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174: Interview With Aaron Flores - Seven Health: Eating Disorder Recovery and Anti Diet Nutritionist

Episode 174: Today's interview is with registered dietitian nutritionist, Aaron Flores. We chat about his transition from traditional dietetics to Health At Every Size, his experience with the Body Trust Certification, and his work with body image and men.


Nov 28.2019


Nov 28.2019

Aaron Flores is a registered dietitian nutritionist based out of Los Angeles, California. With over 10 years of experience, Aaron has worked with eating disorders in a variety of settings.

He currently works part-time at Center for Discovery and part-time in his private practice in Calabasas, CA. He is a Certified Body Trust® provider, and his main areas of focus are Intuitive Eating and Health at Every Size®. In his work, Aaron helps individuals learn how to make peace with food and develop body-positive behaviors.

Aaron is a frequent speaker and has presented at the 2016 and 2017 Binge Eating Disorder Awareness Annual Conference, the 2018 and 2019 International Conference on Eating Disorders and the 2018 Association for Size Diversity and Health Conference. Along with his work with eating disorders, he also is a co-host of the podcast, Dietitians Unplugged.

Here’s what we talk about in this podcast episode:


00:00:00

Intro

Chris Sandel: Welcome to Episode 174 of Real Health Radio. You can find the links talked about as part of this episode at the show notes, which is www.seven-health.com/174.

Welcome to Real Health Radio: Health advice that’s more than just about how you look. Here’s your host, Chris Sandel.

Hey, everyone. Welcome back to another episode of Real Health Radio. This week on the show, it’s another guest interview, and I’m chatting with Aaron Flores.

Aaron is a registered dietitian nutritionist based out of Los Angeles, California. With over 10 years of experience, Aaron has worked with eating disorders in a variety of settings. He currently works part-time at Center for Discovery and part-time in his private practice in Calabasas, California. He is a Certified Body Trust provider, and his main areas of focus are Intuitive Eating and Health at Every Size.

In his work, Aaron helps individuals learn how to make peace with food and develop body-positive behaviors. Aaron is a frequent speaker and has presented at the 2016 and 2017 Binge Eating Disorder Awareness Annual Conference, the 2018 and 2019 International Conference on Eating Disorders, and the 2018 Association for Size Diversity and Health Conference. Along with his work with eating disorders, he is also a co-host of the podcast Dietitians Unplugged.

I’ve been aware of Aaron for a number of years. The podcast hat he hosts, Dietitians Unplugged, started I think a couple of months after Real Health Radio, so it’s been running for over 4 years. I think I discovered it fairly early on, so this is obviously long overdue.

As part of this episode, we talk about how Aaron got into being a dietitian. This is actually a second career; it’s something he didn’t begin until his early thirties, so not the usual trajectory for a lot of guests on the show. Aaron originally started out helping with the VA and doing a weight loss program with them, so his views have radically shifted since then. We talk about this journey for him, being exposed to Health at Every Size and Intuitive Eating and how he’s changed over the years.

We talk about the Body Trust training that Aaron has done and why he’s found it so beneficial. This is actually a training that I’m personally wanting to do, so I selfishly got to ask Aaron all the questions and pick his brain about this. (As a side note, I’ve interviewed Dana Sturtevant, who is one of the co-creators of the training. It’s Episode 149, if you want to check it out.)

With Aaron, we talk about male body image. This isn’t a topic I’ve covered much on the show. Knowing what Aaron works with and knowing that he works with a lot of men and also runs a group coaching that is specifically aimed for men, I wanted to delve into this with him. It’s actually something I’ve started to think about more after our conversation, and there’s been a couple of things that have happened that I wish I’d been able to bring up with him in the conversation, but because they happened more recently, we didn’t get a chance to speak about it.

The first is that I’ve been going to a local swimming pool most weekends. We’re going away in January time to Thailand and Australia, and Ramsay is currently learning to swim. He’s not in official swimming lessons; we did that when he was younger, but we now just go every weekend, we go to the pool, and he absolutely adores it. He has a grin from ear to ear the whole time.

But why I’m mentioning this is because going to a pool, I’m seeing lots of bodies in swimwear. And this is a regular swimming pool out in the countryside. It’s not some private members’ club that skews to some particular type of clientele and body type. It’s families in the pool with kids. It’s just been a really good reminder of the diversity of body shapes and sizes that are out there, and that no one looks like they are going to appear on the front cover of Men’s Health, and that’s okay. People are simply having fun with their kids.

Undoubtedly there are people in that environment who probably feel body-conscious, who struggle with body image, but at least as they look around, they are seeing a fair representation of what different bodies look like.

The other thing that happened was that I watched the Diego Maradona documentary. My dad was talking about this when my folks were recently over visiting, and was saying how much he enjoyed it. It was directed by Asif Kapadia. (I’ve never heard his name pronounced, so I’m not sure how to pronounce it.) He also directed Amy, all about Amy Winehouse, and Senna, all about Ayrton Senna. All three of them are fantastic documentaries and worth seeing.

But what struck me about the Maradona documentary was the physique of the football players. The majority of the film centers around the time Maradona was at Naples, which was between 1984 and 1990, and there were many scenes as part of the documentary where they would be in the locker room or people would be training, and this was particularly in the locker rooms when they won the league or won Argentina won the World Cup.

What struck me was just how regular the guys’ bodies looked. They were clearly fit and could play a 90-minute game of football, but they didn’t look ripped. You now compare this to Cristiano Ronaldo or many of the other footballers today, and the physique and the aesthetic has completely changed. In a 30-year timespan, what a top-class footballer looks like has drastically changed. I just think that this is interesting because this has a trickle-down effect on the perception of what a body should look like, and our perception today versus what it was 30 years ago seems to me to be so drastically different.

It also reminded me of a scene from the documentary Bigger, Faster, Stronger*, which is also really great and also worth a watch. As part of that, there’s a scene where they look at the original G.I. Joe from the 1960s and then walk their way through, all the way up to present day, and just how much, over time, they got more and more ripped and bigger and more muscle definition, ending to something most recently that just defies anything that the human body could ever look like. Again, this just starts to get normalized.

Anyway, I just wanted to mention all this here because it was stuff that I wish I could’ve had a chance to speak to Aaron about in our conversation, but just didn’t get a chance to.

The final thing that we cover as part of our conversation is a support group that Aaron has set up for eating disorder clinicians who are struggling with their own issues around food. From hearing about this and talking with Aaron about it, it’s something that I’ve realized is really needed, and I’m glad that he’s doing that work.

This has been a rather extended intro, so let’s get on with it. Here is my conversation with Aaron Flores.

Hey, Aaron. Thanks for joining me on the show today.

Aaron Flores: Chris, thanks for having me.

Chris Sandel: I am a big fan of your podcast, Dietitians Unplugged, that you host with Glenys. I’m actually recording an episode with her next week, so it’ll be great to have both of you on the show.

Aaron Flores: That’s great.

Chris Sandel: There’s a lot I want to talk about today. There’s two areas I really want to hit, and we can spend a bit of time on them. One is your Body Trust certification and just chatting around that and what you got out of it and how that’s helped you as a practitioner, and then the second topic is on men and body image and eating disorders. I don’t work with a lot of male clients, and it’s not a topic I’ve covered in any level of depth on the show. Given what I’ve heard you talk about before, and I know what you do, you are definitely the right person to fill that void.

So they’re two of the big areas, and then we can just go in all the other directions and see what happens.

Aaron Flores: Great.

00:09:25

A bit about Aaron's background

Chris Sandel: To start with, do you want to give listeners a bit of background on yourself? A brief bio, like who you are, what training you’ve done, that sort of thing?

Aaron Flores: Yeah. I’m based out of LA, and I’m a registered dietitian nutritionist. I finished that in 2006, so it’s been about 12 or 13 years since I’ve been a dietitian. It’s my career change. I came from a previous career of internet game development. I was full in on the dot-com boom and trying to reap the rewards of that, and it just did not go well. I was quite miserable in that work anyway.

So I went back to school at 30 to become a dietitian, and since then I’ve worked in a variety of settings. I started my career working at the Veterans Administration, working with veterans here in the U.S. and helping with their healthcare. It’s interesting because where I am now is so different from where I started, but back then I was actually working with and then eventually running a weight loss program within the VA.

I did that for a few years and tried to straddle some paradigms with Health at Every Size and weight loss for quite some time, and finally just had to push over fully into working from this more weight-inclusive space, because I just couldn’t do it anymore. I realized I was actually doing more harm to the clients, to the vets, than anyone else. They were like, “I don’t get this. You’re not really congruent with what you’re talking about and what this program is about. I’m confused. I don’t know what I should do.”

It was actually where I first learned about binge eating disorder because all these veterans who were coming in for weight loss had trauma history, they had been weight cycling for years, and food was one of their main coping tools. A lot of them had developed eating disorders because of it.

Through that experience and reading Intuitive Eating and things like that, I decided I need to do something totally different. So I started to work mainly with eating disorders. I started doing that, and then I became a certified Body Trust provider, like you mentioned. That’s a certification that I received through Hilary Kinavey and Dana Sturtevant in Portland, Oregon. They own a company called Be Nourished.

That is basically a year-long training that I went through. Most of it’s online, but you do a lot of in-person work as well, and it focuses around the principles that were already foundational to me – Intuitive Eating, Health at Every Size – but it added a really deep weight stigma component, a really strong social justice component to it, and a lot of feminist theory of therapy, a lot of trauma-informed care nuances – things that I as a dietitian had never been trained with. That singularly really was one of the best things I’ve done professionally because it really allowed me to think about not only how I work with my clients, but how I show up in the room as well.

So between all those – the work as a dietitian, the Body Trust certification – I’ve really carved out a space within this eating disorder community to address those things. I work with all different sorts of clients. I work with men, I work with women, I work with folks all over the gender spectrum, adolescents, adults. I work with binge eating disorder, anorexia – I work with all the eating disorders.

It’s really been quite a career transformation over the past 12 years, but I find I’m much happier now than I was back then at the VA.

00:13:45

What made Aaron want to change careers

Chris Sandel: That transition at age 30, how did you make the decision of “I want to do dietetics, I want to study as a dietitian”?

Aaron Flores: I would be curious, if we asked every dietitian why they became a dietitian, if they have a similar answer to mine. Really, it was because I had my own stuff with food. I had struggled with weight and eating pretty much – well, yes, all my adult life up till then, for sure. And not all of my childhood, but a good amount of my childhood.

When I went to become a dietitian, I was in the middle of a lot of dieting behavior, a lot of restrictive eating, a lot of obsessive exercise. I was never diagnosed, but it probably looked a lot like an eating disorder. I went back to school really in that mindset and in the throes of those behaviors, with the goal of trying – I said to myself, and I said to my partner – we weren’t married yet, and I told her, “I think I’m going to go back to school, because if I can lose weight, everyone can. I’m going to be the new Richard Simmons, and I’m going to coach people because there aren’t any men who are doing this.”

So I really came at this career focused on helping people lose weight.

Chris Sandel: So it was at a time when you were “winning” that battle?

Aaron Flores: Yeah. That’s a good way of putting it. Yes, I felt like I was winning. In reality, I was miserable. When I look back on it now, the food I ate was sad. The rules and the limits I set on myself around food were strict and rigid. I ate the same lunch for years and justified it in many different ways, but really it came down to it was low calorie.

It took a lot of work through school, and even after, as a dietitian, to undo a lot of that and build a more sustainable relationship with food. And yes, I was definitely in it. I think that’s a good way to put it – I thought I was winning, for sure.

00:16:20

When did his issues with food and body image start?

Chris Sandel: You said some of this started from childhood, so how far back are we going?

Aaron Flores: I remember from a very – I would say around puberty for me, I really noticed that my body was a little bit different from my friends’. I was athletic and I played sports, and I was moderately good at them. I wasn’t going to go pro, but I could hold my own. But my body never developed, at least from a masculinity standpoint, the way I thought it should. It didn’t develop muscles the way it should.

I remember around 15, my mother asked if I wanted to go see a dietitian. It was someone that she had seen that had helped her lose weight. I don’t know if I had voiced concern, but she obviously had some concerns about the size of my body and my relationship with food then. So at 15, I went to see a dietitian, and I hated all of it. I consented to go. It wasn’t like pulling teeth. But once I was there, I was like, what am I doing here?

I didn’t do anything she said. I lied on my food journal. She had me self-report my weight, so I just told her I lost a half pound every week. Really, that was it. I didn’t really do anything that she told me to do. I saved that until I went to college – well, after college. Because when I went away to school, all the food rules were gone. I got to eat however I wanted, and I did. Just like anyone who’s had some restrictions, whether they were family-imposed or self-imposed, you sort of swing to the other side, and I swung to the other side, and I gained weight during that process.

It wasn’t until my mid-twenties that I applied all of the things that this dietitian taught me when I was 15 into my life, and that’s what really started this really intense dieting/restrictive eating behavior cycle.

Chris Sandel: When I think about 15-year-olds, it’s much more associated with women or girls going on diets. How common was it with your male counterparts doing that? Or was part of the reason you didn’t follow any of it because you were like “this feels so different to what everyone else is having to do”?

Aaron Flores: That’s a great question. I don’t think I ever talked about it with any of my friends. I don’t think it ever came up. Put it this way: if I don’t think it came up, that means I must’ve felt embarrassed about it, and I wasn’t going to say anything to them. So I don’t think this is something that we ever talked about. Not once, about dieting or anything like that.

I do remember at some point, as I played high school volleyball, that there were some conversations around eating for performance, but it wasn’t anything structured. It was more like almost laughing about carb loading for a volleyball match, which you don’t need. But that’s where it might’ve come in a little bit. But it wasn’t really anything I spoke about or anything my friends talked about at all.

Chris Sandel: Yeah. I think you’re older than me, but the rhetoric of what was talked about with diets when you and I were at school is very different to how things are talked about now.

Aaron Flores: I’m sure, yeah. I think dieting is probably more entrenched in our culture right now – and maybe I’m biased because I see it. This is my work. But I see it entrenched in a much different and much more pervasive way than when I was a kid. But again, that was 30-40 years ago.

00:20:40

What food was like for him growing up

Chris Sandel: You mentioned about your mom being the one who took you or recommended you going to the dietitian. What was food like in your house in terms of your parents’ eating and their thoughts around eating and body shape and dieting and all of that?

Aaron Flores: I definitely remember my mom dieting as a kid, and I definitely remember hearing self-talk about “This picture looks good, this picture doesn’t. Look at me then, look at me now” type comments. So that was really important.

My parents are divorced, so I really was raised primarily by my mom from age 6 or 7 till I left for high school. My dad, although I spent some time with him, I didn’t live with him, so I didn’t notice any diet culture from him. My mom is from the United States; my dad is from Mexico. So culturally, I think there’s also some differences around food. My mom is Jewish, my dad was raised Catholic but is not observant with that. I think it added definitely some different nuances.

What I know now, too, is I think each of their upbringings around food was incredibly different. One came from a more food-insecure home, one came from a more food-stable home. I think those things play a role as well. So definitely I felt more of that from my mom, but just because also I lived with her and I was raised by her, mostly.

Chris Sandel: Sure. What about other siblings? Do you have brothers and sisters – in terms of body shape? If you do, are they similar to you?

Aaron Flores: I have an older brother, and we definitely have different body types. I definitely have my dad’s body. We look alike in a lot of different ways, and I think I see my body type in him really clearly. My brother is in a smaller body than I am, and was always in a smaller body than I was when we were growing up. So that comparison piece was definitely there in my head.

Chris Sandel: Part of the reason I ask that is I’ve got an older brother and a younger sister, and we all have very different body shapes. I’ve always been the one who’s been smaller and leaner. It’s really interesting to reflect on that because none of us did anything differently. It was just this is how we were born into it. And yes, some people had more of a focus on food or more pleasure from food or whatever, but again, that wasn’t a choice. That was just what naturally happened.

Aaron Flores: Yeah.

00:23:45

How deciding to study nutrition changed Aaron's life

Chris Sandel: Talking about you deciding to make that change at 30 and study as a dietitian, how much of a big decision did that feel to you?

Aaron Flores: Oh, it was huge. You know those movies where you just jump off the cliff and you hope everything’s going to be okay? That’s what it was. I had a very stable career. I was making – I’d originally dropped out of college, in my twenties. I dropped out. I never finished. So without a college degree, I was making fairly decent money in the internet world doing the things I was doing. But I was miserable. Really just miserable. I would come home on a Friday and cry because I had to go back to work on a Monday.

I changed jobs a bunch of times because I thought it was the place. I was like, “Oh, this place is whack. I’m leaving.” So I’d go to another place and I’d be like, “This place is crazy just like the other one. Why am I here?” Then finally I went to a career counselor a couple times. I read this book called What Color Is Your Parachute?, which gives you all these exercises to figure out what kind of things you’d be good at. And I realized, I think I need to go back to school and get my degree and become a dietitian.

I was engaged at the time. This was June, and we were going to be married in September. I was like, I think I need to do this. My partner was like, “Yeah, you should totally do this. Yeah, it’s a change for us, but we’ll do it.” And I did. It was a huge leap. It was a complete 180.

Chris Sandel: Looking back on it now, when you say you were so miserable as part of that previous job or jobs, what is it that you do now that is so much more fulfilling that wasn’t there?

Aaron Flores: I think the number one thing is I work directly with people. Just to fast forward a little bit, why I love the Body Trust work and the community I found through there is in my work with my clients right now, I really feel like there’s two – I know this sounds weird, but there’s a humanity that shows up in the room when I do this work with folks. That feels really good.

So the intrinsic things that I get from this work are that I get to build these – I get to see how what we talk about in the room – it sounds corny, but it’s true – really has the potential to change and even save someone’s life. And that is really profound. I do not take that lightly at all. So that’s number one. I feel like I get to be connected to people on a daily basis.

In my other career, I was not. All the effort I was putting in was for a stupid video game. It was great to see, hey, 10,000 people played this game this week, but I didn’t know who those 10,000 people are. Were they happy because I did all this work? I was working like 60-70 hour weeks. Was the effort worth the reward? And it wasn’t.

So for me, having that human connection and knowing that the work I’m putting in has a direct effect on the person sitting across from me is really profound.

Chris Sandel: Is that what you had identified in terms of going to see the career counselor or reading the book, like “I’m just missing that humanity as part of my work”?

Aaron Flores: A large part of it, yeah. It was like, do I want to be the CEO of these companies so I can run them better? That wasn’t it. I wasn’t trying to be Steve Jobs or run the company or be that person. I didn’t have to own it. But what I did need, I needed to feel like when I went home at night, I was making a difference in someone’s life, or in the world. I just needed to have that real-world, tangible feeling that this work, the effort I’m putting in, is worth it.

Chris Sandel: What you’re describing there is why I do the work that I do and why I’m also so passionate about it. But interestingly, that wasn’t what initially got me into studying nutrition and doing this. It was more of that interest in food and interest in health and helping people. But even the helping people, it still wasn’t as deep as the way that I think about it now. But now that’s the part that I like the most and why I spend the time wanting to study so much about how to be a better practitioner and understanding psychology and all those components, because for me, that’s the really interesting bit.

Aaron Flores: Yeah. How long have you been doing this?

Chris Sandel: I qualified in 2008, so like 11 years.

Aaron Flores: All right, so we’re around the same timeframe. It’s interesting; the folks that I see who graduated with me or completed their coursework around me or became dietitians around the time I did, a lot of them were younger, and it’s interesting because some of them have had that same epiphany I had. Like you said, “I just came into this because I liked food, but I didn’t find the passion that was going to keep me going in this career” – a lot of those folks have changed careers now.

Chris Sandel: Yeah. While there may have been some worry about coming into this career later in life, there’s a lot that I’ve learnt through just being older that helps me so much in terms of the work that I do that you don’t learn in a textbook. You just have to go through in terms of experience, whether that be becoming a parent or just getting older and things that happen in life, that you would’ve then been able to funnel into the work that you do with people.

Aaron Flores: Yeah, totally. Listen, I was 30, and really, for the most part, I was married during most of it, and I treated school like my job. I was going to go to school religiously. I was going to study like it was my job, and I was going to commit like it was my job. Even if I just had class for 2 hours a day, that doesn’t mean I did 2 hours of work. I’d put in a full day’s work. Because I felt like I had the maturity to do that.

When I went to school the first time, it was not that way at all. I was the worst student ever. I would sign up for a class and go twice, and then never go again. For a lot of different reasons, but basically it was because I was not ready to go to college. I didn’t know what I wanted. I had no direction, and I fumbled through all of it.

So I get what you’re saying completely. There is a part of this where maturity and age is a factor in it.

Chris Sandel: Definitely. In terms of picking dietetics, were you a science-y kid? Had that always been an interest for you?

Aaron Flores: No, not really. I remember high school chemistry, I failed and had to redo in summer school. It’s not because I didn’t get it; it’s just because I didn’t work at it. But when I went back to school – when I first started university when I was 18, I was a history major. I thought that that was going to be really interesting. And it was, but I’m definitely more science-y than I thought.

When I went back to school at 30, I loved chemistry. I loved it so much that I ended up tutoring people. Even today, I love stoichiometry. Doing all those equations is so much fun to me. My kids are just learning algebra, and I’m the happiest dad in the world, helping with algebra homework.

00:32:35

What made him start to doubt traditional dietetics

Chris Sandel: [laughs] Nice. You talked about when you were working with the veterans, and you developing this ambivalence around the work that you were doing and having these mixed ideas about what’s right, what you should be doing. Was that coming more from your own personal journey or just the results that you were seeing with the guys you were working with?

Aaron Flores: It was less about my own personal stuff and more about what I was seeing. But also, that’s around the time I had read Intuitive Eating and was really then understanding what some of this stuff is about. When I say “this stuff,” I mean a more weight-inclusive approach. I was really starting to understand more about what it would mean to apply that, both personally but also professionally.

So it was a bunch of things that came together in this space of like, huh, these folks are coming in, they’re doing the best they can, but the number on the scale doesn’t change, and they’re showing up really despondent, and they’re showing up full of – what I now know is full of shame. They’re showing up eager to do the work and eager to engage, and also they’re showing up on certain days totally in their trauma. I’m like, what’s going on with all of this? If I were to zoom out, what’s the big picture that’s going on here?

It was definitely some stuff that I was reading that started to force me to ask some questions about what I was seeing in this lived experience of the veterans that I was working with.

Chris Sandel: Had you had any trauma experience or training in terms of how that’s going to impact on the veterans?

Aaron Flores: Zero point zero. No. This is the fault of the work in dietetics, in my opinion. We don’t get any training around the impact of trauma on health. I learned because obviously I’m in the VA, and obviously there are a lot of therapists and psychologists and a whole mental health department that is there to focus on trauma. There were a few psychologists that would work in our weight loss program, and they brought up the trauma stuff. So I was listening to them, really, and we were doing groups together, so I was hearing these veterans talk about their trauma and being in it – especially around Fourth of July and hearing fireworks and things like that.

It was just exposure to how the psychologists were talking about trauma, but I never really got any formal training like that until I did the Body Trust work. And again, that’s not really trauma work; it’s more like being trauma-informed.

Chris Sandel: Definitely. I haven’t done any real official training on trauma. I’ve read a fair few books on it, but there’s definitely a point where I’m like, okay, I know enough to have a conversation about this, but I’m not your trauma worker. This is where I refer out.

Aaron Flores: Exactly.

00:36:15

The impact Intuitive Eating had on Aaron

Chris Sandel: In terms of Intuitive Eating, talk about what that was like for you, discovering Intuitive Eating. How did your own personal eating start to morph or take that onboard?

Aaron Flores: I originally had heard about the book in college, when I was doing my undergrad stuff. I didn’t really pick up on it too much until I heard one of the co-authors, Elyse Resch, speak here in LA. After I heard her speak, I was like, I think I need to give this book another chance. I reread it, and that’s when a lot of stuff just clicked.

I emailed her and I said, “Thank you for writing this book. It’s great. I can understand how it’s so profound and helpful for people. Just thank you,” and she wrote back and said, “Thank you so much. I run a supervision group here in LA. You’re always welcome. We’d love to have you join.” So I did. I went once a month, probably for about 2, 3, maybe 4 years, on a really consistent basis.

To be honest, that was my work. I just listened and brought in some cases here and there, but just listened to people as they were talking about this. That’s where I started to really liberalize a lot of my food stuff and started to bring a different lunch and started to think about, why can’t I have sourdough bread? Why do I need to have wheat bread? I hate wheat bread. Sourdough is so much more yummy. Why can’t I have it? Doing things like that that really – it took, I would say if I really think about it, like 4-5 years of challenging all the very overt food rules, but also the subtle ones that were way deep.

Chris Sandel: Were you someone who had followed lots of official diets, or more just “healthy eating” or just trying to have lower amounts of calories, that kind of thing?

Aaron Flores: Again, when I was in it, in my mid-twenties, it was really trying to watch the amount of calories I took in. It was more focused on that. I wouldn’t say any specific diet per se.

Once I was in school, becoming a dietitian, it was probably more focused on maybe a little bit of calories and stuff – here’s what I knew about the science from an early point, and also lived experience: because I had lost so much weight as an adult, I knew that in order for me to maintain the weight loss that I had, I had to be super strict. I had to be super vigilant, and I couldn’t go over a certain number. That’s the sort of food rule that stuck for the most, and breaking that was hard.

Chris Sandel: How was this experience in terms of discovering Intuitive Eating and changing your eating patterns with your partner? Or she could’ve been wife by then. Do they have a history around dieting? Was this something you guys did together? How did that come together?

Aaron Flores: My partner, she has her own food stuff that she’s done work on. When I started to do this Intuitive Eating stuff, I was like, “I think you’ve got to read this book.” I can’t remember if she has fully read it or not. I think she has, but I don’t remember. I’m her husband; I’m not her dietitian. That’s a very clear distinction I make.

But she has been super supportive throughout all of this, and as I’ve changed careers, changed trajectory of a career, super supportive. Like, “Yes, I see why this is going to be important for you. I’m going to be behind you 100%” and has never faltered in any way in that realm. Even as my body’s changed, she has not cared. As our bodies change, neither of us have cared. We each know that food can be tricky for each of us, and we’re just going to be there to support each other. Again, I’m not her dietitian. I told her from very early, “I don’t want to be your dietitian. And when I am, you get to say that.”

Chris Sandel: Definitely. You said “kid” – do you have children? One, two?

Aaron Flores: Yeah, I have twins. They just turned 12.

00:41:20

How Aaron approaches food + eating with his kids

Chris Sandel: How has it been in terms of raising them as eaters?

Aaron Flores: Being a dad is really hard. Being a parent is really hard. Being a dietitian and a parent is miserable. [laughs] You’re trying to get out of your head. You’re trying to get out of that professional head, and instead just realize, okay, my kid didn’t have a vegetable for two days. It’s okay. They’re going to survive. I don’t need to do that thing that I know is not going to be helpful to say “you’ve got to eat a vegetable today.”

So I really had to stand back and honor that I’m going to be their dad, and I’m going to model all the food stuff that I can, and I’m just going to help them develop their own positive relationship with food and trust their body. That’s going to look different than how I was raised and how I thought I should do food.

It was very different, but it was great. Now, in the end, I’m so thankful that we did what we did with our kids, because they do have a fairly solid relationship with food and a fairly solid relationship with their body.

Chris Sandel: Nice.

Aaron Flores: And just like your siblings, their bodies are totally different. They were born on the same day, but they’re totally different kids, from a personality and body-wise.

Chris Sandel: I’ve got a two-year-old son, and we have very much from the beginning done the whole division of responsibility where we prepare the food, we put it down in front of him, he has kind of a buffet of food in front of him at every meal, and then once the food is on the table, my responsibility ends. He then gets to choose what he wants to eat, how much of it he wants to eat. At this stage, I think there’s probably just a little bit more of him wanting to get out of his chair, so that’s probably a little bit of a battle at the moment. But apart from that – and it is amazing how much there is no stress.

And look, undoubtedly that’s going to change as he gets older and there’ll be things that come up, but I’m not at any point thinking, “Please, why are you not eating your broccoli? Why are you not eating this or that?” I know he’s going to start eating that at some point, and there’s days where he just eats nothing but white rice, and there’s days where he eats more than me, and it’s phenomenal to see someone that small put away that amount of food.

I think they are just the most pure intuitive eaters.

Aaron Flores: Right. Absolutely. I think the way we thought about it is like, let’s not get in the way. [laughs] Let’s try and nurture that and not mess it up by trying to intervene in some way.

Chris Sandel: Definitely. Look, I’m also the first to acknowledge, I have lots of privilege. I haven’t had a dieting history. I’ve lived in a thinner body. Same with my partner. We’ve got the money and the means to buy nice food, and we have the time to cook meals and all of those things that make this process so much easier. But at the same time, there’s a lot of people in that position who really do get in the way of trying to micromanage it – with the best of intentions – where then meals become a battleground.

Aaron Flores: Yeah, absolutely.

00:45:10

What is the Body Trust certification all about?

Chris Sandel: I’d love to hear about the Body Trust certification. I’ve had Dana on the podcast before, and it’s a training that I personally want to do. Just with having a child more recently, and other stuff, it just hasn’t happened. [laughs]

But yeah, maybe start with giving an overview – and I know you touched on this a little bit at the beginning, but an overview of what the training is? And then we can dive into the bits that you really liked from it.

Aaron Flores: Yeah. Let me first off say I’m not a paid sponsor by them at all. It might sound like I am, but it’s really just how much I love the work and how much it has meant to me.

Again, like I said earlier, if I were to explain Body Trust and the certification, it’s taking the paradigms of Health at Every Size and Intuitive Eating as a foundation, but building upon those this really focused social justice lens that’s going to bring in topics like weight stigma, race, gender, privilege, social determinants of health, really looking at systems of oppression and how those have impacted health, and using a lot of other feminist theories and trauma-informed care to help bring all that together in how do we have conversations with folks around their body and externalizing the shame and blame that they might be living with, and understanding that all of these things like diet culture and like the need and strive to be thin is all things that you never consented to be a part of.

These are all things that were thrust upon you, and here’s a different way of thinking about it. Your body has been with you for your entire life, has shown up for you in many different ways, no matter how you’ve treated it, and so let’s start to rebuild that relationship with your body so that you end up trusting it the way you probably started to do when you were a kid.

Chris Sandel: Right. The part that I really like about it is, as you described there, it’s just touching on so many different areas. For all of that, how much of those do you think you knew or were strengths going into it, and how much of that was like “this is completely new stuff to me”?

Aaron Flores: I definitely knew about Intuitive Eating and I definitely knew about Health at Every Size. I felt very comfortable with those. I felt mildly comfortable to moderately comfortable with weight stigma. I did not feel very comfortable with talking about other forms of oppression, though. I think as someone who exists in this world with also a lot of privilege, being cisgender and heterosexual and white and having financial means, I have a lot of privilege in this world, and that’s a blinder in a lot of ways for me as I do this work.

The Body Trust work allowed me to really understand the biases that I have, understand why they’re there, and how do I work on a personal level to dismantle those or challenge those on a daily basis? Because they’re going to show up in my office, and some clients really don’t like that I talk about it, and some clients love that I talk about social justice, and I talk about these things all the time – because I feel like we have to.

I feel like in order to move this process along, to help people really feel comfortable in their bodies, they need to understand why it’s such a radical act, why everyone is saying this is not something you’re allowed to do – and when you do it, you’re really being a rebel, and rebellions need a community. Rebellions need the other rebels to band together and say, “I hear you. What you’re saying is right, and I’m going to stand behind you in this fight.”

I think that’s what Body Trust did for me. It not only helped me bring that into the room, but it gave me a community of other providers who are out there, doing this work, being radical, being revolutionary, saying things that are not popular, but we all have each other’s back.

Chris Sandel: You said that some people don’t like you talking about this, and maybe even some clients don’t like you talking about this. What’s the reason that they don’t like it?

Aaron Flores: I’ve had clients who say, “Listen, the social justice part doesn’t resonate with me. I don’t see how it is relevant to our work,” and have chosen to find other folks who might speak differently in their office – which I respect. Almost every time that’s happened, people have been upfront about it with me, which is helpful.

But I also notice it professionally. I’m getting to the point in my career where my outspokenness, some people feel, is challenging. Maybe too challenging to give a voice to. Sometimes there’s a ramification of that, of speaking your mind. So I see it on both levels.

Chris Sandel: Does it skew in the direction of the people who are most put off by it are also the people who have the most privilege?

Aaron Flores: Yes and no. I would say from a client standpoint, the folks that struggled with it, maybe it just wasn’t a part of what they already were coming in with, and it seemed – especially in the United States – and I’m sure it sounds very similar right now in the UK – politics is really an intense topic. I feel like some people really want to move forward in that and some people are like, “This is the one place I don’t want politics to enter into my work.”

But I tell people, bodies are political. It’s not like a red state, blue state or Tory Party or something else. We’re talking who gets a voice. Which bodies are given more power and more of a voice. That’s what I mean by political. How do we raise up the voices that are marginalized? That’s where I’ve seen clients come up, like “Eh, that doesn’t land for me. I don’t want to talk about politics. I don’t want that to be a thing that we focus on.”

Chris Sandel: Then the ones where it really does land, do you think that’s helping them in a way that you weren’t able to do before?

Aaron Flores: Yeah.

Chris Sandel: Is it about the language that they then have to use, or just extra lenses that they’re able to see the complexity through?

Aaron Flores: I think the first thing is noticing “Holy shit, this stuff shows up everywhere. I didn’t realize it, but it’s everywhere.” So I think that’s one piece. The other piece is, yes, for sure language. It’s like, “Oh, this is what that’s called. When I come in for my flu shot and my doctor gives me a 15-minute lecture on weight loss after I get my flu shot, that’s weight stigma. Oh, I can put a language to that.”

But I think the other thing that is really powerful is this Body Trust work I feel like helps give people a voice and helps give them the tools to stand up and say, “You know what? I don’t need a lecture for 15 minutes about weight loss right now. I need my flu shot and then I’m going to leave.” It’s like setting a boundary with friends and family. “Can we not talk about bodies today? Can we not talk about your diet? I really want to hear how things are going in your life and in your work life, but I don’t care about what foods you’re eating.”

It’s maybe adding a voice to stand up and say, “I deserve a safe boundary on these topics. And if you can’t accept that, then I’m going to have to really set firmer boundaries about who I let into my life now.”

00:54:20

How his understanding of weight stigma changed

Chris Sandel: You also said about the weight stigma piece, where you were like “I knew about it, but I think I learnt more by doing this.” Was it learning more in terms of the damage that stigma can do, or the fact that it’s just so ubiquitous in all parts of life? What was it that you got out of that piece?

Aaron Flores: I know you have a podcast on the ACEs Study, and I think that was a big thing, tying in how, wow, someone who’s been in a larger body has been traumatized maybe their entire lives around this. What is the health impact of that recurrent re-traumatization of the individual? And what is the health impact of weight stigma? Why are we not talking about this? That was a huge piece.

I think the other part was also very similar to what my clients experience. Hilary and Dana, what I am most thankful to them is they model the work of trying to be inclusive and how hard that is. Inclusion work, there’s no right way to do it. You’re going to mess up. You’re going to make mistakes, and you’re going to mess up. That’s not the important thing. The important thing is how can you do repair work? How can you listen? How can you do the education for yourself to help understand other lived experiences?

So when I went to this training, you spend a week with your cohort. It was really amazing just to see, oh, this is what an inclusive space can look like, and this is what it can feel like as an individual to be in an inclusive space. It was really seeing firsthand, oh, this is how people are doing this work, what it really looks like when you actually try to apply that in a real-world setting.

Chris Sandel: I think the point you said there about they’re trying to do this work, it’s messy, they’re going to make mistakes, and that’s okay – I think that’s great. I also feel like we’re at a time where you say the wrong thing and you get jumped on, and it’s almost like intentions don’t matter. So I think it is important to be able to create a space where people can try things out and they might make mistakes, and that’s okay, and they can then learn from it.

Aaron Flores: Yeah. It is a very interesting time with regards to that, for sure.

Chris Sandel: Yeah. I think it’s Dana who has huge amounts of experience with motivational interviewing. Was that a big part of it as well?

Aaron Flores: Yes, there’s definitely a really great couple parts of our training that focus on motivational interviewing and how to do it. We talk a lot about empathy. What does empathy look like? Why do we struggle with it so much? So yes, there’s a component to that as well.

Chris Sandel: Was motivational interviewing something you had done training on before or was that part of your practice?

Aaron Flores: Believe it or not, at the VA they gave us a lot of MI work there that I was really thankful for. So I felt like that was something that was already planted. It’s something that I continue to work at a lot, and it’s, again, really hard to do in a session. I sometimes find myself in my head saying, “That’s not what I really need to say right now. I think I need to stop and listen more than talk right now.” So it’s definitely something that I knew about, but it continued to develop with this Body Trust work for sure.

Chris Sandel: I need to go back and check, but I have a feeling that motivational interviewing started fairly early in working with the veterans as part of how it was developed. Or maybe I’m mixing that up with something else.

Aaron Flores: Maybe. They might’ve told us that, and because of the trauma of working at the VA, I probably forgot it. [laughs]

00:59:10

Aaron's work with the Center For Discovery

Chris Sandel: I know you work for Center for Discovery, so talk a little bit about that – what it is, what’s the work that you do there.

Aaron Flores: Yeah. I started with them in January of 2017, and I was really thankful. They approached me and we had some conversations about coming on board and helping develop a tract in their outpatient facilities for binge eating disorder. That was something that was really interesting to me. So that’s when I joined, and I was one of the voices to add curriculum to that and help launch that off the ground.

Since then, I’ve continued to just be a voice within that tract, but also a dietitian in their outpatient location, and hopefully transitioning into maybe a new different job to be sort of a HAES advisor to them as we continue to grow and do this work.

But what I really appreciate from Center for Discovery is they’re really trying to also do this inclusion work, which is challenging for a big company to do this work. There’s a lot of moving parts. There’s a lot of systems that need to be looked at and how we do it. But what I’m thankful for is there’s a lot of folks internally that are really committed to this and looking at how we do this work around eating disorders, and we do it better and also realize that we’re going to mess up, too, and how do we learn to do repair work.

Chris Sandel: You said that they reached out to you as part of the position. Was it because of your background in terms of Health at Every Size and that skillset that you have there?

Aaron Flores: Actually, it was – again, this is a small world. One of the women who is the outpatient director of the dietitians on the outpatient level, we were in Elyse Resch’s supervision group for Intuitive Eating together. We had just stayed connected, and we were talking, and she was like, “Hey, there might be this job open. Would you be interested?” I was like, “Yeah, that’d be awesome.” So it was really just a friendly conversation that led to eventually getting a job.

Chris Sandel: You said you’re trying to bring the Health at Every Size into there. How are they with that at the moment? Where were they when you first started?

Aaron Flores: Really, the reason I joined was because it wasn’t just me who was talking about these things. There were many other dietitians, psychologists. They had members of ASDAH, the Association for Size Diversity & Health, board members within the company. So there were a lot of folks across the company who were HAES advocates and really trying to bring this message in. They just needed to add another voice, really.

I was really excited to join because there were some people already talking about this and already wanting to do some of this. So it was by no means something that I brought to them. It was already there, and people were already doing this work.

What it looks like now is really trying to help Center for Discovery look at everything, how we’re doing from an eating disorder perspective around food and body image and trying to look at it from a HAES perspective and say, what do we need to change? In a perfect world, what would we do differently? How would we do it, and then how do we help people actually do it?

And realizing with a big company, it’s not about me at all. I’m just one person. It’s about the person who has the day-to-day interaction with the client. That could be anyone from the dietitian, the therapist, the facility manager, the counselor who’s helping them overnight if they’re in a residential setting. It’s the diet tech who might be serving them or plating a meal with them. It’s everyone. It’s the psychiatrist that’s talking to them about their meds. It’s the doctor or the nurse who’s checking vitals. The multitude of people that you need to have on board – that’s the challenge. But I think we’re really interested in how we do some trainings that really help people understand what this is about.

Chris Sandel: Is that pretty much then going to be integrated in terms of let’s then reeducate the people that are here through various trainings?

Aaron Flores: Ideally. I think what we’re also thinking about is if we’re going to commit to being a truly HAES company, how do we recruit people? How do we find other HAES people out there and really make that a part of the philosophy of recruiting people, so that when people are hired, they know that this is something we’re doing?

But it’s also just like – I don’t know, Chris, it’s even the small day-to-day things about like, huh, is there weight bias showing up in how we do these meal plans? Is there weight bias showing up in how we do some of these group activities? The rabbit hole goes deep. There’s a lot of work. But what’s nice is we’re getting a lot of freedom and a lot of autonomy to try and really do this in a real way. I think if we can prove that it can be done within such a large corporation, it’s going to have a huge ripple effect in the eating disorder community.

Chris Sandel: Definitely. Is there any pushback from people there? Because I know it can sometimes feel like everyone’s on board with this, and you get into the little bubble of the world that we live in, but obviously not everyone thinks in this way. Are there people at Center for Discovery that are like “I think this is a mistake, this isn’t what we should be doing”?

Aaron Flores: I wouldn’t say that. I would say there’s healthy skepticism.

Chris Sandel: Which is not a bad thing.

Aaron Flores: Not a bad thing. I think what we’re trying to make space for is how we have these conversations internally so that we don’t confuse the client, or we don’t traumatize the client. That’s one of the things – listen, I want healthy skepticism. That’s fine. I’m always down to have a conversation about why you might not be on board with this way of working with our clients. I’m also completely open to hearing why, as long as you can also hear me about why we need to do this and why it is so important. I’m open to dialogue with folks about this, for sure.

Chris Sandel: Definitely. I think that’s something that I want to see more of, people being able to have conversations around this, saying “But what about in this case?” or “This is where this thing breaks down” or “I think this is over-reaching a little bit,” where it doesn’t just become an ideology.

Aaron Flores: Mm-hm.

01:07:15

His work with men + body image

Chris Sandel: I want to definitely chat about working with men. As I said at the beginning, this isn’t something that I’ve got much experience with, and it’s not something I spend a lot of time chatting about on the podcast, but I do think it’s really important. Just as a starter, how much of your client base would be male versus female, if I’m just using that binary distinction?

Aaron Flores: Well, I will push back on the binary distinction and say –

Chris Sandel: Sorry. [laughs]

Aaron Flores: No, it’s okay. I would say of my current folks that I see, those that are male and identify as male are probably 30%, plus or minus. It’s not something I outwardly specialize in. I have a lot of folks who don’t want to work with me because I’m male, I have a lot of folks who want to work with me because I’m male, and some people who really don’t care.

Let me just say this. The conversation comes up around – because there aren’t many of us who are male dietitians and who come from a HAES perspective. There’s a handful of us. I get asked about male body image and doing work with males all the time, and my answer is this: it’s different, but it’s also not.

If you can be empathetic and hear someone’s lived experience that you might not have had your own, that you don’t identify with but you can empathize with and you can listen to and you can see the problems and the issues and be just a compassionate person towards, you can work with anyone. It’s the same skill. We’re really trying to create a safe space where someone can explore what these feelings are and where their own safety is in their body.

The thing that is maybe going to be nuanced is that for especially maybe some of the cisgender men that I work with that have a lot of privilege also in life, they’re just not used to talking about a topic that is might marginalize them. They don’t know what maybe some of that marginalization might feel like in some sense. So if they’re in a larger body, they’re like “I guess I don’t have privilege there, but I don’t know how to identify that as a marginalization” because they’ve had so much privilege in many other ways.

So I think it’s just making space for building language around body image, and “this feeling, we can tie it to this word,” and connecting some of those dots about how weight ideals, body ideals, what is considered masculine, what’s not, how those have come into our thinking the same way diet culture has. You didn’t ask for it. No one asked if this is how you wanted to live your life. It’s just like “this is what you do, here’s how you should be.” And then using that same framework to help people dismantle and externalize the blame that they might be feeling, or the shame they might be feeling, around their body.

Chris Sandel: I think you’re right in terms of I don’t have any fear about doing the work with a man, and I would feel very comfortable being in that space, because you’re right; the skillset is still the same of being able to have a conversation with someone and be compassionate and have empathy and be a good listener and all of that.

And at the same time, I’m just aware that I don’t know what I don’t know. There’s going to be things where there is certain nuance or where there are certain differences that I just haven’t been exposed to because I haven’t worked with that subset of the population that is male that is going through an eating disorder or going through body image struggles that might be more specific or just something I haven’t come across.

Aaron Flores: Yeah, I definitely appreciate that. I think the biggest nuance that I’m seeing is how to address or how to help folks really land with self-compassion, and seeing self-compassion as a necessary tool and as a healing tool, and not as a sign of weakness or giving up – or even they might associate it with femininity. Especially cisgender men, really being afraid of “doesn’t this make me – I don’t know, this is something my wife could do, but I can’t do.” It’s sort of challenging that.

I think that’s a really great nuanced place to spend time with clients, like how we think about self-compassion from that perspective, when you’ve been taught for years “just rub some dirt on it, get back in the game, suck it up, no pain, no gain, you push through what you need to push through and you don’t stop.”

Chris Sandel: Yeah. Does the self-compassion piece then also extend to self-care, where talking about that or focusing on that feels more feminine and it feels like something they can’t do?

Aaron Flores: Not really, to be honest. It’s more like I hear that – I would say the example that comes up probably most often is like, “I know I shouldn’t be doing X. I am doing it. I wish I wasn’t.” And then adding to the conversation, okay, but how can we bring in self-compassion to this? Instead of shame, instead of blame, how can we make space for self-compassion?

Maybe this behavior is the best you could do right now. It’s not perfect, but it’s the best you could’ve done right then. There’s wisdom in your body’s coping. If we can make space for that, how does that help you move forward instead of staying in the cycle of “I’m wrong, I’m broken, I’m just not working hard enough,” all that stuff? That piece of saying “I’m just doing the best I can right now” is really sometimes challenging for folks.

01:14:10

The unique body image struggles faced by many men

Chris Sandel: Are there areas where men’s struggle with body image is different to women?

Aaron Flores: Yeah. I would say for the cisgender men that I’m working with, one is there’s not a lot of people talking about it. They’re not hanging out with their friends and they’re not talking about their body and they’re not talking about how uncomfortable they are with their body. They’re not talking about other men who might be out in the community having these conversations as someone to aspire to. There’s no role model out there who is being brave in these conversations, so there’s not a lot of representation that they might see. There aren’t a lot of books on the topic.

So it’s really just lack of resources that show up. Like, “It’s great that I can talk about this with someone, but I’ve never had this conversation outside of this space.”

Chris Sandel: Yeah. When I think of women, or even maybe a slight caricature of women, it’s that they can all talk about how much they hate their bodies to one another, and there’s almost this camaraderie around not liking their body and a way of showing vulnerability around that. But at least with the guys that I know, that doesn’t translate to what guys typically would talk about.

Aaron Flores: Yeah.

Chris Sandel: You mentioned or made reference to body standards for men. What are some of the unrealistic standards men have? The first thing I think of when I’m thinking of that kind of topic would be porn or Men’s Health. But how does that also feed into it?

Aaron Flores: I think those are two big influences. I also would say sports, seeing athletes’ bodies, is a big influence. Marvel movies, superhero movies are going to be an influence also.

But I think it’s also this idea of, especially for some of the men I talk to, especially as they age, it’s like, “I used to be like I could do everything. I used to be able to go out, play football, come home, then play a game of basketball, then go run, do everything, and nothing was hard. And now just getting up and going for a walk hurts.” So there’s that thing, like “this was what my body used to be, and because I’ve never really developed sustainable behaviors, I don’t do any of that stuff anymore, and I’m grieving that I’m older and that my body’s changed.”

So I think it’s interesting, our own personal body experience of getting older and being like “Aw man, I’m not 18 anymore and I can’t do the things I used to do when I was 18.”

Chris Sandel: For those clients, that’s almost part of their identity of “I’m the guy who can go and play a whole range of sports and it’s not going to affect me”?

Aaron Flores: Yeah, exactly.

Chris Sandel: What about – you maybe referenced it when you said sports, but just gym culture more generally? Is that a big impact?

Aaron Flores: It’s interesting; not as many of the clients I’m currently seeing – I definitely think it’s an impact, yes. I think it definitely shows up. I feel like just my current folks that I’m working with, that’s not a huge topic that’s coming up. It’s actually a topic that’s coming up with a lot of the female-identified clients that I have. Gym culture is showing up in that.

But it’s interesting. I would love to get some experience with men who are gym rats, who are constantly in the gym and pushing their body in a way that might be unsustainable, but they’re like, “No, I’ve just got to work through it.” But currently, I don’t have those clients.

Chris Sandel: You mean in terms of like bigorexia or that kind of thing?

Aaron Flores: Exactly, yeah.

01:18:45

Then men's group that Aaron runs

Chris Sandel: I know you run a specifically men’s group. What are you talking about as part of this, or how do you facilitate them?

Aaron Flores: It’s a 6-week group, and I use Body Trust curriculum. We go through each week and we have different topics that focus around Body Trust principles. We touch on Intuitive Eating, we touch on ideas of Health at Every Size, but we also talk about other aspects that would help them develop those sustainable behaviors that are around self-compassion and around having more empathy and curiosity around their lived experience, rather than trying to create the cycle of fixing/problem-solving with their body.

Chris Sandel: With the men that you’re working with, how many of them would be or have received a diagnosis for eating disorders?

Aaron Flores: It’s a good question, and here’s the thing: formal diagnosis, I would say it’s probably a third, maybe a little bit higher. But I would also say that maybe more would have eating disorders; it’s just they haven’t been diagnosed, and that’s a whole other conversation about why men with eating disorders are not being screened properly, are not being diagnosed, are never being even considered for having an eating disorder, because of our biases in the community.

Chris Sandel: Talk more about that, because I was thinking about this. Is there a stigma because it’s almost seen like this isn’t a male thing? I know how ridiculous that is, but that’s the perception.

Aaron Flores: I think there’s still that, for sure. There are some questionnaires, but I don’t know if they’re validated or used very often. All the validated questionnaires are still skewed towards women, still skewed towards restrictive eating disorders. Men might not answer some of these questions because it’s not an issue for them, and then they’re like “Oh, you don’t have an eating disorder because you didn’t come up on the screen.”

But I think it’s also we don’t see – listen, when you talk about the gym culture and bigorexia and these folks who are super restrictive with their eating and then binging on certain days, and obsessed with the gym, etc., etc., I think if we were to take gender out of that, we would see a lot of eating disorder behaviors. Our red flag would go up much higher. Because of our biases, we’re really pulling the wool over our eyes. A lot of people are struggling with eating disorders, but we just think they’re being healthy.

Chris Sandel: Meaning potentially because of how the male body works physically, it doesn’t have this outward appearance of having an eating disorder the way that it potentially could for a woman?

Aaron Flores: Exactly. This person is not thin – or dangerously thin. So that’s not a red flag. They’re just doing something that seems culturally okay. “They don’t look sick, so they must not be.”

Chris Sandel: I think as well, with the language – I can’t remember the article – I think it was talking about Dorsey, the guy from Twitter. Jack Dorsey, I think. I might be getting his name wrong, but yeah, the head of Twitter, who has what I would say is a fairly complicated relationship with food. But within the tech, male spaces, you change the language and then it becomes like a superpower in terms of “I’m doing biohacking” or “I’m doing this thing for longevity.” You add some science-y sounding language to it and you dress it up, and actually it’s just the same destructive behaviors that women have been doing for a very long time.

Aaron Flores: Exactly. I think the folks who developed Soylent are under the same thing. They developed this thing so that if I’m coding, I don’t want to get up and go eat, so I’m going to get this probably horrible – I’ve never had it – but probably horrible to average tasting drink that has everything I need, and I’m just going to drink it so I can stay coding.

It’s the frigging Matrix, where they spit out this gruel and they’re like “It’s got all the amino acids your body needs. Some people even think it tastes like chicken.” It’s like, oh my God, is this where we’re evolving to? Let’s have food that tastes really frigging good and eat the damn frigging good food.

01:24:10

Resources Aaron has found helpful

Chris Sandel: You said before that there’s not a lot of good resources in this space in terms of books for men or resources for men. But have you found any that have been useful, either for you personally or for the guys in the group?

Aaron Flores: I’m going to be honest, this is probably one of the hardest books someone’s going to read, but it’s probably the best too. It’s a book called Manhood. It is a series of pictures and essays. The pictures are of men’s penises – it’s 100 men and people who identify as men, all different body types, all different ages – and then an essay about their penis or about masculinity.

It is awesome. I’m telling you, there’s some men that are going to look at it and be like, “I’m not reading a penis book.” And that was me too. But when I read it, and reading these stories, it really helps synthesize why masculinity and this idea of what is masculine, how problematic that can be for us as we develop. It talks a lot about porn culture. It talks a lot about feeling inadequate and not feeling “man enough.” I think it’s a really interesting group of essays to put together to give a lived experience of what it’s like to be male and identify as male in this world.

Chris Sandel: Is it a book that you would also recommend for females? Because I read a lot of books that are aimed at a female audience where I’m like, “Okay, this is great. I’m so happy I read this. This helps me in life a lot.” Would you say it also does for both?

Aaron Flores: Yeah. The woman who did it – actually, she’s from the UK, and all of the men who participated are from the UK. She did a book first with women and pictures of their breasts. So if the one about the males is maybe off-putting to women, there’s one for women that she did. I think it’s called Womanhood. I’d have to look it up.

Chris Sandel: Cool. That sounds really interesting. I just finished reading Sara Pascoe’s book. I think it’s called Sex, Money, Power. She’s a standup comedian over here. She’s done a book called Animal, and then she did this other book called Sex, Money, Power, and it looks at porn, the sex industry, it looks at the biology around sex and our desire to have sex from the male perspective and the female perspective. It’s really interesting.

One of the things she talked about is just the difference in porn in terms of the general population – I think the average male penis is 6 inches; in porn, it’s 12 inches – and how for so many men, this is a real struggle. When she started to look into it and explore it, it’s not even about “I think I’m going to be better in bed or my partner’s going to like it more,” because a lot of the time people are told that’s going to make absolutely no difference. But it’s almost like the judgment of other men that gets into people’s head, more than anything else, which I found was really fascinating in terms of that perspective.

Aaron Flores: Totally. Just going back, the author of that book – her name is Laura Dodsworth, and it’s called Manhood: The Bare Reality. Then she did one called Bare Reality and it was about 100 women, and then she did another one called Womanhood: The Bare Reality. So Laura Dodsworth is who you want to check out.

Chris Sandel: Okay, cool. I will order all three.

01:28:15

The work Aaron does to support other practitioners

I also know you’ve been doing work with Rachel Millner to support other practitioners, so talk a little bit about this.

Aaron Flores: Yeah. Rachel Millner is another Body Trust provider, and we’ve become great friends through this work.

Chris Sandel: Did she do it at the same time as you?

Aaron Flores: No. She was cohort 1; I’m cohort 2. Cohort 1 lords it over all of us that they were the OG folks. No, so we met through this work, and we talk a lot on a regular basis.

One of the things that came up is so many folks come to this work because of their own eating disorder history. None of us are perfect. So many people will relapse. Where are the folks who are relapsing going for support? The reality is, nowhere. They don’t want to go to treatment with other folks who they might know, might’ve treated, or whatever. So there’s a lot of stigma around that. There’s not a lot of acceptance in our community for people when they are struggling, but they are going to struggle.

So we were like, let’s create this group. We’re just going to offer a support group to anyone who’s an eating disorder clinician. It doesn’t matter where they are in their process. They’re allowed to come, show up to our group, and we’re going to support them, and the group’s going to support them.

And it’s been great. We started it in July, and we’re in our second round of doing it. It’s truly amazing how much of a healing space these folks need, and we’re thankful to offer it.

Chris Sandel: Yeah. I’ve definitely talked on the podcast before about worries with people who’ve recently had eating disorders and have recovered who then dive straight into becoming dietitians and nutritionists and the problems that that can then create when people aren’t fully recovered.

But as you say, just because someone is “fully recovered,” doesn’t mean there isn’t going to be something at some point later in their life that can knock them off that perch. Things start to come up again. You’re right; where does someone have to go? Especially if you’re doing work with other folks around this stuff, to then have to raise your hand and say “Hey, I’m struggling with this myself,” if you’ve been someone who has promoted full recovery, that can really feel like a slap in the face. You don’t want to be doing that.

Aaron Flores: Yeah. One of the discussions I hope that we have as a community is, what word are we going to use to talk about as we get better? Some people like “fully recovered,” some people like “in recovery.” I’ll be honest; I don’t like either. [laughs] Just because neither land with me.

I want to make more space for, again, the human experience. If you’ve struggled with this, you’re going to be triggered. Things are going to pop up and something’s going to happen in your life where it might be front and center again. I think that’s just how life is. To put a label on it where you’re like “oh, no, I’m past this,” I think it creates more shame when we do struggle.

Chris Sandel: Yeah. It’s a really tough one, because I can see the benefits of both and I can see the problems with both. Saying that someone has to be in recovery for now and the rest of their life and comparing it to, I don’t know, alcohol or drug addiction or something like that, can feel not great when people are like “But I feel like I can get to a place where this is no longer a thing.” There’s a lot of people with lived experience where that’s how it completely feels for them. For them to have to constantly say “no, I’m in recovery” somewhat invalidates that.

But I also see, as you’re talking about, that that then creates a problem because if I’m meant to be fully recovered and now I’m not, what does that say about me, or what does that say about my recovery journey, or what does that say about where I’m at?

Aaron Flores: Right. Just like gender. We have all these words for the spectrum. Maybe we need a whole spectrum of words.

Chris Sandel: Yeah. It’s not up to you to pick one, but do you have one that you’ve been using as a stopgap?

Aaron Flores: No, I really haven’t. That’s a great question. I want to come up with something. I want something to – I would love to say, “Hey, here’s my idea of a word.” The phrase I’m using a lot with my clients, and I put some stuff on Instagram and whatever, is I want people to recover into bravery, not safety. Don’t eat the safe foods. Eat the brave foods.

The other thing I tell people is I want you to eat with full technicolor brilliance. I don’t want you to eat drab, gray, boring food, and it doesn’t have to be black or white either. I want you to eat the full spectrum of colors when it comes to food, as an experience. Not as like eat the rainbow, but as an experience. And all of those colors can represent a different influence, why we choose foods. So just eat with that technicolor brilliance.

Chris Sandel: Nice. With the group that you’re doing with Rachel, what is the focus of it? Are you then trying to offer support so that people can find other support? Or it’s talking about what it’s like to be a practitioner that’s going through this? What’s the focus?

Aaron Flores: It’s really a support group in nature. Whatever the participants check in with, we’re here to support them through. If it’s something that’s come up professionally, we can talk about it. If it’s something personally that they’re struggling with, we make space for all of it. We don’t really have a set agenda each week. Whatever a participant is going to want to discuss, we make space for.

Chris Sandel: Nice. This has been a really wonderful conversation. I’m just wondering, is there anything else we haven’t chatted about or I haven’t asked you about that you wanted to cover?

Aaron Flores: No, I think we covered all of some really important stuff. I’m really thankful that I get to share all this information with your listeners. I’m really happy with what we talked about.

Chris Sandel: Perfect. Where can people be finding you if they want to find out more information? I mentioned at the top Dietitians Unplugged, which I recommendation people checking out, but where else can they be going to get more information on you?

Aaron Flores: I’m on Instagram. My handle is @aaronfloresrdn. Registered Dietitian Nutritionist is what RDN stands for. And then my website is www.smashtheweightriarchy.com. That’s where you can learn about my practice. I work with clients virtually, so if people are not in LA and want to work with me, they can always check out and get some information from my website.

Chris Sandel: Awesome. Thank you for coming on the show and, as I said, for chatting about things that we often, or I often, don’t get to cover. It was really good.

Aaron Flores: Thank you, Chris. It’s been great talking to you.

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One response to “174: Interview With Aaron Flores”

  1. […] this, dietitian, Aaron Flores, has said, “When we restrict to X calories a day, we are likely not getting enough food. When we struggle […]

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