Eating Your ADHD with Dietitian Nicole DeMasi Malcher

Sep 13

How's your relationship with food? Do any emotional eating lately? Feeling that magnetic pull to McDonalds? You think there might be any ADHD hidden in there knocking away at you? Nicole DeMasi Malcher is a Registered Dietitian Nutritionist and founder of eatingwithADHD.com, where she helps people with ADHD stop binge-eating and learn to have a healthier relationship with food and body image and she's going to help us all out this week.

Along the way, we learn about the role of a dietitian in your life and how they can help you build a better relationship with food. She helps us understand our relationship with diet, intermittent fasting and food rules, and how we can move toward healthier relationships with food by embracing gentle nutrition and intuitive eating.

Pete Wright:
Hello, everybody and happy birthday, Nikki Kinzer. Oh, it's also the Take Control ADHD podcast.

Nikki Kinzer:
Thank you.

Pete Wright:
Yay, party.

Nikki Kinzer:
Yay, party.

Pete Wright:
Part.

Nikki Kinzer:
Yes, we're recording on my birthday.

Pete Wright:
I can't believe you're letting this happen.

Nikki Kinzer:
That I myself have a birthday?

Pete Wright:
No, that you're letting us podcast on your birthday. I cannot believe that.

Nikki Kinzer:
I know. Well, you know why, is because I took a whole week off last week to celebrate this birthday.

Pete Wright:
I was setting you up to be a real martyr, and you just gave it up. You just gave that up.

Nikki Kinzer:
No, I'm not going to. No, I don't do that. Usually, I do take my birthday off and I would've taken my birthday off except for, I did take all of last week off.

Pete Wright:
I get it. Well, welcome back to and happy birthday.

Nikki Kinzer:
It's very, very good. Thank you. Thank you.

Pete Wright:
It's very good to see you. It's been a little break. We are talking about food nutrition today. We've already actually recorded the interview, so I can tell you right now, when you look at the time in your podcast app, this is a long episode and there is a lot going on. And I know normally we try not to do that to you because you know ADHD, but please remember, you can pause and come back and come back.

Nikki Kinzer:
And come back.

Pete Wright:
Yeah, you can always pause and come back. You don't have to listen to it all the way through. Pause and come back. It's okay. So, we're going to get started with Nicole DeMasi Malcher. She's amazing. But before we do that, head over to takecontroladhd.com. Get to know us a little bit better. You can listen to the show right there on the website or subscribe to the mailing list and we'll send you an email each time a new episode is released.
You can connect with us on Facebook, Instagram, or Pinterest at Take Control ADHD, but to really connect with us, head over to the Discord community. We love our ADHD Discord community, and it's super easy to jump right into the general community chat channel. Just visit, takecontroladhd.com/discord. and you will be whisked over to the general invitation. You can log in. If you're looking for a little bit more, particularly if this show has ever touched you or helped you with your ADHD in any way, we invite you to support the show directly through Patreon. Patreon is listener supported podcasting, and with a few dollars a month, you can help guarantee that we continue to grow this show, add new features and invest more heavily in our community. Visit patreon.com/theADHDpodcast to learn more. Do we have any announcements?

Nikki Kinzer:
Not right now.

Pete Wright:
Outstanding. Let's go. Let's go get Nicole. Nicole? Nicole DeMasi Malcher is a registered dietician, nutritionist and founder of Eating With ADHD. I didn't even know that was a thing, I'm so relieved to know it exists. That's where she helps people with ADHD stop binge eating and learn to have a healthier relationship with food, and body image. And she's here to help us out today. Nicole, welcome to the ADHD podcast. Your work is officially cut out for you.

Nicole DeMasi Malcher:
Thank you so much for having me. I'm excited to be here.

Nikki Kinzer:
Welcome.

Pete Wright:
Can we start by just... I'd like you to share a little bit about how you got into, I mean, I know how people get into the nutrition and health business, but how'd you get into the ADHD nutrition and health?

Nicole DeMasi Malcher:
It kind of goes back to when I was in college. I guess I was the typical undiagnosed ADHD-er where I had no idea what I wanted to do. I was kind of lost. I took every single course you can think of, just to try to find what I actually wanted to do. I finally stumbled upon a nutrition course. And when I was a junior after three years, my mom's like, "Okay, you probably should choose a major now." I'm like, "Okay." So, I took it and I was always interested in nutrition anyway. So I finally decided on nutrition as my major, but I had struggled with disordered eating and all of that, for years and years and years, without even realizing it. I didn't know why I struggled, but as we get into it today during the podcast, we'll talk about disordered eating and how that affects us.
But there was basically just this period of time where I was really struggling, and this was prior to my ADHD diagnosis as a dietician. I was a dietician for about eight years before I actually got diagnosed with ADHD. I didn't even realize that it was disordered eating and all that, all the issues that I was struggling with. So basically as soon as I got diagnosed, I immediately went down the rabbit hole of researching everything that there could possibly, every type of research out there that you could possibly imagine on ADHD and nutrition, just like most of us do, right?
It was sort of this, like I was trying to find everything that I could to see how I could sort of fix my brain. And I think that's where a lot of us go to when we first get diagnosed, we're like, "Okay, how can I fix this?" But we know it's not fixable. It's not something that you can fix. And I don't want to fix it, now that I know all of the amazing things that you can do with your brain and how I'm wired. I think it's fine to have, of course, you can put your mind to anything really. But I think the biggest thing is me struggling with disordered eating as a dietician. I was like, "There's got to be something else going on here." And then, I started putting together the pieces. I'm like, "Okay, so we have all these issues with ADHD. It's got to be related to why I'm struggling so much." And that's when I started doing all the research. I know that was sort of a roundabout way to say it, but...

Nikki Kinzer:
I was just going to ask, what does a dietician do exactly?

Nicole DeMasi Malcher:
That's a great question. So, there's tons of different things that you can do as a dietician. Most of us have a clinical background. So, we basically have to do all the same classes as a nurse would do. So you have to go through all the science classes, psychology, really hands-on stuff. You have to do training in a hospital. You have to do training in long term care facilities, all that. So, you have all this knowledge and clinical background, so you can go into digestive issues and diabetes and all these other things, but there's very, very rare that you get a dietician who specializes in ADHD. I think there's only a handful of us that I know of. So what a dietician does basically is, assesses the nutrition of the client or the patient that she's working with, and basically makes sure that they are eating in an optimal way.
But unfortunately, with our training as dieticians, most of us actually have an unhealthy relationship with food because of it, because it's so strongly linked to perfectionism. So, it's what is the optimal way to eat. And that's basically trying to find the perfect nutrients, or the perfect fruits and vegetables, or getting in the perfect amount of food all the time, when it's actually going to cause more disordered eating because you are so stressed about the perfectionism, rather than just finding a practical way to eat. So it's assessing the client, assessing the different ways that they need to eat, and then making sure that you come up with a plan so that they can actually get those foods available to them and accessible to them.

Pete Wright:
It's really interesting to me, because you said something early on about how, when you got your diagnosis, you went down the rabbit hole of doing all the research, and because I think you were already a dietician, much of that was linked to food and the way you were eating. Is that a fair assessment?

Nicole DeMasi Malcher:
Yeah, definitely.

Pete Wright:
Okay. That was not my experience. My experience was, "Oh my God, I have ADHD. I now have words to use. And I guess I'm going to deal with the grief and shock by eating a bunch of crap." There was never any intentionality of assessing my relationship with ADHD by assessing my relationship with food. And maybe that's because I already had some negative behavioral roles with food, but I feel like that gets to a really important issue, I think for us, which is how living with ADHD exacerbates negative eating behavior, if you're not in touch with it. Is that a fair question?

Nicole DeMasi Malcher:
Yeah, absolutely. It's because there's first off, it depends on if even, when you were diagnosed with ADHD and if you've had any type of coping mechanisms along the way. Like me being diagnosed at 33, I didn't know what was going on in my brain. Most people listening, right? Or a lot of people listening who are undiagnosed. So it's just, food is just an easy way to cope with things. And because with ADHD, because we have such difficulty regulating our emotions, we're going through these extremes all the time. So it's high, super highs and then very low lows. When we feel things, we feel things to an extreme, or at least that's my way of understanding it, and that's how I experience it. So when you have these extremes all the time, it's like, "Oh, I don't really know how to process that emotion," first off, because we have a hard time to focus on things long enough to process them. So, food is just a really easy way to deal with that emotion.

Pete Wright:
Well, it's the one thing in life that has no friction. I can walk into the kitchen and start eating and satisfy a craving, an urge, salve a pain in seconds and everything else in my life, the way I deal with my brain, I have to have accommodations to deal with friction. And I don't have to do that with food.

Nicole DeMasi Malcher:
Yeah. Well, there's a reason for that, right? I mean, biologically, we need food to survive. So our body doesn't really want there to be friction between us and food, because we need it. So if food is supposed to taste good, it's supposed to serve a purpose of being, you're supposed to be excited by food. You're supposed to like it. Otherwise, we wouldn't survive as a species. So I think it's really important to understand that. And it's important to not be ashamed of that, everyone uses food to cope. Everyone uses it as a way to sooth, and it starts off when we're infants. I mean, baby's crying. What do you do? You give them a bottle. Baby needs self soothing, the baby's using a pacifier, or when you're a little kid and you fall on the ground, what do your parents do? Like, "Oh, I'm so sorry you fell. Do you want a cookie?"
Or do you want some type of food as a reward, or as a punishment sometimes as well. So, it's really important to think about how our experiences with foods over our lives has really shaped our relationship with it. And a lot of that does come from diet culture also, which is just this huge, overwhelming cloud, I guess that's over us that sort of makes us feel like we need to have all these food rules, and there's certain ways to eat. And it makes us feel like a lot of shame when we're not able to follow the perfect way of eating, which there is no perfect way to eat, especially not for us neuro-divergent brains, who we don't have the exact executive functioning to really follow meal plans and do everything as by the book, so called, I'm using air quotes for all of you who are listening, but there is no perfect way to eat.

Nikki Kinzer:
My question is when you talked about disordered eating, can you talk a little bit more about what that means?

Nicole DeMasi Malcher:
Yeah. So, there's eating disorders and then there's disordered eating. An eating disorder is actually, it has to be clinically assessed. It's got to be clinically diagnosed by the psychiatrist or somebody who's qualified. Disordered eating can be, we can all relate to it in a way because it's basically eating in a way that's an unhealthy relationship with food.

Nikki Kinzer:
So it's kind of what Pete was saying. That would be more disordered eating.

Nicole DeMasi Malcher:
Having a "healthy" relationship with food would be eating when you're hungry, stopping when you're full or stopping when you're satisfied, not feeling any guilt or shame around food, not feeling this like you're doing anything wrong, not labeling foods as good or bad. And these are things that we all do in just day-to-day life like, "Oh, I'm so bad because I ate that cheeseburger or whatever. Oh, I shouldn't have done that." And then you feel guilt. And then what happens is, the next day you might restrict because of what you ate the day before. And so there's this sort of binge restrict cycle that we get ourselves into, because of this idea that we need to have food rules. And so, I think it's important to kind of break those down and figure out that we actually don't need all those rules to be healthy. And we actually shouldn't be because it is making things much, much worse, and it's making things much more complicated, especially for our ADHD brains that need things to be very simple with eating.

Nikki Kinzer:
Are people with ADHD then at a higher percentage of being diagnosed with eating disorders?

Nicole DeMasi Malcher:
So, we're definitely at higher risk for them.

Nikki Kinzer:
Higher risk, yeah.

Nicole DeMasi Malcher:
Binge eating specifically, we are. Binge eating and bulimia, which is when you binge eat and then you purge or make yourself vomit, or over exercise and things like that. So, we are definitely at a higher risk for that, and it is because of different things. So, it's not just diet culture. It's also the fact that we have impulsivity issues. We tend to be very impulsive with food, but the other one that we don't talk about as much as just poor working memory, time blindness. So what if you go all day without eating, because you just forgot to eat, maybe you were hyper-focused. Maybe you take stimulants and your appetite is very low. So you go throughout the whole day and then all of a sudden your meds wear off and boom, you're starving, and you feel like you need to eat a lot of food to feel full.
And so, that sometimes would feel like you feel your body's out of control because you can't stop eating, but it's actually your body biologically telling you, "You haven't fed me all day. You need to eat some food." And so, of course the first thing we do is we go for the carbs and things like sugar, because it's quick in your body, quickly digest those types of foods and it can get the energy that it needs from it very quickly. So, there's all these different types of things that factor into it.

Pete Wright:
Well, I think the satisfying sort of trigger is that I eat the carbs or the sugars, and then my energy gets back up to what my expected sort of energy level is. And I feel like I've solved the problem. It's just not sustainable. It just doesn't last until the next kind of crash.

Nicole DeMasi Malcher:
Yeah, and I think that's why it's important to try to eat consistently, rather than focusing on specific foods. Because I know there's always these questions of like, "Oh, I have ADHD, what should I be eating?"

Pete Wright:
Yeah.

Nikki Kinzer:
Right.

Nicole DeMasi Malcher:
Actually, we need to figure out how you can actually just eat consistently. And we need to figure out how you can do things, like plan your meals and shop and cook before you can get to the place where you're optimizing your health. Because those things come first, there's only so much you can do if you are only eating one meal a day or two meals a day, it doesn't matter how perfect that meal is. You're going to have lots of issues if you are skipping meals, or you're just sort of like, grazing is okay too, if you're using it as a way to stimulate, which a lot of us do. So, using food to stim is another thing that we do as well.

Pete Wright:
Well, talk about that.

Nicole DeMasi Malcher:
I know there's so much we can get into.

Nikki Kinzer:
But I'm curious about the intermittent fasting. What do you think of that?

Nicole DeMasi Malcher:
So, intermittent fasting is just another diet. It's basically, this is something that we haven't got into yet, but I guess we did a little bit, but anytime you restrict yourself from eating, especially during a specific period of time, you're getting further and further away from your body's natural ability to tell you when it's hungry and when it's full, you're basically undermining what your body's saying. You're like, "Nope, I know you're telling me you're hungry, but I'm just going to ignore you right now. And I'm going to eat when this diet tells me I can eat. So, I'm only going to eat during this window of time." And because of that, the period of time where you are ignoring those hunger cues and you're getting further and further away from listening to your body and telling you what it needs, then you're setting yourself up for a binge, or you're setting yourself up to quickly fail on that diet and then gain a bunch of weight at the end of the diet.
And the reason for that is because anytime you're restricting, it's sort of like when you tell a kid they can't have candy. All they think about is candy, right? It's sort of like you're putting that food on a pedestal, and you're making it more important than it is. So, we tend to feel out of control around those types of foods. So when people go on low carb diets, for example, if you don't have carbohydrates, first off, you're going to feel really low in energy because your brain runs on carbohydrates. But what you're doing is you are making those carbs seem very, very exciting. And so as soon as you go back to eating your "normal" diet, then you're going to not feel in control around those carbs. And you're going to be like, "Oh, I never get to eat these. I'm just going to go wild and have as much as I possibly want."

Nikki Kinzer:
The whole loaf of bread, please.

Nicole DeMasi Malcher:
I deserve this because I didn't allow myself to have it for so long. So with intermittent fasting, it's the same exact thing. It's like you're restricting during a certain time window, which I know they say for people with ADHD, it's easier because you only have to think about eating during that time window. And that's all I have to think about, but it's not necessarily healthy for your brain in the long term. We know that based on studies, based on the research, that two-thirds of people who go on diets, whether it's for weight loss or intermittent fasting, whatever, it might be end up gaining more weight than what they started with. And the reason is because your metabolism keeps going lower, and lower and lower.

Nikki Kinzer:
So what about these? And I know these are probably the questions you're always getting, because they're so common, but I want to know. Vegetarian diets, vegan diets, plant based diets. I went to a nutritionist a few years ago, and they really pushed the plant based diet on me. And so I'm curious to know what your thoughts are around those type of diets, because they're also taking away meat and vegan, especially. I mean they're taking away eggs, dairy, all of that.

Nicole DeMasi Malcher:
So, I say it's the same thing. When I was really restrictive prior to my ADHD diagnosis, I was gluten free. I was vegan. I was all these things because I thought it was going to be better for my health, when actually I was just very undernourished at the time. It doesn't mean that if you go vegan or if you go vegetarian that you're going to be undernourished, because there are ways to get these nutrients in, but it's much, much harder. Number one, it's going to be much harder for someone with ADHD, unless that's your thing, and that's your hyper focus is to focus on food. But chances are, if you're telling yourself that you can't eat something, it's probably going to be the food that you binge on later on. So, we need to try to accept all foods into our diet so that they don't seem as exciting.
And I know what people are thinking. They're like, "Well, if I allow myself to just eat whatever I want, doesn't that mean that I'm just going to eat McDonald's and Burger King every single day and I'm not going to be healthy?" That's actually not true. So, people who accept all foods into their diet without guilt and without shame, they actually start to crave foods that are more nourishing, like more fruits and more veggies and all these other types of foods, because you're actually listening to your body. You're in tune with what it needs, rather than following all these food rules and following these specific guidelines. Your body is very, very smart. It's going to tell you what it needs. So, the people who come to me and they do my programs, once we get into it, they find that, "Oh yeah, actually I have been limiting dairy because I heard when I was younger, that it was really bad for you."
And so, I've just cut it out all these years and I've never even thought about it, when it's actually making life a little bit more difficult because you are having to avoid all these other foods. And then, you realize that you feel out of control around things like cake and cookies and all that stuff because they have dairy, and those are things that you can't eat. And then as soon as they start incorporating them back into their lives, they're like, "You know what? I actually don't even crave cookies anymore. I don't even crave cake anymore because I can have it. It has no strong attachment to what I can and can't have."

Nikki Kinzer:
So it's almost like you're saying, and if I'm understanding this correctly, it's almost like it's more of a choice now. It's not this restrictive thing. "Oh, I can't have that." It's more of, "I'm just choosing, I don't want that. I'm not craving it. This is the diet." I mean, this is just the way I like to eat. I eat clean, whatever. Is that kind of what I'm getting at?

Nicole DeMasi Malcher:
Absolutely, it's all about your mindset. So, it's about making peace with those foods and knowing that, you know what? I could eat that if I want to, but I've tried to eat it, and I actually don't feel well when I eat it. So I'm choosing not to have it, but you can't get there unless you allow these foods into your life and you make them, you'd kind of normalize them. So there's a process called habituation that we do with intuitive eating. And what that is, is basically just bringing these foods into your life, normalizing them and seeing how they make you feel. That's the most important thing. How is this food that I'm going to eat, make me feel, and how am I going to feel when I'm done with it? So, that takes a lot of checking in with yourself and making sure that you are actually hungry.
Why are you eating that food? Am I eating it because I am bored? Am I eating it because I'm tired? Am I eating it because I just feel really stressed out right now? And chances are when you eat in those situations, you're going to eat a lot more of it, or you're going to be eating it for the wrong reason. So it's a lot of checking in. It's a lot of looking at the big picture. Have I actually eaten today? And if I haven't eaten, maybe I'm having these cravings because my body's just telling me that you need food in general. So yes, you can be vegan or you can be vegetarian and still eat intuitively, and it doesn't necessarily have to do with weight loss. But a lot of people do go on those diets just for weight loss.

Nikki Kinzer:
For weight loss.

Nicole DeMasi Malcher:
And that's where...

Nikki Kinzer:
So that's the difference of having it be a lifestyle choice versus really just to lose weight. And then I've lost the weight. I lose the diet, and then I'm gaining it back is sort of what the cycle is, a lot of times of what you're saying.

Nicole DeMasi Malcher:
Yeah, exactly. But there's also people who do it just for a healthy lifestyle. And it's called pseudo-dieting. Pseudo-dieting is basically when you don't realize that you're on a diet, but you're still restricting because you think it's healthy for you. Regardless of how you restrict, you're still going to have those food rules in your head that affect the way that you eat. So, you really do have to make peace with all foods, unless you have a food allergy or something like that.

Nikki Kinzer:
Right. But these food rules, so a couple things that are coming up for me, one is I want to know more about intuitive eating. And then these food rules, how do you get past that? Because I can tell you, I know exactly what you're talking about. If you're on Weight Watchers, you're looking at that's three points right there, that's zero points. If you're on a low carb diet, I can't have the bread. Don't even bring it to the table. I mean, there are these rules that are just so ingrained.

Pete Wright:
There are. And I want to add something to that though, because this probably gets into intuitive eating maybe, but this is the other side of the eating equation. Being able to understand what my body is doing when I eat certain things is, sometimes there's a long delay between the time I ingest something and the time I actually feel the trouble with it. And so, it's hard to build new habits based on those things based on looking at a food and saying, "God, when I see that food, I know that hurts me. I know that eventually I'm going to feel terrible if I eat that thing, but I really love that thing." And in the moment I think, "Well, just this once will be fine." So, sometimes building those food rules can really, really help you if you're able to make that connection. And I want to know how to better reinforce those connections. So, take all of that and see what you think.

Nicole DeMasi Malcher:
Well, because what I'm hearing when you say, "Oh, just this one time," that is coming from a place of restriction still, rather than, "I'm choosing to eat this food, even though I know it's probably going to make me feel ill."

Pete Wright:
Yeah.

Nikki Kinzer:
It's like ice cream. I had a bowl of ice cream last night, knowing that it was probably not going to make me feel well and sure enough, about a half hour later, my stomach wasn't feeling good.

Nicole DeMasi Malcher:
So it's basically, you're saying the consequences of eating it is still not stopping you from eating it.

Nikki Kinzer:
It didn't last night.

Pete Wright:
Sometimes it doesn't, yeah. And I'm curious what that behavior is all about because I happen to know exactly what certain foods are going to do to me and what they're going to do to my joints.

Nikki Kinzer:
And I'll still do it, yeah.

Pete Wright:
And my nervous system. And I still sometimes do it. And we call that my 13-year-old, who rides around on my back and tells me what to do, trying to build a better relationship with him.

Nicole DeMasi Malcher:
Yeah. I mean, it really depends. So if it's digestive health, for example, if we talk about ice cream and dairy and that type of stuff, how's that going to make me feel? Well, you're like, "I know that this is going to bother me, but I'm eating it anyway." Sometimes it really just takes owning your choice. And next time you can say, "Do I really want to feel that way?" But why is it that you're choosing it in the first place, right? What's leading, driving you to choose that food. Is it because you feel like, "Oh, I had a bad day. I deserve it." Or are you thinking, "Oh, I really need some ice cream right now because I'm feeling stressed out." What is it that's driving those behaviors?

Nikki Kinzer:
So I can tell you yesterday, it happens to be my birthday today. There's my balloon.

Nicole DeMasi Malcher:
Happy birthday.

Nikki Kinzer:
Thank you. And it's a big birthday. It's this birthday.

Pete Wright:
Oh God, 50.

Nicole DeMasi Malcher:
A big one.

Nikki Kinzer:
It's a big one. And my husband, he eats ice cream all the time, because he doesn't have these problems at all. And I know exactly what came to my mind is that, "Hey, it's my birthday tomorrow. I'm going to have that bowl of ice cream." I guess it was maybe that little bit of, "I deserve it." Yeah. Let's make this exception. Not exception, because I'm not saying that I'm restricting ice cream right now, but that was sort of when you were talking, I would say it was the, "Oh I deserve this."

Pete Wright:
Yeah.

Nicole DeMasi Malcher:
Yeah. And that's what a lot of us do. That's like, don't feel ashamed by that, but just know that it does put ice cream on a pedestal when you think that it's a good or a bad food. So, not labeling foods as good or bad as really important to making that peace with food. It's identifying why you are eating it. So let's say, "Okay, it's my birthday. I deserve to eat this." You can eat ice cream whenever you want. It doesn't have to be your birthday, and it doesn't need to make it special. So, that means that you're putting ice cream in a little box that says, "This is special. I can only eat it on certain occasions because it makes me feel ill." But what if it makes you feel in a digestive way? Can you maybe take some lactase enzyme, or something like that, or it just depends on the physical feeling? I don't know how much you want to get into personal level but if it's digestive issues, there's always something that we can do.
And if you know that you're not choosing to eat it because it makes you feel ill. It's not just because you're restricting it out of fear of calories or things like that, then you can usually find an alternative that's going to make you feel as good. Or you can sit with the idea of, "You know what? I can eat this whenever I want. I'm choosing not to, because I don't want to feel ill on my birthday and I deserve to feel well. So, I'm going to choose to eat something else that will make me feel good." And then there's the driving factor of, why do I need food to make me feel good right now?

Pete Wright:
There we go. Bingo.

Nicole DeMasi Malcher:
What is it that's causing these emotions to come up? So there's a lot that goes into it.

Nikki Kinzer:
I hear you. Yeah, there is. Well, and so then my question, if you do need to lose weight, your doctor and I'll be honest, my doctor has said, "You need to lose weight. You're at a health risk." Then how do you that with what we're talking about? With not thinking that food is good or bad, but also understanding I'm not going to lose any weight if I keep eating ice cream every night.

Nicole DeMasi Malcher:
So, that's one of the main issues in healthcare is this misunderstanding about weight. Weight is not what increases your risk for disease. Most of the time, it's your lifestyle choices. So, there's been hundreds of studies that show that weight alone is not the cause for heart disease. It's not the cause for diabetes. It's not the cause for all these other things, it's actually what you're putting into your body and how you're treating your body. Stress is a big one, more than even food and exercise. So overall stress levels, for example, genetics and things like that, of course come into play as well. But most doctors are very, very quick to pull the weight card and say, "Oh, you just need to lose weight and you'll be fine." But what happens when you lose the weight, you go to your doctor, your doctor's happy. And then you just go back to the way you were.
Or even worse, we get into a more unhealthy relationship with food because of the diet that your doctor put you on to lose that weight. So, it's not a good long term solution to just say, "Oh, you need to lose weight. Come back to me in six months," doctor's happy. But then what? What now, what happens, right? It's much better to say, "I'm going to focus on how foods make me feel because my body is smart. My body's going to tell me what I need, and I'm not going to restrict any of these foods. I'm just going to eat what makes me feel good, and I'm going to allow all these foods into my life," and sure enough, eventually I will get to a place where I'm eating a variety of foods, maybe adding in more fruits and veggies because they feel good and I can eat ice cream or cake or cookies, whatever, whenever I want, but you're not really craving them because they're not off limits as much.
And of course, you can include them into your diet on a daily basis and still be... It's still okay, basically. So what I would say to you is, don't focus on the weight, focus on how you want to feel. And most of the time, for most people that is adding in, or eating consistently, eating enough so that your blood sugar levels aren't fluctuating too much throughout the day, right? You're eating in a way that feels good, consistently. And then also adding in some nourishing foods, and adding in movement. And I hesitate to say exercise, because we associate exercise with weight loss, but movement we know is important for everything, including ADHD, right? To spike dopamine. It's good for your heart health. It's good for sleep, mental health, everything. So, focusing on those things and how you want to incorporate them into your day is much better than weight. You don't even have to get weighed at the doctors. If you don't want to, you can actually.

Nikki Kinzer:
Really?

Nicole DeMasi Malcher:
You can tell them, "I don't want to be weighed or I don't want to see my weight."

Nikki Kinzer:
I'm going to stop to having them do it.

Pete Wright:
Man, they do it all the time.

Nicole DeMasi Malcher:
Yeah. You don't have to see your weight. They don't even need to check it unless they need your weight to prescribe certain medication or something like that, but they don't even need it. No, I would. Yeah.

Nikki Kinzer:
So, you've talked about intuitive eating, and I know in our conversation it's kind of come in and out of conversation, but tell me, what is it? How does it work? How does it help with people with ADHD?

Nicole DeMasi Malcher:
Yeah. So intuitive eating, I guess for most people it's kind of like a new buzzword or buzz phrase, I guess. It's been around for a long time. And it basically was created for people with disordered eating. It is just a way of eating without any food rules, allowing your body to do all the decision making, so you're being in tune with your body. You're allowing yourself to feel your hunger cues, feel your fullness cues, stop eating when you're hungry. Sorry, stop eating when you're full, when you're satisfied. My brain. I know I don't have to explain brain, thanks to you guys.

Nikki Kinzer:
No.

Nicole DeMasi Malcher:
But yeah, it's basically just, it's eating in a way that is anti-diet, but feeling good. So, you are making peace with food. You're rejecting all that diet mentality that we have. You are figuring out your emotions, and you're being just really in tune with your body to figure out when you need to eat and when you need to stop eating, it's really eating before dieting ever came into play. Right? It's just eating, is what it is.

Pete Wright:
It's just eating.

Nikki Kinzer:
So what's the difference between that and gentle nutrition?

Nicole DeMasi Malcher:
So, gentle nutrition is a part of intuitive eating. So potential nutrition is just basically, it's like the last step of intuitive eating. Intuitive eating is formed on 10 steps and it is rejecting the diet mentality, making peace with food and moving your body, and all these things that I talked about. And then gentle nutrition is sort of this last piece. And the reason it's saved for the end, is because you need to go through all of these steps before you can even start thinking about how to incorporate different nutrients into your diet. Because if you just go straight to gentle nutrition, and you just go straight to focusing on, "Okay, how can I get more fruits and veggies in my diet?"Then you might be stuck on that diet mentality before you can actually incorporate all foods in, if that makes sense.
So, we want to make sure that we're not provoking any sort of dieting back into your mindset. And it takes a long time for people to get out of that mindset, because we've had food rules for years and years and years. I mean, some of us when we were young when we were even teens, I have some clients who used to go to Weight Watchers with their mom when they were like 12, they started at a very young age, and definitely it affects you because you feel like you need to follow these rules for your whole life. And you really don't. It's just making things much worse.

Pete Wright:
That's one of those things, I feel like not only having a rough relationship with food, but then being diagnosed with ADHD going on 20, more than 20 years, I feel like it has taken me that long to figure out some of those mechanics, and to use my body's relationship with food, to be able to make decisions based on what we were talking about, the things that make me feel bad, to equate those with not eating them, and the things that make me feel good, my body will tell me, "Those make you feel good. You should have some of those." Right. And it's for the first time in my life, I could walk into the kitchen and see a cucumber on the counter and be like, "Oh, I'm going to give me some of that cucumber, maybe a tomato." That's news. You know what I mean? And it sounds so stupid to think about it, but tomato be looking good.

Nicole DeMasi Malcher:
It's interesting, yeah.

Pete Wright:
I just totally sexed up my kitchen. I apologize for that.

Nikki Kinzer:
Oh dear. No, but to your point, Pete, what I think is interesting is when Nicole said, when we were talking about the ice cream, why do you feel like you need it? What's that underlying? "Oh, I deserve this, it's my birthday." It just makes me pause and think that's true. That wasn't going to make me feel any better, was going to make me feel worse and I'm celebrating. Why am I gravitating towards something that, yeah. I mean the whole thing is just really, like you said, there's so many layers, but I think just to pause and think about it for a moment, and really what is the reason I want this or not want this? Well, that's such a connect the dots.

Pete Wright:
That's such a good way to think about it too, Nikki, because it's like, when you start talking about it, you can see the scales. The scales are, I get immediate benefit by being in a celebratory space with people and eating something everybody else is eating and telling myself, "I love this ice cream," which I do love the ice cream, but everybody else is eating. And it's like that. I get the immediate satisfaction of that, or I get the longer term, and I know that the cost of having that immediate celebratory experience is the cost of having the discomfort later.
Or you can shift the scales and say, "You know what? Now I'm going to reprogram myself and realize that, oh right. Ice cream does make my body feel bad. I think I need to focus on something that makes it feel good and is also delightful." But this gets to a question that is, I think an important one for me personally, which is replacement thinking, and I know this is sort of a variant on dieting and food rules, but being able to say, "I know this thing makes me feel bad, but if I find a satisfactory replacement item that does make me feel good, and I enjoy and don't hurt and don't stink up the place later," how does that model fit in with intuitive eating?

Nicole DeMasi Malcher:
That's totally fine. So, that's because it's about mindset. So you're not restricting it just because you feel like you should, you're restricting it because you genuinely have this physiological effect when you eat it, and that's perfectly fine.

Pete Wright:
Conscious choice, conscious choice. It's a win.

Nicole DeMasi Malcher:
Conscious choice. Yes, absolutely. And I think it's really impressive that you've been able to get to that mindset on your own, but I do think it's important for us to dig a little bit deeper. Like Nikki was saying, when you really think about it's like, "Oh actually, maybe I do have a food rule that I'm not allowed to have ice cream in." And because it's my birthday, now I can. So I will, because it's a special treat. That's making it a treat. That's making it special. So if we remove all of that and we just know that, okay, ice cream is just food, it's no more special than an apple or an orange. It's just food. Then it becomes a little bit more habituated. So there's that. And obviously, I'm not denying the fact that an apple or an orange has more nutrients than ice cream in it, because that's obviously not true.
It does have a lot of... I'm sorry. It is true. It's got a lot more nutrients in it, but that doesn't mean that we can't incorporate these play foods, they call them in the intuitive eating world, into our diets as well. So that being said, I do want to mention the fact that for those who are listening and they're like, "Well, you know what? I don't really have a lot of issues with dieting. I just really don't have the executive functioning to meal plan and shop and cook and all these things, and I actually don't even know what to eat. That's my problem." Because that's with a lot of us, that whole other layer that comes with it is just, "Okay, I'm making peace with food. I can eat whatever foods I want, but I'm just eating foods that don't make me feel well, because I don't really know what else to eat." That's the other layer.

Pete Wright:
We fall prey to the marketed foods, to the drive-throughs, to the things that are easy and present that maybe just, we don't know any better. So we just take the least, sort of the road.

Nikki Kinzer:
Well, how can people find out more information about that? I know you mentioned you have some programs, but yeah. Tell us about those. If I just really don't know where to start, it's too overwhelming when you get on the Internet. I mean, there's so much stuff. So, where does somebody start?

Nicole DeMasi Malcher:
Yeah, well, I have on my website eatingwithadhd.com. I have a free 40 minute training for anyone who's listening. You just go to eatingwithadhd.com and you click on the link, and it'll give you all of that information. I basically go through all of the eating challenges that we have. I talk about why we're at risk for binge eating, things that cause binge eating. I talk about things like emotional dysregulation, and how boredom and low dopamine and all these things affect you and sensory issues as well, which is another thing that we haven't really discussed. But I talk about all these different things, and give you an understanding and an awareness of them. And that's a great place to start, is just understanding why your brain is doing the things that it does with ADHD. It's so complex. So, that's a great place to start, is that free training.
And then once you get in there, you have access to my community, which is basically access to my course. I have a very thorough course on ADHD and eating. It's an online course and community, where people talk about the course modules and they give each other support, which is really nice. And then I also have one on one coaching and group coaching programs as well, for people who are listening that want help with figuring out how to meal shop, meal plan, shop, and cook and all these other things. And then of course, what type of foods should I be eating? Not should. I wanted to say the word should, let me take that back. What type of foods can I eat to make me feel good? And exploring all of that, so that's all found on my website.

Nikki Kinzer:
And we'll put all of that information in the show notes. Pete, I know we have a couple of listener questions. Should we ask those right now?

Pete Wright:
Yeah. Where would you like to start? You want to go back up to emotional eating, or?

Nikki Kinzer:
I'll talk, I'll do this first one about decisions around food and nutrition. So, this is coming from a listener. My partner and I are both very picky eaters. My friend says we have the diet of a toddler, French fries, chicken tenders, plain burgers, etc. Is there a reason why we only seem to want that food? Does our ADHD just make it seem like it's the easiest thing to eat?

Nicole DeMasi Malcher:
At first, it depends on preference. So maybe they just really like those foods, and that's okay. There's nothing wrong with them. There's no bad foods. I think it does become easy over time, especially if it's just, it takes less executive functioning because you're used to having those foods. So, you just have them over and over and over again, less steps makes it much easier. Two, it could be that maybe those foods give you a lot more stimulation. So, if they have intense flavors, because we tend to seek dopamine. We're dopamine seekers. And so, if those foods are what stimulate your brain, then that could be a reason for it. The third thing is yes, if it's easy, maybe you're just not thinking of other options that you have, because it maybe provokes a little bit of anxiety. So what I would recommend is, you can definitely keep eating those foods, but maybe just add some other options along with it.
You don't have to completely reinvent the wheel, but maybe just adding in maybe some greens or some tomatoes or something on the burger, for example, or maybe having it on the side, along with it. And it also really depends on, why is it? Is it the time, you don't have enough time to cook foods? Are you forgetting to shop, are you forgetting to make a list to go to the grocery store? So, you just end up getting the same things over and over. So it really depends on the reason for it. You kind of have to dig a little bit deeper.
Why is it that we're actually choosing these foods? I always say to start by making a list of foods that you actually really enjoy, that you really like. And then realistically, which foods on this list can I make at home, and how can I get those started? And then use that list to take with you to the grocery store. Because oftentimes with our poor working memory, we just forget our options. We're like, "Oh, I can't think of anything right now. I'm in a pinch. I'm just going to grab what I know and it's easy." And then it becomes a habit. So, just sort of adding things to that.

Nikki Kinzer:
Well, and I think now, especially after COVID, I think that the meal, what are those meal delivery places?

Pete Wright:
Yeah, like Hello Fresh and stuff.

Nikki Kinzer:
I think those are great alternatives for ADHD-ers because you will get a balanced meal, you get to choose what you want. And they're really easy to put together, and you don't have to go to the store. So maybe I think this is a good idea and it's a bad idea. So, tell me what you think. I mean, is that a good thing or am I highlighting something that maybe we shouldn't be doing? I don't know.

Nicole DeMasi Malcher:
No, I think those would be really great for people that don't mind cooking, but I know I've had some clients that are like, "Oh, I bought those and they worked great for two weeks and then they just died in my fridge."

Nikki Kinzer:
And never did them, yeah.

Nicole DeMasi Malcher:
Yeah. So, it really depends on the person. If you're the type of person that likes to cook and you like to be in the kitchen, but you just want to take away all of the decision making, then those would be great to get. But if it's something where you don't want to deal with that, you can get meals that are already prepared, delivered as well. If you're somebody who's like, "No way, I like to eat the same thing every day," then maybe it's a little bit too much for you. And then there's people who are like, "Nope, I don't like to eat the same thing every day. I have to switch it up." We're all so different. It just depends. So find, figure out something that works for you. And those are all included in my course, as well, those different options.

Pete Wright:
How can I manage healthy eating habits when I have an unhealthy relationship with food? I only realized that within the last two years I have an eating disorder. I associate eating fast food with my emotional state. Am I happy? McDonald's. Am I sad? McDonald's. Is it Wednesday? McDonald's. It's making craving healthy items, incredibly difficult. And I'm depressed about my weight.

Nicole DeMasi Malcher:
Yeah, that's very, very common. First off, don't be ashamed. That's very, very common removing the guilt and shame is number one because the guilt and shame, that's what keeps us in that binge restrict cycle, it keeps us there. So making peace with that food and knowing that, you know what? Eating McDonald's does not make you a bad person. There's nothing wrong with it, and you can eat it. You could eat it every day if you wanted to. But how is it making you feel? What are some of the things that we can do instead of eating foods to change our mood? Is there first off when we go a long time without eating, let's say, like I mentioned before, if you're time blind, for example, which we all are, we can go four or five hours without eating. And then we realized, "Oh my gosh, I'm starving."
So in that moment, we're much more likely to make, I don't want to say the word poor because that would be associating it with bad, but to make less nourishing food decisions. So, we might just go with the McDonald's or something like, "Oh, I'm just going to get this," because we have a hard time regulating emotions when our blood sugar is low. So, making sure that you eat every three to four hours is really, really important in terms of regulating emotion, and making sure that you have a plan or some backup food.
So, I always recommend keeping a list of foods stocked that you check in with yourself every three to four hours, whether it's setting an alarm or whatever type of system that you use for your ADHD reminders, you have to eat either a snack or maybe a meal at that time. And that will really help you to regulate your emotion. And when I say to eat something, I mean something with carbohydrate and protein combined together, to keep your blood sugars nice and stable. Otherwise, if you're skipping meals or your blood sugars drop, you will be craving carbs or something that is just quick energy. And oftentimes, it is fast food or things like that. We don't really make as good decisions in that moment.

Nikki Kinzer:
This comes from, it's a picky eater question. "I like veggies and fruits, but my partner doesn't. Is any way of getting him to at least try them?" And when I first read that, it's like, "Oh, it almost sounds like a parent to a child. Let's just try this."

Pete Wright:
I know you so far only eat white and brown foods, but we're going to try something red, or green.

Nikki Kinzer:
Yeah. But what's so interesting is that yeah. I mean, this is an adult talking to another adult, so it's not just a parent and child problem. We're in this household together. We need to make a dinner together or whatever, and one doesn't want something. So, yeah. I'm just curious what you think about that.

Nicole DeMasi Malcher:
Yeah. Believe it or not, I hear that all the time, especially if that person has ADHD or autism and they have issues with texture and sensory issues, and things like that. That's when a lot of times, that picky eating comes into play. But a lot of times, we associate fruits and vegetables with being bland or flavorless. And usually it's because we associate it with dieting, rather than just exploring different flavors and textures and making it fun. So with ADHD, we need things to be novel. We need things to be exciting. So, if there is a specific type of dip or a marinade or a sauce, it doesn't have to be a healthy dressing or anything like that. It can be whatever you like, any type of flavor, put that on the veggies and see if maybe he'll eat it that way, he or she will eat it that way.
It can be cooking it different ways, maybe roasting it or grilling the veggies, or maybe blending the fruit into a smoothie or different types of things like that, just to find new ways. But what I do think is important is to make the person who is picky involved in choosing the fruits and vegetables that they're going to eat because that's, I think the most important thing. Having them actually go to the store, pick them out can be helpful as well, because then they're more interested in actually eating them if that's a possibility, but it is very, very common. So, just finding different ways to make it that might seem more exciting, and making sure that it's flavorful and not so bland.

Nikki Kinzer:
I wonder if that, I mean, I don't know about their situation, but I know for me personally, when I think of vegetables right off the top of my head, I do think of steamed broccoli. Oh, well that doesn't even sound fun. But when you do start grilling it and putting some spices and garlic and olive oil, I mean, it can be really good. So it is probably being a little more experimentative, and open to new ways of cooking it.

Nicole DeMasi Malcher:
Absolutely. You can use, if you have an air fryer or just roasting veggies and like you said, putting some fat on there, a lot of olive oil and spices, it makes it really good. To me, anyway.

Pete Wright:
Well another, let's say precarious picky eater. My teenager is a bit beyond selective, nearing avoidant, restrictive food intake disorder, but not bad enough for a diagnosis. They won't touch anything remotely outside their comfort zone, which is mostly carbs and cheese type foods. They recently had a significant vitamin D deficiency, everything else tests within normal range, but they're tired all the time. We're dealing with anxiety and depression, as well. So it's hard to know what the root causes are. I don't know how to navigate getting them to try new things, or guiding them to eat a bit healthier in hopes that they won't be so tired. We also just started Concerta, so it feels even more precarious. I don't want to cause a worse relationship to food.

Nicole DeMasi Malcher:
That's really tough. And I'm sorry for whichever listener that was, it's just a really difficult situation. I have worked with people that have ARFID in the past, which is disordered eating that's not related to weight, doesn't have anything to do with the size of the body. It can be very difficult. And it's always recommended to do either CBTT, or DBT right. Cognitive behavioral therapy, and that's actually the first line of therapy for it, because of the fact that sometimes it can be related to difficulty swallowing, or the fear of swallowing or choking and things like that. So, it's really important to get to the root cause of why you said her daughter, is it, or he or she?

Pete Wright:
Teenager is all they said.

Nicole DeMasi Malcher:
Decide why the teenager is actually having those issues. And then I would recommend the same thing that I said with the last person is, just to try different textures and shapes and sizes and things like that. Even cutting something a different way can be really helpful, like chopping something versus giving it whole, and then always offering new foods along with foods that are safe foods. So if you're going to offer something new, that's a different color or a different texture or shape, whatever, make sure that you have food that they already like along with it, that way it's not too much. It's not too anxiety provoking for that meal, but I highly, highly recommend therapy, even if it's not considered an eating disorder.

Nikki Kinzer:
I just want to add, my teenager was diagnosed with an eating disorder a couple years ago, and I think therapy is definitely really important, but not only for the child, but also for the parent, because it is a really hard to navigate through that. And I remember our therapist saying to my husband and I, "Remember it's the disorder, it's not her." And because there would be times where she would really lash out, and get really angry. And it helped us to know too, kind of like what to say what not to say, but also to remember that it's the disorder, it's not her. And that was really helpful for us to not take things personally. So, that's my two cents is for the parents to also get help on how to deal with that, because it's really, really hard to see, and to witness.

Nicole DeMasi Malcher:
Yeah, I definitely recommend that. And also along with that, so family therapy, and then having that therapist recommend a dietician who focuses on that in the area. And usually your health insurance will cover that, as well.

Pete Wright:
We've got this last set of questions in and around supplements. How should we navigate the world of supplements? Do we need to take a multivitamin? Should we all be consuming turmeric and black pepper to ward off chronic inflammation? What is a good resource to help guide us away from taking supplements that only result in expensive pee, and sort of related question. I always see ads and erroneous articles for miracle supplements or vitamins that are recommended to aid in treating ADHD, especially omega-3. Is there any truth to that? Are there certain vitamins or supplements that assist in promoting executive function, or are there foods that are rich in these that I can eat instead of buying and taking another vitamin?

Nicole DeMasi Malcher:
That's a great question. That's always one of the first questions I get is, what supplements should I be taking? Supplements are not like a miracle drug. They're not a drug, it's a supplement. So there's nothing that you can take that will out-supplement a good quality diet, sleep and exercise. I think with ADHD, medication is obviously going to be recommended overtaking supplements. If you can tolerate it, if that's part of your plan, if you've decided that it's okay, you have to be on board with it, but in terms of supplements, it really depends. If you are eating a consistent diet and you feel like you're eating a variety of foods, most people don't need to take a multivitamin. You can, if you feel like you're not really eating well, or you've been eating inconsistently, it doesn't usually hurt to take one, but I can never recommend taking any supplements without first speaking to your doctor, especially if you're taking prescription medications that might be interfering with it.
Omega-3s are the one supplement that are recommended for ADHD. They're the most research. They are the one that I feel comfortable recommending to people. So yes, you can take omega supplements, but you can also get it from food as well. So things like fatty fish, like salmon and trout, and sardines and walnuts, flaxseed, flax oil, things like that. I do recommend those, but the thing that's going to make the most difference is just eating consistently. So, like I mentioned earlier is making sure that you're eating every three to four hours, and you're combining carbohydrate with protein is going to help. If you're not eating enough and you're not giving your brain the energy that it needs from food and from hydration, from water, it's not going to function properly. So even a little bit of dehydration is going to make your ADHD symptoms worse, so staying hydrated is also the most important thing. I would say, rather than going and taking supplements, they are sort of a placebo effect, a lot of the time.

Nikki Kinzer:
So much great information. Thank you so much for being here, and being patient with us as we're asking all of these questions.

Pete Wright:
So many questions.

Nikki Kinzer:
So many questions.

Pete Wright:
I'm hungry.

Nicole DeMasi Malcher:
Yeah. That's good.

Nikki Kinzer:
Yeah. And now you're ready.

Nicole DeMasi Malcher:
Your body's telling you that it needs.

Nikki Kinzer:
That's right.

Pete Wright:
That's exactly, exactly right. Well, we sure appreciate you taking the time to be with us. Nicole DeMasi Malcher, over at eatingwithadhd.com. Head over there, link in the show notes. And thank you for downloading and listening to this show. Thanks for your time and your attention. And don't forget if you have something to contribute about this conversation. We're heading over to the show talk channel in our Discord server. You can join us right there by becoming a supporting member at the deluxe level or better. On behalf of Nikki Kinzer and Nicole DeMasi Malcher, I'm Pete Wright, and we'll see you right back here next week on Taking Control, the ADHD podcast.