Redefining "Health" and Decoding Symptoms as Body Communication

Welcome to the Satiated Podcast, where we explore physical and emotional hunger, satiation and healing your relationship with your food and body. I'm your host, Stephanie Mara Fox, your Somatic Nutritional Counselor.

Eating disorders and digestive issues often go hand in hand. One study in the Clinical Journal of Gastroenterology showed that individuals with eating disorders also showed gastrointestinal disturbances such as post meal fullness, gut and gastric distention, pain, early satiety, and altered esophageal motility. Those with eating disorders have a higher likelihood of irritable bowel syndrome, constipation, acid reflux, and electrolyte imbalances. This can often become a cycle where undereating or overeating cause distress on your digestive tract, food is assigned the role as the problem that needs to be fixed making you afraid of food, leading you to under or overeat more to try to gain a sense of safety and control over your body. Your body stays stuck in the sympathetic nervous system where digestion is shut down and so even when you start to try to eat more consistently or diversify the foods you're eating, it may feel difficult as your body is now perceiving food as threatening and your digestion is not working optimally. Symptoms like digestive issues are not always about the food itself but rather how we think, interact, and believe certain things about food.

I discuss this and more with Tamar Samuels today. Tamar is a registered dietitian nutritionist and the co- founder of Culina Health. Her unique approach to nutrition care integrates lifestyle medicine and behavioral change techniques pulled from her training in clinical nutrition and coaching science. She's helped countless people transform their relationship with food and their health to improve a variety of health conditions. Tamar has her Masters in Clinical Nutrition from New York University and completed her clinical training at Mount Sinai Hospital in New York City. She has been recognized as one of the top holistic dietitians in New York City by Well + Good. We discuss the gut brain connection, how stress influences food behaviors, the physical and emotional factors to healing, rethinking food labels, understanding research, building your support team, navigating health care with empowerment, and a whole lot more.

If you want to support the Satiated Podcast in 2025 please consider joining Satiated+ where you can donate a few dollars to the show each month and receive an ask me anything email every first week of the month to ask me anything about what we discuss here on the podcast or your relationship with your food and body. You can click the link in the show notes to join today. Now, welcome Tamar!

I am so excited to get into our conversation today, and I always like to start out with learning more about you and how you got into this work. I'm so excited that you're here, and would love to hear more about like your ebb and flow and your adventure of how you got into the work that you're doing today.

Tamar Samuels 03:35

Well, hi Stephanie. I'm really excited to be here too. So I actually am from Woodstock, New York. I kind of grew up in a little bit of a bubble with, like, local farms being everywhere, and my parents were hippies, and, you know, there wasn't a McDonald's in my town or anything like that. So when I moved to New York as a teenager, I was exposed to a different way of living and eating, and I experienced some pretty chronic GI issues. As part of that, I was diagnosed with something called Small Intestine Bacterial Overgrowth. And as part of that, I had pretty difficult symptoms that were not so severe that I needed to be hospitalized, but a sort of like low grade discomfort every time I ate, which had a really big impact on my relationship with food, because I was really working to kind of self manage that as someone who was not an expert, navigating the health system was really challenging for me, and as I noticed, for so many people, and so I started to sort of develop this relationship with food that was more fear based. And that led to, you know, just this constant experience where I was consumed by this experience of eating, which is something we do every day, all the time. And so I eventually met a dietician through my journey, and I didn't know that a dietitian was an actual career, and after meeting one, I felt really grateful, because it really created this new awareness for me about, you know, how I can really work on not only become an expert, to support myself, but support others in managing their health, knowing the impact that health has on quality of life for so many of us. So that was over 10 years ago at this point, and thankfully, I'm no longer managing, you know, chronic GI conditions. And, you know, have a really happy, healthy, balanced relationship with food, and it's been like a real journey to be a dietitian, particularly where we're at now with Culina Health. So it's a very short version of my story, but that's how I got here.

Stephanie Mara 05:53

Oh my gosh. I had no idea that that was also in your background. What started me on my journey was also digestive issues. I love that you also pointed out that when you're dealing with any particular bodily symptom, whether that be digestive issues or something else, depending upon you know who's listening, that it can affect your relationship with food, like I really remember that experience of feeling a lot of fear around food, going into every meal just not knowing if I was gonna experience pain, bloating, distension, like was I going to be out for the rest of the afternoon simply because I ate food, and it does kind of create this like fear cycle with something that you naturally need to be in relationship with every single day.

Tamar Samuels 06:43

That's right. And actually, the research does show that people who have GI conditions tend to have higher incidences of disordered eating, eating disorders, and so there's definitely a deep connection there. We also know that we have quite a lot of serotonin in our gut, and so our gut really does impact our mood. So it's this symbiotic relationship. You know, when our when our GI system is imbalanced, it can impact overall mood, but also anxiety and immunity and a number of other things. But we've got this physiological connection with our brain and our gut, but then we also have this lived behavioral experience where you know this is very visceral experience when you have a GI condition, especially related to food, or exacerbated by food, it can be really destabilizing and frustrating, and it really, I think, speaks to that outcome that I said, with the increased incidence of having disordered eating with the GI condition.

Stephanie Mara 07:44

Yeah, I'm glad you brought in the piece around serotonin, because it becomes like this really complicated, confusing thing where, yeah, I think it's about 95% of serotonin is made in our gut. And then if you're struggling in your relationship with food, there can kind of feel like this pressure of, like, I gotta eat better. I gotta eat this certain way. And like, we can get into like, what eating better actually means, but, you know, and then there can be this pressure of like, oh, I gotta eat this certain way so that I make sure that my gut is working optimally, so that I can feel happier in my life. But then that pressure ultimately feels so dysregulating that, then we find ourselves eating foods that maybe don't facilitate some gut health, and then it can kind of create this shame cycle, like, I'm curious, if you've seen that experience that.

Tamar Samuels 08:33

Yeah, and I'll just add another kind of complex layer to that is this fight or flight experience that we all have, you know, or biologically wired to experience fight or flight, the survival mechanism, and yet often it's activated in circumstances where we're not actually in, you know, a life or death situation. And so when we're in fight or flight, we're actually shuttling away our resources to digestion, and really deep prioritizing digestion, we call the opposite of fight or flight as rest and digest. And so when we're experiencing anxiety or increased stress, it also impacts our ability to have a healthy, functional digestive tract, which then creates this vicious cycle of, you know, being stressed about food, or your symptoms about food, activating fight or flight, making those symptoms worse, you know, making foods that much more difficult to tolerate during those periods of stress, feeling out of control. I think there is absolutely a cycle of frustration, resentment, and it can be really, really challenging to manage. And I think from a medical perspective, like we don't have a lot of solutions for some of the functional GI conditions. We've come a really long way since I wasdiagnosed, but a big part of getting better is being able to effectively manage stress. And as part of that, your relationship with food, which can feel so challenging when you're really in it, you know, something like, you need to stress less. You're like, what?

Stephanie Mara 10:18

Yeah, absolutely. And you know, we talk a lot about the nervous system here, so I'm so glad that you brought that piece in as well. Is that, like, there is so many different layers of what is potentially also like, kind of fueling, what is guiding you towards certain foods and for a really wise reason, and that your body is doing the best it can to navigate perceived threat, and that it does kind of make it feel just like really difficult to kind of tune into your body's wisdom and what would feel most supportive in any particular moment when it comes to like, what should I feed myself? And this can become such a confusing thing when you're navigating, like, high stress levels and diet culture, and I'm trying to heal my relationship with food. And it's like, I find that a lot of individuals are kind of confused about, like, what do I focus on first? I'm curious if even you've noticed this of like, well, do I focus on the physical healing first, or do I focus on my relationship with food first?

Tamar Samuels 11:21

Yeah, it's such a good question. I think that answer is really personalized. For some individuals, the relationship with food is driving the physiological symptoms more, and for others, it's the, you know, physiological, medical symptoms that are driving the relationship with food more, which was the case for me and so really working with, you know, an expert to help you understand those nuances. And this is hard, but being open to experimenting, there isn't a test or, you know, a validated survey that you can do that will give you this answer. You have to trust a healthcare provider or an ally who is an expert in this space, really you trust and help guide you through this process of really identifying the root or the main driving force of how you can get well.

Stephanie Mara 12:14

Yeah, yeah. I really appreciate you just naming like this is so individualized. Like, I know that a lot of people who come to me, they've been trying to work on the physical healing first for so long, but it's actually some of the nervous system regulation, even, like some of the trauma work that I do that sometimes needs to occur first, to feel safer in your body, and like you were talking about, like, decrease those stress levels a little bit, that then kind of also naturally leads into some of the physical healing, because you're living in a body that is not feeling as stressed, that's fueling some of the symptoms.

Tamar Samuels 12:51

Yeah, yeah, exactly. I think it's so important too, of course, ultimately, you're going to need to address both right? That, I think is just something that we all need to accept, but it's really important to try and experiment. Like you just said something really powerful Stephanie, which was a lot of people who come to see you have tried, you know, they have tried this method. They've tried to work on the physical healing. You know, they're doing, you know, meditation, they're doing, the workouts, they're eating healthy, and it's certainly not harmful, but it's not getting them to the point where they thought that they would be after having done, you know, those positive behavior, lifestyle behaviors. And so I think that's a clear signal that, okay, right. In order for us to get to that point, we need to address this social, emotional, physiological, you know, component of your wellness.

Stephanie Mara 13:44

Yeah, and I'm curious, coming back to what we were just talking about a second ago, of like, this idea of, you know, better eating, and that there can be a lot of sometimes pressure, but even with those that I work with around, like, binge eating, that there can feel like a lot of shame, of like, oh, but I'm eating the foods that aren't leading to me creating a quote, unquote healthy body and so that kind of makes it a little bit just difficult to be like, okay, but I'm eating these foods for a reason, and can I see them not as unhealthy? And even I'm wondering if we can kind of explore a little bit around this idea of, like, just the societal message of, like, what a health food is, what a non healthy food is. And I know now the words that we use are, like, ultra processed, hyper palatable, instead of junk foods. But even there, it's still putting a value on a particular food.

Tamar Samuels 14:38

Yeah, yeah. It's really interesting, particularly as a dietitian, to navigate this. I think it's very, very positive, moving away from valuing, moral valuation of food and getting very objective about how we talk about food. It's a really important concept and it can be extremely empowering to work with a provider who is using these neutral terms to talk about health, right? And it's not just about nutrition, it's just health in general, right? We're making huge strides in the healthcare industry and how we talk about health, so we are creating a safe and inviting experience for our patients to talk about these things that have been charged for their entire life, and they're charged not because we want them to be charged. They're charged because of messaging that we receive from so many different stakeholders, from diet companies, supplement companies, media influencers, not influencers, but people who have influence on the internet.

Stephanie Mara 15:52

Yeah, yeah. I mean influencers also, and people making nutritional suggestions that have no background in nutrition whatsoever.

Tamar Samuels 16:01

Yeah, yeah, and, but even from healthcare providers, right? So there's a huge positive shift that we are seeing in our vernacular and discussing health with our patients, right? Because ultimately, especially when it comes to nutrition, right? There's a lot of information out there. Some of it is evidence based, some of it is evidence based, some of it is trustworthy. Others, it's not. But we as consumers have to make a lot of decisions, and having a healthcare provider who is an expert to help make those decisions is invaluable, but that is also a relationship, and you need to be able to trust that individual in order for you to make these positive changes, talking about weight, talking about your relationship with food, is very challenging for most people, when you're using words that are charged to discuss body weight, for example, it's not going to create an environment where your patient is going to feel comfortable discussing their challenges, they already have a lot of shame. They don't want to feel shame when they talk to their doctor or their dietician, who is supposed to help them, you know, move past this. The word healthy, I think, is one that is, I think, in some instances, can be neutral, but it can also be really charged, right? And so when we talk about health promoting foods, I think that could be a good reframe. It doesn't mean that other foods are bad, but we have some pretty strong evidence to say that there are certain foods we know promote overall health, right? And so taking away that good, bad, healthy, unhealthy, and really talking about it in the framework of research and context, I think can be really empowering for the everyday person who we're speaking to about these things. Right? I think we have to be very careful as healthcare providers to ensure that we are creating a collaborative, respectful space for our patients when we talk about food and other things, all things related to health, because it is such a sensitive topic.

Stephanie Mara 18:10

Yeah, it's so interesting. I was literally talking with someone yesterday about this, of like, really having to become a lot more aware of the language that people are using around food, to also even, you know, for example, to find the people that you most resonate with, like on social media, and to notice how they talk about food. What are the words that they're using, because that's sending a particular message about even their potential beliefs about food, and does that resonate with you? Does that support you in feeling safe to be in relationship with food? And I'm curious, just as you were talking about like, you're seeing the vernacular change, I'm wondering what you have been noticing and tracking about, like, how we need to be talking about our interactions with food that does lead to kind of that decrease in shame and more curiosity and openness?

Tamar Samuels 19:06

Yeah, yeah. I think it's really about working individually on understanding, like, what our patients feel comfortable with, presenting information in a neutral way, based on, you know, the evidence that we do have, but also presenting information very clearly where there are gaps in the research, right? I think there's a lot to be said about, you know, ultra processed foods, and I think a large body of research shows that ultra processed foods, when consumed in excess over a long period of time, can be harmful. That said there are a lot of caveats there, right? I think that's the part that people miss is, you know, often these large research studies are extremely valuable for highlighting the importance of eating patterns that are beneficial for health and other eating patterns that are not health promoting, but typically, when they're presented in the media, they're very sensationalized, right? And so when you really dig into the research, it shows that, well, you can have ultra processed foods, right? It becomes more harmful to health when you're having an excess amount of ultra processed foods over the course of, you know, many, many years. That doesn't mean that you need to avoid ultra processed foods, which is what you know, the media might lead you to think. And we become fearful and scared, and we believe that the little chips that we're feeding our kids like are those ultra processed like what do we do, you know? So I think it's really important too when you are consuming media around nutrition, to, as you said, Stephanie, really align and notice how people are talking about nutrition. Are they talking about it in a way that presents, you know, the gaps in the research? Are they presenting research at all? If they are, are they talking about it in a way where they are discussing the very clear gaps in the research. In nutrition research, there's a lot of gaps. And so are they talking about those gaps? Are they using language that applies the research into everyday life? I think also is really important too, because people read these articles and they're like, what does this mean? Like, does this mean that I need to avoid these foods? And the answer is, no, you don't have to. You can use the word ultra processed food, but the way that you talk about ultra processed food has to include context. It has to include, you know, more neutral language, and then there has to be application to how you integrate that information into your everyday life.

Stephanie Mara 21:37

Yeah, yeah. It's really interesting. Something that you keep bringing back around is like just the research, and that, because of the creation of social media, like we can receive a lot of false information, or research can even be skewed in a different particular way that kind of proves the point that someone's trying to make, and not actually even citing the research accurately. Having to, going through my PhD right now, had to read like, so many research articles on binge eating and so, you know, like, it's really interesting just to see, like, the various different research that's out there and how people phrase it. But there are some times where I'd be like, what is this person trying to say? Like, the way that people write research articles. So even saying like, hey, go towards the research and read that can also be fairly difficult sometimes, when even the way that the kind of scholarly world works is you have to write research in a particular way that isn't using language that's very friendly to being able to like, I don't understand the finding that you're even trying to tell me right now.

Tamar Samuels 22:48

Yeah, yeah. It feels like a little bit of gatekeeping, in a way, but I think it just speaks to like, a larger challenge that we have around nutrition, right? There's a lot of gaps in the research itself, right? Because the challenges that we're navigating in nutrition are extremely complex. It's not simple to treat obesity, manage your weight, to treat a GI condition, to treat binge eating disorder. These are extremely complex conditions that require multi disciplinary care from multiple experts, and even on top of that, you know, there's a lot of personalization that's involved in any real treatment plan for complex conditions, both psychological and medical conditions. So I think that's why it's so important to find a team to support you if you're managing a complex condition, physical health or mental health.

Stephanie Mara 23:46

Yeah, I hope that everyone that is listening right now feels just a moment of compassion for themselves, like I'm feeling like, just like so much compassion in my body right now of like, yes, I feel like I see people come through even my private practice, just having worked with so many individuals, and feeling a little helpless and hopeless, of like, what am I doing kind of wrong? Quote, unquote. And that it's like you're not doing anything wrong, it's hard to change things in the body, and that your body moved in this particular direction for a reason, and that change takes a lot of time and a lot of different approaches. And it's not as simple as even social media or even a single practitioner could make it of you just have to do this, and then you'll be healed. It's never that simple. And that can also be really disappointing.

Tamar Samuels 24:39

It can be, but I promise, when you accept this, it's going to make everything a lot easier, right? I think just accepting that concept is the first step. You know, when we talk about behavioral modification, I think there's quite a lot of challenges, as we've discussed, and a big part of that is this resentment, frustration and that is actually a barrier to getting to where you want to be. It's not easy to get over resentment and frustration, but know that when you really do the work to accept that this is the process, and there are going to be many wins as part of that process, they might not be these huge wins where you know you are completely healed right away, within 24 hours, but you'll have a lot of wins, but it will take some time. And managing those expectations, I think, is invaluable. It's one of the most important foundational steps that you can do on your path to healing.

Stephanie Mara 25:37

Yeah, and you were talking about like you need to create a team for yourself and I'm wondering if you could say more about what that even looks like, because I know that can be really confusing when someone's navigating, like a lot of different health issues and even struggling in also their relationship with food. Like, what would be the team that someone would even need to be creating for themselves?

Tamar Samuels 26:00

Yeah, so I think a really good starting point is a primary care doctor that you trust, a behavioral health, mental health expert also that you trust, and a Registered Dietitian. I think that's a great core team that can help you navigate any other additional resources that you might need. But I think with that core team, you're covering a lot of phases with medical health, behavioral health and lifestyle. That's really like the core to a lot of the work is, you know, mental, behavioral, lifestyle, which includes nutrition, exercise, risk management and the medical component. So starting there, I think is a good first step, and then that team can help you resource anyone else you might need that's integrated into our jobs is to help be a resource for you, to be able to assess your needs as a patient and understand where you might need additional resourcing. That's a huge core component of primary care doctors also really core component of mental health, behavioral health and registered dietitians as well.

Stephanie Mara 27:07

Yeah, it makes me think, like, way back when I was in undergrad and went to a therapist because I was struggling at the time, and we were talking about even what I was struggling with, with my digestion and my relationship with food and all these things. And that therapist at that time had suggested that I go check out an on campus nutritionist. And I had also just similar to you, had never seen a nutritionist before, and was like, oh, this is a thing? Like, people can help me, like, understand what I should be eating and not, like, follow some diet that I've been following some diet rules for years. It was like mind blowing. And I like, I reference this first nutritionist that I saw still to this day of the things that I learned from her, because it was such a powerful experience to be like, oh my gosh, I don't have to navigate this food thing by myself. Like no one taught me what was like, how to listen to my body, or, you know, how to pay attention to, like, eating consistently throughout the day, and why that's important. Like, no one just even taught me the basics of nutrition, and I didn't get that from school. And, like, my mom loved to cook, but didn't really, like teach me about nutrition growing up, like she was doing the best she could. And so yeah, like, building on that team slowly, it was like, okay, I'm kind of addressing now emotional support. I'm getting physical support. And they were both important. And so yeah, and I heard you also use the word trust, that when you're working with people, like really feeling seen and held and understood by that person that you're working with so you even, like, look forward to the sessions. You know, if you see someone for a few sessions and like you're dreading the sessions, like, pay attention to that.

Tamar Samuels 28:48

Yes, definitely, definitely. And you'll know, you know, if your healthcare provider tries to take on too much, you know, they're like, yeah, I can help you with that. I can do this test. I can, you know, I think that's a red flag, you'll know you're in good hands when whichever of those team members you're working with is like, this is out of my scope. Let me refer you to this person, or I think you might need some additional support here. Are you open to, you know, working with someone who is more specialized in this area, right? And you might not need that. But I think at least having you know, the mental, behavioral, lifestyle and medical team will be able to assess that for you, right? So you don't have to bear the burden of, should I find this doctor or this doctor or that doctor, right? We'll work together to really assess that for you.

Stephanie Mara 29:38

Yeah, and what that also makes me think of just in with the people that I work with often, who are, let's say, struggling with binge eating, and they're worried and concerned that how they're eating is going to affect their health, where it's like, let's go check that out, go work with a doctor, go get your blood drawn. And sometimes it can just feel a little bit more like, I always like to use word safety producing, but move a person into that rest and digest mode a little bit more, where we do more powerful healing, just to even receive your blood work back and be like, look, your blood is not showing that anything is out of balance, anything is wrong right now, like it doesn't diminish that you are still struggling with food, and that this pattern that is happening with food still needs to be addressed, but internally, your body is doing the best it can to navigate what is happening with food and like, you're okay.

Tamar Samuels 30:30

Yeah, that's right. And then on the other end of the spectrum, right? If we get labs back, the labs are showing some markers that are out of range. It can be really motivating for individuals, right like, okay, wow, my condition right now and my relationship with food is having this impact on my physical health, and while that's really scary, I can prioritize this in my life, because I know how important my health is to me, and I have agency over this, and I can enact change to help to get these markers within range. So it can be a really helpful tool, from a behavior modification perspective, just to have that data, and it really takes away from the charge and the fear and the unknown right, not knowing is just as scary as knowing, right? But knowing has a lot of added benefits.

Stephanie Mara 31:24

Yeah, absolutely, completely agree with that, and I've seen that as well, where sometimes, when you are trying to heal your relationship with food, it can sometimes feel hard to come up with an intention of why you want this, because that food behavior is doing so much for someone emotionally to even create a momentary experience of safety, and sometimes that feels way more important than anything else. And so sometimes to get that blood work back and say, okay, actually, the way that I'm eating is affecting the way that I function. It sometimes gives that intention of like, well, I want to take care of my body. Like, I'm still really struggling emotionally with a lot of different things, but I don't want to keep harming my body. I don't always love to use the word harm, because, like, no one's doing that, like, intentionally, it's you're just doing the best that you can. But I don't want to have my body continue to struggle. Let's say that instead, you know, there are different ways that maybe I could facilitate eating differently, to support my body in functioning optimally, which sometimes can lead to, well, okay, now I need to, kind of, like, takes a little gentle nudge outside of like, I really need to start kind of exploring, meeting myself emotionally in a different, non food way, and it's different for every person I know. Sometimes, when people get to that point, they're like, nope, it's still way too overwhelming to change what I'm eating right now.

Tamar Samuels 32:50

Yes, it depends on where you are in your journey. It really does. But that is the ultimate goal, right? Like, it's very difficult to change any behavior if you haven't identified what your motivators are to change that behavior, just showing up and getting help. It's clear that the behavior is having an impact on your quality of life, right? And so you just have to identify, okay, what do I care about most, and how does this behavior impact what I care about the most, right? I am biased towards health as a huge value of mine, which is why I'm in the industry that I am. But some people don't value their health as much as they value other things, which is okay. But the best part about our body is that we need it to do everything. So we can find a way that comes back to connecting what's important to us that comes back to our health always, right? And it gets about connecting those dots and really feeling empowered to make the change because you because of whatever value you want, you know, whatever you're hoping to feel good about. It doesn't have to be, you know, very specific to your labs. It can be, you know, more specific to your energy levels, you know, and that is a huge one, right? Like, if you don't have energy, then it's difficult for you to show up to do these other things, and those are the things that make you most happy. Like, how can we drink more water to, like, easy wins, you know, there's, there's a lot that we can add that can make people feel really excited and empowered, because we get this instant feedback mechanism for some things, some things, it's not as instant, but gotta celebrate the quick ones.

Stephanie Mara 32:50

Absolutely. Yes, yes. It is finding those really small baby steps that someone can feel like, okay, I'm taking some steps forward towards feeling the way I want to feel in my body. And I'm curious for you, just in health being something that you're so passionate about, like, how you have viewed health, and maybe something that, like, if this is included for you, like, let's go there, but I'm even wondering just of what you've been talking about, like the way a body looks, or what you're eating isn't necessarily like, a sign of health, and like, how you have defined, like, what does it mean to live in a healthy body? Like, how do we know that we're living in a healthy body that doesn't even always have to do with, like, our weight, or that we're eating, like, the perfect things all the time?

Tamar Samuels 35:20

Yeah, it's, I think it goes back to this conversation about healthy versus unhealthy, right, like we can define what we consider to feel healthy, right? Like I have a cold right now, and as part of that, I am a little raspy. Does that mean that I'm unhealthy? Probably not, right, so, definitely not, you know. So I think it's really important for us to move away from the black and white and really move into this gray space and embrace the gray space that is highly personalized, because then we don't get that cascade of charred feelings around, you know, guilt, shame, that stuff that we've mentioned before, right? Like some person's version of health can look a lot different than another person's version of health, and we have some objective measurements of health, which are, of course, very important. But even within those objective measurements, like the perfect example is someone who has diabetes, type two diabetes, has different ranges for optimal blood sugar than someone who doesn't have diabetes. So even within you know these very objective measures, we still have flexibility, right? And then, if we think about using this diabetes example, right, if we have someone who has had diabetes for many, many years, and they are a senior or older age, their blood sugar control might not be as good as someone who's just diagnosed with diabetes, right? And so their optimal health looks really different than someone who may have just been diagnosed or someone who has pre diabetes. And so there's a lot of nuance as to how we define health, we have objective measures. It's really important for us to use those to track trends over time, and certainly when it comes to like emergency medicine, they're even more important life or death circumstances. But we have some flexibility in how we think about what is healthy for us. You know, maybe you aren't able to exercise four days a week, but you're walking 10,000 steps a day, or 8000 steps a day, before you were walking 4000, you've doubled your numbers like you're doing great. So again, I think it's really about context.

Stephanie Mara 37:32

Oh my gosh. I love everything you just said. And even posing the question of, just because you have a cold, does that mean you're unhealthy? If anything, that means your body is very healthy, doing exactly what it's meant to be doing to maybe fight something off, or, you know, like, it's giving the message of, hey, the immune system is a little bit depleted, and so it gave you the symptom of, like, hey, I need to support you in slowing down. Like, just even kind of questioning this idea of like, when we have a symptom, oftentimes what we receive is that means we're unhealthy, but that doesn't have to mean that.

Tamar Samuels 38:08

No, it doesn't. It doesn't. I think that cascade of guilt and shame is really, you know, my labs are abnormal. I shouldn't be eating the way that I am. You know, that shouldn't. That should. The shame. It's actually really doing the opposite of actually moving towards healing and so being able to work with that and move past that again, you know, when we talk about foundational steps, that's that's another huge foundational step here.

Stephanie Mara 38:35

Yeah, and you were talking earlier about, like, finding that intrinsic motivation, and it has to be unique to each person around like what inspires them to want to maybe care for themselves differently. And I'm curious if you could say more about that, and what you have found even has been supportive for people to guide them towards discovering what that like internal inspiration motivation could be, and how to tap that into the uniqueness that's going to be unique to the person.

Tamar Samuels 39:04

Yeah, yeah. This is one of my favorite things to do, is to really explore values and strengths as sort of foundational to identifying what your motivators are. So really leveraging some positive psychology strategies and starting with the good, right? What is most important to you in this world, right? What are you really good at? Most people don't ask those questions, sadly, right? Like, maybe if you're in a job interview, but then you have to, you know, present in a very different way. But if you really ask yourself those questions, you know, like, what is really important to me? What makes me happy, what gives energy right when I do X thing, what makes me feel empowered, right? So really start by focusing on the positive. Then you can more clearly identify what your strengths are and what your values are. And then you can think about, okay, well, how are my behaviors in terms of alignment with those strengths and values, right? Or what is the impact that my behaviors have on those strengths and values? And then you start to connect the dots between where you want to be and what makes you happy and fulfilled, and the behaviors that are either helping you to get there or not helping you to get there right? And then when you really lay that out and see that, it starts to really tap into that intrinsic motivation, like, okay, this is what I'm good at. This is what's important to me. This is what lights me up and gives me this deep connection to myself and to the world. And this behavior takes away from my ability to do that more, right? And then you can really start to build on top of that, right? But that's really foundational to the work with in terms of motivation. I mean, there's a lot, there's a huge field, but that is one of my favorite strategies to work with.

Stephanie Mara 40:57

Yeah, I love all of that and such great suggestions because, yeah, it's amazing how little we are asked to reflect on what we like, what we appreciate about ourselves, where our strengths lie. And it's always like, how could I be better? How could I fix myself? Where am I, you know, falling short, and even just to frame different questions towards yourself, of like, yeah, what am I really good at? And what are the things that even I judge or hide because I don't want other people to know how good I am at that thing. Because we get all these messages about like, not being a show off, or, you know, whatever it might be, and say, like, actually, can I own those things? And how could they guide me in how I want to care for myself, and what would be in alignment with this, like you said, like strengths, values that I'm starting to identify.

Tamar Samuels 41:51

Yeah, yeah. And then we also have to think about, like, your readiness to make the changes and any barriers, right? And then you start to get a little bit more practical. But I think, you know, starting with the motivation is so empowering and uplifting, and then you can action plan it right? Then you can start thinking about, okay, well, I know where I want to be. I know what's important to me. I know how my behaviors impact my ability to get those things. But I also have a lot of barriers. I have a lot of tools. Some people have a lot of tools, right, but they also have a lot of barriers. So like, how can we work with what we have to close that gap, right? And that's really the core of personalized healthcare. It's not about here's an evidence based research article on, you know, everything you need to know about managing binge eating disorder, right? Yes, we have research. We leverage that research. There are best practices. There's quite a lot. Of course, when it comes to nutrition, foods that we know can be very healing, we practice medical nutrition therapy as registered dieticians. How can we incorporate these foods to support wellness, longevity, chronic disease management, all of that is foundational, but so is this personalized action plan and personalized outcome measures that can really help to empower people to feel like they're making progress because they are, right? Instead of just saying, oh, did I lose 10 pounds? No, okay, you failed at this, right? That's the difference.

Stephanie Mara 42:13

I also really appreciate you bringing in of assessing, okay, where is my readiness for change? I like to call it capacity. Like, if I could rate my scale on 1 to 10 of like, where's my capacity to approach this? And if it's really low you just might not feel ready yet to approach that thing, that maybe at some point you're like, ah, probably need to look at that. But that might not be where you are now. And sometimes we can stay stuck on focusing on the things that we're not ready yet to change, where your capacity or your readiness for something else could be very available. And also, like you even said earlier, like coming to terms with, like, it's okay that I'm not ready yet. Like, you don't have to be this takes time.

Tamar Samuels 44:09

That can actually be really empowering. Like, I can deprioritize this. Yes, you can, but we have to prioritize something. What's it gonna be? You get to choose, right? I had this conversation with one of my patients this morning. She's like, I don't want to do these food journals. I'm like, don't do that. This is not a priority. Don't do them.

Stephanie Mara 44:30

Yes, yes, yeah, exactly. And so I find even just in hearing that, like building that trust in yourself, that if there's something that you're not ready for, that's okay, that's not wrong. And sometimes actually trying to push yourself towards the thing that even an external practitioner is suggesting that you do but you're not ready for might leave you feeling more frustrated and more resistant and more stuck, because there's so much focus on this one thing, where there may be a ton of other places where there's some readiness and some curiosity about, like, oh, but I could be more ready. Like, your suggestion earlier, like I could be ready to drink more water today. I could try that. And that's like, yes, every baby step counts. Every single one!

Tamar Samuels 45:11

Yeah, you drink more water, you have more energy. You have more energy, you feel like maybe moving your body more. You move your body more, right? Like, there is this upward spiral and this cataclysmic effect that people experience when they're empowered to have agency in their healthcare journey. There are a lot of things that we can do to feel better, and we lean on our healthcare team to guide us, but we get to choose at the end of the day, and no one could take that from you, right? And instead of feeling disempowered like you can feel empowered by knowing that you have the agency to decide what you want to focus on, and that can build a foundation that will enable you to focus on something even bigger, you know. So I think going back full circle this really helps to explain how you know nuanced personalized health care is, and how important it is, and how it really does produce just better outcomes.

Stephanie Mara 46:07

And I love that word agency, because I find that is so crucial, and that you know to everyone listening, that you feel empowered, that you are behind the driver's wheel, like any practitioner you work with is kind of actually more in the passenger seat, wanting to be on the journey with you, but you actually get to call the shots of what you're ready for, and that is going to make the adventure feel a lot more doable and even potentially like fun, that you are going towards what you're ready for and what you're ready to explore or approach or try something new and that no one can kind of tell you what's going to be best for you.

Tamar Samuels 46:45

Yeah, and that's how healthcare should be. As patients should be empowered to want to make these changes, because we know that they will make us feel better. But that's not how things are right now, right? Like, that's not how you know the typical nutrition counseling experience is, that's not how you know the typical doctors experience is. And I think it's really important to like, really redefine like that's our mission at Culina Health, is to really redefine what that experience is like for people so they feel empowered to make these changes in their health because they trust themselves. They trust their healthcare team. And, you know, without that, it's really hard to enact any change.

Stephanie Mara 47:31

Yeah, I always like to wrap up with like a baby step, and I feel like we just gave like, a million little baby steps that someone could explore. I'm curious if there's, like, anything that when someone's like, listening to this, or hearing this, and they're like, okay, even, like we were talking about earlier, like, where do we start? What baby step would you even synthesize, or even a baby step we hadn't talked about, that you would offer in this moment?

Tamar Samuels 47:55

I think the strength based work can be really empowering, and the value based work, asking yourself those simple questions, like, what are my strengths? You know, what is most important to me that can open up creative, positive space as you embark on your health journey, really starting with the good and then also starting with things you can add instead of take away, right? Like, how can I add more things to my life that make me feel good. I feel good when I drink more water. I feel good when I eat more fiber. You know, we're producing the same outcome, but the process is really different. When you say, okay, I have to do Whole30 and I have to eliminate all these foods, and I probably won't be able to go out right like it's a very different process, ultimately, right? By eliminating some foods, you're forced to eat other foods a lot of the time. Those foods have more fiber, depending on what the protocol is. But right, we're getting the same outcome, but it's a much more empowering experience that is much more sustainable over time.

Stephanie Mara 48:57

Yeah, such a great suggestion. And completely agree with that, and shifting the focus towards what you can add in. And there's so many things that you can add in with everything that you're also navigating.

Tamar Samuels 49:07

Yeah, so much, so much everybody can add something.

Stephanie Mara 49:11

Yeah. Well, I'm curious how listeners can keep in touch with you, and would love for you to say a little bit more about Culina Health and what you're doing there.

Tamar Samuels 49:20

Yeah, yeah. So the Culina Health is a virtual nutrition care platform that provides inclusive, culturally affirming nutrition care that is 100% personalized to you. And as part of our mission for accessibility, we also take insurance. As I mentioned, we're available virtually, so we really make you know, nutrition care that I talked about today, accessible for everyone is really part of the work of redefining what it means to work with a dietitian. So you can find us at Culinahealth.com We're also on all of social media platforms. Our handle is @Culinahealth. I am on social media also @tamarsamuelsrd, so you can check me out, although I've been kind of busy, so I haven't been very active on those platforms. So go to Culina Health instead. We have lots of free resources, and you can also book your session with your dietitian online. So it's really easy to get into care with one of our incredible team members who specialize in binge eating disorder, but also a number of other chronic conditions and just overall wellness relationships with food. So we have a really awesome team that can really support anything that you need when it comes to eating.

Stephanie Mara 50:27

Yeah, I will put all of those links in the show notes, and just thank you so much for the work that you're doing. It's so important. And I just hear that word accessibility, because sometimes when we get into the conversation around nutrition, it feels like sometimes this like, oh, that's only for you know, this elitist thing, and it's like, no everyone should have access to being supported in their body and their symptoms and their relationship with food. So the work you're doing is so important in the world.

Tamar Samuels 50:56

Thank you, Stephanie, thank you for the platform to be able to speak about these topics that are really challenging, but life saving.

Stephanie Mara 51:03

Yeah. Thank you so much for being here and sharing all of your wisdom. I just absolutely loved our conversation today.

Tamar Samuels 51:09

Likewise.

Stephanie Mara 51:10

Well, to everyone who is listening, if you have any questions, as always, I will leave our contact information in the show notes, so reach out anytime, and I hope you all have a satiating rest of your day. Talk to y'all soon. Bye!

Keep in touch with Tamar:

Instagram: https://www.instagram.com/tamarsamuels.rd/

https://www.instagram.com/culinahealth/

Culina Health: https://culinahealth.com/