calling people daily, weekly checking in, behavior coaches, the whole nine. We still see about seven in our best studies, seven out of every 10 people will regain the weight by three to six years. And that's in our best study. So then we're kind of looking at this and this is a big passion of mine, which is what's going on. And we have all these like how to lose weight, you know, my hormones, this, that, all these different things. But we actually have weight loss well understood. We don't have weight maintenance well understood. And I think that's why things like Ozempic are so tempting because if we were to stay on that, we see perhaps some assistance with weight maintenance. And so that's why we do need to have a new view in all of this, because weight loss is well understood and, but everyone regaining, what did we achieve? If, if not a little bit of healthy weight loss that promotes long term health. And we're not really achieving that often. So to that end, we have to look at the behaviors that have to be in, installed in a brain and in a lifestyle that then basically opens the gate to maintenance. And so many fat loss and deficit phases don't open the gate to maintenance. We're playing one game and not preparing for the best. So if we have that behavioral track running alongside a high quality biochemical track, we hopefully are installing a bunch of things inside of a brain and inside of a lifestyle that then will open the gate to long term maintenance, if that makes sense.

I mean, that makes perfect sense. So when you say that you're doing this simultaneously. So what I heard is that we're dealing with the biomechanics of creating an actual energy deficit. And for a calorie deficit, essentially is what we're talking about for Kal's deficit is energy. So then we're dealing with. And then on top of that, we're also doing the behavior change. Now just. And it's interesting to me because I was anticipating you saying, you know, that the low quality deficit doesn't like we see a lot of regain. But I'm surprised to hear that we're actually also seeing regain with behavior change. That did surprise me. So I'm curious in terms of, you know, your specific approach, when you're doing the tracks at the same time, how do you manage building new neural pathways without creating too much change at once so that they actually can sustain the change?

Good question. So when we look at those high quality weight loss studies and we get a preservation of lean mass and some fat loss, and pretty successfully, we still are seeing things like macro counting, calorie counting, a lot of numeric nap. And we're not necessarily seeing these soft skills that I like to focus on. I almost think of them as like the fine motor skill of a food relationship, which is something like, okay, I can figure out your macros pretty easily and easily get you the math on what's going to be a high quality calorie deficit for you. And then I can make you strength train and walk and sleep, and we're going to get fat off a body. But what happens when patient X comes home from a long day at Work. They've been dieting for six months. They're kind of in maintenance and their husband's driving them crazy and they just want to like pour that glass of wine, grab the tortilla chips and salsa and sit outside alone and like eat the whole bag because they're just so frustrated. That is actually going to not be a macro problem. They know it doesn't meet their macros. It's not going to be a discipline problem. They just dieted successfully for six months. This person is not lacking discipline. It's not a sleep issue. They're not just going to out sleep this emotion, they're sleeping well. This is an emotion regulation problem. And it's not even a problem in the sense that it's not like it's not normal. It's normal. Especially if in their food story, comfort food or stress eating began when they were 10, 11, 12 years old. So we had this brain stop its stress eating for six months, but they had 40 years of stress eating before. So this is that soft skill that is not about meeting our macros. It is not about discipline. It's about a nervous system and a brain and a set of emotions and memories working in a new way. And this is an interesting piece where we see in our high quality research those 3 out of every 10 people who actually sustain the weight loss. When we go across many studies and we check in with those people at like 6 years, 10 years, 12 years, and we're like, what are you doing? How are you doing this? You know, you're an anomaly. What? Why? They actually have something in common. Across many studies, the successful people, the successful research participant often report things like, I became a new version of myself. I'm not who I used to be as a person. And that is speaking to what I'm trying to get at, which is, okay, this new version of me, calories aside, I give a crap about my calorie when I've had one of those days, right? And I want to go home and, you know, order takeout. I'm sick of cooking, I'm sick of the growth in grass. I don't want a glass of wine. And then that might trigger me to feel like I failed because that's in my food relationship, which now is going to make me drink wine and eat more all weekend, which now is actually going to create a calorie surplus. And I'm going to try to restart Monday, but because I'm so ashamed about what I did all weekend, I'm having trouble restarting Monday and the weight Regain story begins. Instead of that first trigger, I need a new food relationship and new soft skills that help me navigate my inner world and the way I'm relating to food. So that long term I actually have a new food relationship because I'm a new version of myself. And that's where we're seeing success. And even still, it's not easy. That is a long process to build that, that new kind of scaffolding in the brain. But it is possible. And those are the people where long term we're seeing health effect.

I mean, people, you know, there's so many books about this. I mean, I think it's the brain that, that rewires itself is where I'm thinking of this is that, is that people forget that when you create a new neural pathway in the brain, the old one doesn't leave, doesn't disappear. You just have to make a conscious choice to go right instead of going left. And that's the work. And that is hard. That's not easy. That's simple, but it's not easy.

Exactly. That is the work. Yeah. Oof.

So, you know, I'm curious, you know, when you're dealing with someone and when you're, when you're building out this, you know, process for a patient, for a, for a person, for a client, and you were talking about like the math, right? Do you even give that math to the client or you really literally just like, listen, this is the first thing that we're doing. We're, we rewire, we're rewiring, we're getting present to your relationship, we're rewiring your brain, we're changing your identity, we're going to look at your food culture and look at your food relationship and then the math is going to sort itself out.

Yes. So I try to start with the most pleasant intervention that's possible and hopefully get some wind in people's sails. Obviously, we need to eat a really nutrient dense diet that does indeed balance. I, you know, the term is so overused. But actually certain types of food do balance hormones. They trigger the release of fullness hormones, they keep our blood sugar pretty happy, blah, blah, blah, blah, blah. We do all that good stuff. We try to fuel really well. I work through. Basically what I do first is to zoom out for a sec is I work on what I call the four types of hunger. So we have our physical hunger, which is literally just low nutrition status. My stomach is empty, I'm gurgling, fidic churning. I'm hungry. It's time to eat. And that is my physical hunger. But I also have nutritional hunger, which is if I'm not eating nutrient dense foods like high protein meals, high fiber meals, healthy fats, things like that, I'm going to be nutritionally starved. I don't have all the amino acids I need and vitamins I need and fats I need. My stomach isn't stretching from fiber and protein, expanding it. And those mechanoreceptors around the stomach lining can't tell my brain, hey, I'm getting full. I won't secrete fullness factor hormone. So I can be physically fed, but nutritionally hungry as well. So I like to take care of physical hunger and nutritional hunger. And then we look at something that I call interest hunger or habit hunger, but primarily interest hunger, which is I'm emotionally regulated, my physical needs are met. But there is something I'd like to like consciously enjoy. So for example, say I just had a really nice healthy dinner. Physical hunger, nutritional hunger met. But my husband made chocolate chip cookies and I'd really like to have one that's interest hunger. Like, oh, I'm not hungry, I'm emotionally regulated. But these fresh cookies on the counter look really good. I'd love to have one. But then the last hunger, the fourth hunger is emotional hunger, which is perhaps my physical hunger, nutritional hunger are met. But this isn't an interest hunger moment. I'm going to the pantry looking for something and I'm not emotionally regulated. So I'm looking for where in someone's life is their emotional hunger and if I can take care of those four. For many of us, if I'm properly nourished, I'm nice and full, satiated and satisfied, uncomfortable between meals. I, I'm using interest hunger at appropriate times. It's not emotionally driven and I am not eating for emotional reasons. So I am dealing with my emotional hunger. Many of our bodies will settle into a place nutritionally that's rather sustainable. And usually we do get quite a bit of physical change by dealing with those four hungers. And of course that's going to be in the setting of sleep resistance training and walking as well. But if I can take care of those four hungers, many of us don't need to get to the math. There's a way to get into an energy deficit and then slide into like, kind of like a gentle maintenance which is really going to be our new lifestyle without actually tracking mathematically. However, if we hit plateaus, if we, if something's happening and we kind of have like a head scratching moment on Our hands. If we have deficiencies, if we have concerns about like blood sugar or saturated fat intake, if I have a client who's iron deficiency anemic, I might use math. So I kind of use math and tracking, mathematical tracking, as a tool that can come and go. There needs to be a reason and there needs to be an strategy always. But all my lifestyle, nutrition and food relationship is going to be here to stay. So I'll try to work through those four hungers with a bunch of lifestyle changes first. And I'll tell people we're only going to use math if we need it. So if they come to me like, I want my macros, I send them into an online macro calculator. You don't need a private nutrition, medical, nutrition therapy and counseling for that. But we only use that if needed.

Yeah. So I have questions around that. I have two questions around this because I'm curious. Like, you know, how often are you dealing with things like plateaus as an example.

Right.

And what do you do and how do you navigate and get to root of plateaus? Because I feel like one, plateaus will come because they're just so chronically used to low weight loss strategies. Like you're going to hit plateaus when you're eating, when you're actually actively lowering your bmr, which happens. It's not starvation mode. But people will lower their metabolic rates when they're just chronically undereating. So I'm curious, you know, like, how do you unpack a plateau? Because, like, you'll see some people be like, there's no such thing as plateau. Then you'll see some people, like, you can't be in a deficit for too long. Like, is there truth to how long someone can eat on a calorie deficit? Like, if they have a lot of energy that or a lot of stored energy in the body, do you need to eat at maintenance for a certain amount of time?

So this is a good question. This is very complicated metabolic science physiology class. Now, it's a great question though, because this is important. Like, are we going to hit these plateaus? What starvation mode? Oh my God, if I had a nickel for every time that term got thrown around. There isn't a starvation mode as, as Beverly had already pointed out. I'm just going to second that. So basically, when we're thinking of that calorie deficit there, I, I want to house this conversation inside of what I call body context. Someone's context for their deficit is going to have components to it that are physical as well as behavioral. So there's a few reasons why someone might hit a plateau. If we're in a calorie deficit, a true calorie deficit, for a long time. Our metabolism does eventually try to equilibrium equilibrialize. That's not a word. Try to reach equilibrium with its caloric burn and its caloric intake. And that's a really important feature of our body that I think we can't underestimate because it's also psychological, which is modern humans are weight loss resistant. That's why we're here. We made it here after many millions of years of evolution. We're the one who were weight loss resistant. We have hypercoagulable blood, we have extremely inflammatory immune responses to things. We can store weight easily. We prefer hypercaloric foods like fats and sugars, especially combined in our modern life. But we prefer these hypercaloric tastes. We do a really nice job of getting energy onto us and holding onto it, and that's how we survive. That's also has psychological components though, like taste preferences, overeating, scavenging, just all sorts of things there. So when we're looking at weight loss, we have a brain component and a biochemical component, but we, we could plateau eventually. But what it is is it's not a plateau, which means I'm still in a deficit and yet my body's not liberating fat stores. That is the myth of starvation mode. If you are in maintenance and you've hit a plateau, it means you are not in a deficit, which is really important. That means my metabolic rate and how much I'm moving and burning through and how much fuel I'm turning over every day has come into equilibrium with how much I'm eating. So I can't be in a deficit and just hold on to fat because my body's panicking. If I'm in a deficit, I am losing weight. Unfortunately, starvation mode, I mean, that would have really benefited us in the wild, but we know it doesn't. The human being can starve to death, so we, we don't have that feature. To us, if we are in a deficit, we are losing weight. If we have plateaued, we have reached equilibrium in our expenditure and in our food intake, which means why am I at equilibrium fat? Have I accidentally been making some cooking oil? Is there a little sniff, you know, that brought up my calories a little bit? Have my portion size has been creeping up? Did I eat out more a few times this week? Have I been a little hangry? And those are things that we behaviorally could do to pull us out of a plateau or I'm sorry, pull us out of a deficit and into a plateau and our body will have a drive for those when we have been in a calorie deficit. This is really important. If I'm in a calorie deficit for a while, my brain is going to do things that try to get me to eat more. So I behaviorally can bring myself into a plateau. And it's very subtle. So I'm certainly not suggesting people are doing this potentially or that their light's flying off the handle. They're, they're having increased hunger, they're having increased food drive. They're having something that's really important called food preoccupation. They're thinking about food more. And these are behavioral interventions that our body stays when we are losing energy off our stores. So that's really important. So am I reaching plateau due to behavioral intervention that my brain is doing kind of sneaky style? That can happen. That only happens though when we really truly been sustaining a deficit for a while. I deal with 100 pound weight loss and things of that nature all the time. This happens. The other thing that can happen, but this takes a lot of time is I literally have lowered my data, my metabolic rate because I've been eating so little or so consistently in a calorie deficit. But again this is going to come from this usually often truly comes more in a very lean setting. So if I have, I, I don't work with bodybuilders at all. But they're, they're actually in a lot of research because they like torture themselves and then we can collect the data. So thank you bodybuilding community. What our bodies will do is it'll pull levers on things that burn calories. So I could stop producing some hormone, for example, and a female could lose her menstrual cycle because that costs calories. I will, especially in a bodybuilding population too. But this does happen in menopause. This happens when we're under slept. This happens if we have indeed, you know, been losing a significant amount of weight for a long time. Our body will lower its meat, which is its non exercise activity. Thermogenesis. You'll see people not pacing around the room as much. They're not talking with their hands anymore. They're not going for walks, they're parking close to the store door, they're blinking slower. When we lower neat. We lower calorie burn so our body will find ways to come into equilibrium with that less amount of food that we're consuming, but that really takes a significant amount of time. The thing that can help protect us from that is resistance training. Protecting our lean mass. If we protect our lean mass, we do not lower our basal metabolic rate. Our bmr. If we can protect our lean mass, we protect bmr, which is super important. And I would never recommend eating numerically fewer calories than our bmr. You're really asking for trouble if you do that. So we wanna always be above that. Which is why when someone's really sustaining a true calorie deficit for a while, diet breaks and reverse dieting can be really beneficial. But again, with a lot of normal people, that's honestly not always needed. I mean, rarely do people need to get into the territory of cycling through deficits and reverse and diet breaks and all these things. If you're really putting on muscle and know your stuff and you have a very good coach and dietitian and that many people watching you, sure. But for the average American, we are way more so going to be focused on food relationship, healthy behaviors, emotion regulation, physical activity, building a new lifestyle. And they won't hit really significant plateaus. But if they do, we can use math and some tricks to collect data to figure that out.

Because what's, what's interesting and what I'm, what I'm curious about, right, Is that there's, you know, 95% of what we do is automated. And this is part of the reason I feel like people miss this and why diets are so appealing is because they kind of automate. Like when you're building all this stuff, it takes work, right?

And it takes.

And what you talked about is the mental preoccupation. I call it like the mental load. Sometimes the thinking about the work that needs to be done is way more expensive in our mental load than actually doing it.

Right.

People will dread it. They will. You know, and we see this in business building. It's just, we're talking about humans now, right? This is just human nature. And so what's interesting to me is that the reason why diets are so appealing is some of that mental load gets taken off you. You don't have to worry about it because someone's already done that work for you. But now what we're doing here is like, no, no, no. The automation's gonna come once you do this work and that. That's the hard part. It's like touching a hot stove, right? No, I don't want to do that right now. You have to cook Again, because once you've burned your hand and that can be really hard. So now the reason I'm saying that and giving all that context is because it's interesting to me because a lot of people aren't present to the truth about what they're doing for lots of reasons, for trauma, big trauma, little trauma, for like maybe they've just had been so misinformed for so long, they grew up in the 90s, right. That they, they will succulent that aren't true. Like oh, I'm in a deficit without even realizing that they're not or, or you know, and then I'm curious about the people that are like I'm doing all the right things and I'm not, I'm just not motivated when really like they're missing a component of flexible discipline. So how do you help someone get present to the truth of what they're actually doing without giving a. Math, without, you know, like how do you expose them to the truth?

Yeah, good question. So one, one important piece I should mention too, I should have even mentioned earlier is something I really like to separate that's so important to keep these different in our mind is food relationship in general health and well being and fat loss. Those are two very different things. In other words, I would not gauge the success, success and quality of a food relationship by fat loss. I could have a very great food relationship, a lot of peace with food, be well within the range of general health and wellness and not necessarily be focused on fat loss or measuring the success of everything over here by a fat loss measuring stick. And this is something that I think also can get misunderstood because leanness is associated with ultimate health. But general health and wellness is actually a pretty wide road. There's a wide range of high quality diet, movement, happiness, great relationships, purpose in life, good sleep. And my body could be somewhere in that wide range of health and I'm doing great. But that might not make me someone with a six pack visible. Six pack fat loss is something different and very lean body composition actually has a lot of drawbacks. There's a lot of negatives to it. There's a lot of hit for the food relationship that a lot of leanness brings. There's a lot of inflexibility that a lot of leanness brings. So we certainly don't want to measure the quality of my food relationship by my leanness. But that's a whole other like deep dot we could go into. I'll try to limit myself, but I'll just say that so I Like to frame with people. When we're doing general health and wellness, like I call it lifestyle nutrition, we are on a four lane highway that is a wide road. There's a lot of softness allowable in there. We have to find what kind of makes sense for us. So there's a lot of uniqueness in that story. There's going to be plenty of wiggle room. There's still going to be great skills like cooking more at home and nutrient density and as I mentioned before, hungers. We're not going to eat for emotional reasons, all sorts of stuff. That loss in body recomposition is like going from a four lane highway to a sidewalk. It's just going to be more narrow over here. So if I have people who are saying I'm eating so healthy, I'm not losing weight, we're going to have that talk first and then we're going to talk about how there's a lot of levers that have to be pulled to achieve fat loss. And if you're in energy maintenance and you want fat loss, if that advanced process is something you're ready for, which is why we want to build a new understanding of food and a lot of skills first so we have a good foundation, then we could look at fat loss if it appropriate for someone and if they want to embark on that journey and if they want to put on muscle and they want to maybe reduce risk of some things and, and visit that idea of, you know, we're reducing visceral, visceral fat and things like that. Okay, great. Medically appropriate, they have built a great foundation. We can talk that less. But yes, we are going over to a sidewalk over here and so that way they understand that there's going to be steps, specificity that's different than general health and wellness. So when we need to talk about, I thought I was in the deficit, but I'm not. We've already set the stage for this is going to be finicky. This isn't going to be like, oh, one huge thing. You know, I was drinking four red canned Cokes a day and I could go to Diet Coke. Like we've already taken care of that stuff. If we're at this place in our journey together now, if we are really trying to narrow in on like what's keeping me out of this deficit. I hopefully should have already built a long rapport and understanding with someone about how nitty gritty this could get. And we can check in on things where, especially if we've built those food relationship skills I might say, you know, I've been eating out like three to five times per week and I know those calories can sneak up. Let me see if I could get it to like two times per week or my cooking oils or there's definitely been some like mindless eating when I'm finishing that paperwork. And you know, like by that point, with the way I work with people, they often have self reflective skill that in the general public and in the wellness industry and in the diet industry, we're not seeing that. One of the reasons we're not seeing that is our culture doesn't promote the regulatory abilities to see ourselves. So like most of us can't see ourselves. Like hello, road rage. Like it'd been meltdowns in airports that we all film and like put on TikTok. Like we don't have a culture of emotion regulation and we also, we don't have emotion regulation because we don't want to see ourselves. So that's why we really want to build that first before we look at like advanced health strategies or hopefully, you know, they'd be symbiotic. But getting nitty gritty is something I try to prime somebody for because I might let my client know, like, hey, this is going to be annoying. This is going to get a little nitty gritty for some of this. But I, if you feel like you're there and you really want this and it's appropriate, we can, we can dive into and that way we find those spots, we find those areas of opportunity and it's not a judgmental finger wagging, I got you moment. It's like, okay, let's like tinker with this. I think that could be happening here and there and here and there and it's like a discovery like process that's very curious and safe. So it's the work that people need.

But not what they want.

Oh no, this is, this is a lot of work, but it's, it just so powerful. I, I see people go through it and it's the coolest thing. But, and, but also the work people don't want is usually the work they most need. And so when I look at a life which, as you know, Beverly, so many Americans are living this way. Oh, I've had clients who have lost and regained £50 five, six times. Is that a good alternative to taking, you know, a good year or more to build a new lifestyle and get out of that torture of weight loss and regain? I think so. I mean, me too, because it's interesting, right?

People, people Lose their perception of time.

Right.

Because my sister will be like, oh, it's going to take so long. Like if they're. She's looking at a year. And I was like, but didn't you just tell me that you have lost and I mean, like, long compared to what you've just told me literally three minutes ago that you have gained and lost the same 30 pounds for the last 30 years. So like, long compared to what? Long compared to that.

Right. You know, and it. Not to mention the muscle losses through all those weight loss cases. Oh my gosh. You're like, that's some metabolic issues there. Right?

And then you also, I mean, it's just, it's, it's intense, right? And, and it's just an intense experience. And then we didn't even talk. I mean, honestly, I could just talk to you forever. Thank God they, you are changing the world in terms of how people approach and look at nutrition because we didn't even get to the obesity pandemic and how we deal with that disease, that it's actually a disease and not what, you know, it.

So many things, but so many. With that said, I know it's a.

Great feeling and I want to be respectful of your time. So for our. So for those of you who want to go deeper with you, right. And tell us, like, what are you doing? Are you still like, how are you supporting coaches and coaches and their clients? Like, what are the best places I should. I can send them.

Oh, thank you, Beverly. So we are working on a few things right now because the wait list for private clients is. It's gotten a little bit heavy. So we're, we're having a hard time getting to everyone, but we're working on it. There's like a three to six month wait right now for one on one counseling. We're super grateful for that. Love my clients so much. They're just amazing humans. So we're working on creating, hopefully I'm, I'm really working hard on this template of a course based like treatment methodology that can serve more people at once, like in small group setting or getting a lot of it like pre recorded so that there can be some legwork on their own and then spending time with me. But they're already like primed for a lot of work. So I'm working on that right now. But my private practice people can definitely find me@erindamill wellness.com and my Instagram is Erin's Uncommon Eats. And I'm working hard on putting together material and treatment methods that are for the client, but also for professionals who want to fold this type of work into their practice as well. But I'm working on it right now.

You doing so great. We'll make sure that we link all of that up. So thank you so much, Erin.

I really appreciate it. Thank you.

Beverly, thank you for listening to the PT Profit Podcast. If you like this episode, chances are your friends will too. So it would be a huge service to us if you would please leave us a review and share with your friends on your social media channels. When you leave us a review, be sure to take a screenshot of it and email that screenshot to my team@infoesimpsonfitness.com and we'll send you a very special Instagram podcast that will show you how to create compelling content so that your ideal clients come to you and you go from wanting clients to a wait list of clients ready for your services. Thank you so much for listening and we'll see you on the next episode.