Dietitian and weight loss coach Tedi Nikova uses a combination of cognitive behavioural therapy, acceptance therapy and commitment therapy to help clients overcome unhealthy relationships with food.
by Karen Hawthorne – first published in Healthing on March 13, 2023.
Tedi Nikova is a registered dietitian and weight loss coach in Toronto who helps women break behaviours that are sabotaging their health so they can move forward with their lives. She spoke to Healthing about how to recognize if you have an unhealthy relationship with food, why we give the scale too much power, and how a change of just 10 per cent can set you up for success.
What is a weight loss coach?
Nikova: I think of coaching as focused on the ‘why’ rather than the prescriptive approach or the ‘what.’ So as a coach, I have a third-party perspective — or lens — in breaking my clients’ patterns that are holding them back from what they know they need to do.
It’s a combination of cognitive behavioural therapy, and acceptance and commitment therapy — the focus is on the thought work. For example, let’s say a client has a limiting belief or a belief pattern that cooking meals for weight loss is hard and it requires a lot of time and meal preparation, and they’re just really busy. As a coach, I break down that belief and show them a different perspective: ‘What if it could be easy and what would that look like?’
You talk a lot about how we relate to food. What are some of the signs that you might have an unhealthy relationship with what you eat?
N.: The number one sign of an unhealthy relationship with food is if you’re giving food morals. If you’re labeling food as good versus bad, or foods that are good for weight loss and then the off-limit junk food.
Food doesn’t have morals, food is just food. A cupcake is just a cupcake. Diet culture gets us to believe that there are the good foods and bad foods for weight loss. So if you’re giving food morals or you’re restricting certain food groups, like if you’re doing a no-sugar cleanse or you’re eliminating dairy because of what you’ve heard about dairy although you don’t have any intolerances, or you’re experiencing fear around certain foods, I think those are the biggest signs of an unhealthy relationship with food.
What are the top three drivers of a bad relationship with food?
N.: Diet culture messaging. What is diet culture? It’s anything that’s promoting the message that weight loss or “healthy eating” is as simple as just eat less and move more. Anything that’s ignoring the physiology around obesity — which is a real medical condition — and weight loss.
Diet culture messaging shows up on Instagram, although I find nowadays it’s a bit more hidden. In the early 2000s, you would see claims like, “Lose 50 pounds in a month.” Now a lot of these commercial diets have rebranded, but the underlying messaging on social media — whether it’s from influencers or certain diets — is promoting the message that, ‘If you follow exactly what we say and you follow this exact meal plan or way of eating or way of exercising, then you will lose x amount of weight.’
The second one is upbringing and the family dynamic around food. So for example, you may have grown up with a mom who was constantly on the latest fad diet or you had a lot of messaging like, “You shouldn’t be eating that food or you shouldn’t be eating candy because this is the bad food and it’s going to make you unhealthy or gain weight.”
The third one is diet cycling. We see this when someone has been on a lot of fad diets that they can’t sustain for the rest of their life and they’re used to following a lot of rules. Or they’ve been given a list of foods that are good for their diet, and then ones to avoid. That can absolutely play into how you look at a healthy food that may have landed on the off-limit list.
Many of us have a love/hate relationship with the scale. What are your thoughts?
N.: This comes up on a daily basis. The scale is taking up way too much power. At the end of the day, we can’t control the number we see on the scale. There’s so many factors involved, like bowel movements, water retention and hormones that play a role in that number day-to-day. But we give it too much power in defining our success. I ask clients, ‘What if the number on the scale never moved? What would success look like to you in your journey?’ I ask them to map out 10 success criteria.
For example, a success criteria for clients might be they’re not emotionally eating at 4 p.m. when they’re faced with a stressor at work, or they’re incorporating some form of joyful movement every day. We focus on the success criteria beyond the scale that you can actually control. And because we can control behaviour change, we can influence the scale. But we really want to focus on what we can control, and then the scale comes secondary.
We often hear stories about people losing massive amounts of weight through aggressive dieting or exercise, only to gain it all back. How can we set ourselves up for success instead of failure?
N.: That’s a really big question. I would say number one focus is sustainability. The rule of thumb — and this is a tough pill to swallow sometimes — is that any change you make, you need to be certain that you can maintain that behaviour change for the rest of your life. So I focus on small, but permanent, behaviour change. A strategy I use with my clients is to focus on 10 per cent tweaks in their eating or movement. That’s a good, manageable percentage. Some clients might say 10 per cent is not enough, and maybe 10 per cent may not be enough in that moment for weight loss, it’s enough for behaviour change and consistency. Over time, that 10 per cent allows for sustainable weight loss.
When I first meet with a client, I get them to focus on making sure they’re having enough protein with breakfast and understand what that’s going to look like. If they’re having avocado toast, so just a slice of bread and avocado with no protein, I would get them to add two eggs to that. Or if they’re having oats for breakfast with no protein, I would get them to add a three-quarter cup of a plain, two per cent Greek yogurt which would get them closer to 20 grams of protein — perfect for breakfast. Protein helps to shut off those hunger hormones, especially in the morning, so we can just feel more control of our food choices throughout the day. Once they master that behaviour change, then we can add on to the next 10 per cent.
What is the most rewarding part of your work?
N.: Empowering women. Clients who come to me are not broken, we don’t need to fix them. They just have some blind spots. A lot of women know what to eat — they don’t need me there to tell them what their diet plan is. They’re telling me, ‘I know what to eat, but for some reason, I keep on overeating or feeling not in control of my food.’
Then I come in and tell them that they actually own their power and that we can tweak those blind spots. We don’t have to take a radical new approach. We just do those 10 per cent tweaks like a kaleidoscope. We just shift the picture. The most rewarding thing is when these women feel empowered, take action and then feel those results. They just thrive so much further beyond the scale. And then they have all this space now where they feel more self-confident — which carries over to other parts of their lives, like their work. I work with physicians as well so they can advocate for their patients and it’s this beautiful ripple effect because they learn, and then they empower their patients.