Ellie Pike:
If you regularly interact with any sort of media, you've probably heard countless headlines about exercise. Things like a new study comes out and it claims you must do X, Y, Z in order to live a long life, or a new fad has totally transformed the life of so and-so, and it's guaranteed to work for you. While corny, it's hard not to get sucked in. After all, moving our bodies is an important part of life, and for many of us, exercise is a coping strategy we reach for to deal with stress or other health conditions. But what happens when these messages become too simple for the complex reality of our bodies and minds? In today's episode, I sit down with an incredible registered dietician and eating disorder specialist to unpack the cultural narratives we've built around exercise and why they don't work for everyone.
Meet Adee Levinstein.
Adee Levinstein:
Hi, I'm Adee Levinstein. I'm a registered dietician and certified eating disorder specialist consultant. I've been working in higher levels of care for eating disorders for the past better part of a decade. I started my career as a sports dietician on a college campus and love working with patients on relationship with food, with body, with exercise. Also, I'm a big plant mom, and I love to do jigsaw puzzles in my spare time.
Ellie Pike:
Adee and I will explore what actually makes movement health promoting, how diet culture shapes our relationship with exercise, and why context, flexibility, and even rest might matter more than hitting a step count. You're listening to Mental Note Podcast. I'm Ellie Pike.
Well, I am so thrilled that you're here today. I appreciate that you are a sports dietician in the collegiate realm for a little while. And I thought that that might really help inform some of our conversation today. And honestly, a lot of this just comes from the banter I hear in the community, the headlines, my own questions. So let's just start off with some of the inspiration for today's episode. I saw a news headline that it was talking about movement helps our mood and it might be as effective or more effective than antidepressants. And I was like, "Ooh, this one's interesting." Another topic I think that has come up is to really support your focus, if you have ADHD, it's really important to get exercise or to do intentional movement, especially maybe at the start of the day.
And so let's just start there. When you see headlines like these, what do they get right and what do you notice that they oversimplify?
Adee Levinstein:
Definitely. Well, I mean, and it always sounds cliche, but this whole one size fits all piece is really where I think we're missing the mark. Across the board, absolutely, there are benefits to movement. Different people relate to movement in different ways. We all come in different walks of life from different lenses, different cultures, different body shapes and sizes, different heights. Some people grew up playing team sports, some people never did that a day in their life. And I think this idea that everyone needs to do something is just, there's very few things in the world that all of us absolutely need to do. We all definitely need to breathe oxygen. We all definitely need to eat food. We all definitely need to sleep.
But this idea that everyone needs to exercise this many mountains for minutes a week or a day, and it needs to look the same way and it's going to feel the same way and have the same effects for everyone. There's just a very kind of overgeneralized broad sweeping declaration that isn't necessarily applicable when we kind of start breaking it down into details.
Ellie Pike:
I know in our world, we can use the phrase individualized like health promoting behaviors. And sometimes a phrase like that, I'm like, "Okay, that sounds nice, but what does it actually mean?" How does that apply here?
Adee Levinstein:
So when we're looking at health promoting behaviors, it's something that, first of all, it's a behavior. It's something we can control, something we can engage in. So it might look like intentionally resting. It might look like intentionally moving our body. It might look like intentional nourishment. It's a lot of intentionality behind a behavior. And it's something that for that person would support their overall health. And so when we're looking at the bigger picture to say exercise, absolutely, movement can be a health promoting behavior, assuming you're not absolutely exhausted. And what would actually be the most supportive behavior in that moment is sleep. Or you're not waking up for the first time in the morning, have had no nutrition for many hours of sleep, and now we're running right into a physical activity that our body doesn't actually have nourishment for. So I think it's looking at the person as a whole individual and where they are in that circumstance to understand what would actually be health promoting for them in that specific situation.
Ellie Pike:
It makes sense. An Olympian would have different health promoting behaviors than someone who has an injury or low energy due to sickness, for example. So really slowing it down to individualize, what I need today as an individual might look really different than what you need.
Adee Levinstein:
Exactly. And what I need as an individual today might look very different at this hour of the day than it might look in four hours from now or in a week from now. And so being able to really see where I am in my life, but not just generally what phase, but also what has my day looked like? Am I waking up after a great night's sleep? And I also have had really great friendship conversations and feeling really connected and this is the thing that's going to really support me and my physical and mental health. Or is it a different type of time where maybe things are really stressful and it's been harder to connect with folks and harder to get sleep. And there's just different things in different phases of life, but also different moments in life that are supportive.
Ellie Pike:
Well, I really want to slow down and call out what you just said that exercise could be beneficial or not beneficial to us in our physical and mental health. So it's not just one. It's important to look at the whole picture. And this is what we think of as a health promoting behavior. It's not just about our physicality, but our mental health as well.
Adee Levinstein:
The way that I talk to folks about it, definitely my clients and patients in my office, is that our world really likes to put these things in different silos. At my mental health on the right side, my physical health on the left side, and they kind of don't interact. But when we actually look at how we are as humans, we are one big Venn diagram, if you will, of the different aspects of our health, but they all overlap and affect each other. So even if someone really only cares about their physical health and their mental health is suffering from it, that mental health deterioration is actually going to impact their ability to digest food and their ability to sleep and their cortisol levels, inflammation in the body, which affects physical health.
And so we have to look at the whole picture. We can't just be so siloed in that thinking in order to, again, decide what is most supportive for us.
Ellie Pike:
I have some people that pop into mind when you say that, because there have been times where I've worked with folks in all levels of abilities, like even the ability to walk with comfort or without comfort. And some of them have even talked about the mental health stress that the word exercise has on them. So we've even had to rephrase some of those words of like, "What word feels good to you? Is it just movement? Is it joyful movement?" Because even using that word in itself re-frames the whole situation. Instead of something that they perceive as exercise as punishment, because maybe as a child, they were told, "You need to exercise to lose weight. You need to exercise to be good enough," was the message. For them, they had to start to rephrase it for themselves so that it didn't have this negative mental health impact.
And when they were feeling distressed about it, I mean, that lowered their motivation in the end. And so looking at that big picture, I can see that in some of those examples.
Adee Levinstein:
Such a good point. I think I use the word exercise as kind of an eating disorder dietician, reclaiming that word, that diet culture doesn't get to co-opt those phrases. But it's so important to ask each individual what does feel supportive? Is it activity? Is it movement? I think movement has such a lovely connotation to it. Words have so much power, and especially in this world that we live in that has such black and white ideas about what things need to look like, to be able to really break it down, slow it down, and see what is supportive for that individual.
Ellie Pike:
I want to slow down and ask this question, even though it might seem like a duh question, but no question is dumb. So here I am. Is exercise actually okay for everyone?
Adee Levinstein:
Ooh, what a good question. As always, it depends. Which my patients love when I say that. I don't think across the board, every single person can exercise or should be exercising, and I don't love the word should. And again, looking at bigger picture, if someone has a severe injury, we absolutely need their body healing. If someone is living in a state of low energy availability, whether it's related to disordered eating or an eating disorder, whether it's related to access to food, whether it's related to so many other factors, we need to be looking at the energy their body has available in order to engage in certain types of activity.
And then I think the last piece of that is what is exercise. Are we talking about movement that is incidental that happens throughout the day? Are we talking about intentional movement? Are we talking about running a marathon? Are we talking about doing some gardening or cleaning around the house? And so I think that again, there's all this what ifs, but across the board, we can't say that this behavior, without defining it more, without understanding that individual context is safe or even recommendable for every single human being.
Ellie Pike:
To be clear, if something says evidence-based. So if this research is evidence-based, it does not mean that it's universally acceptable or even appropriate for everyone.
Adee Levinstein:
From my interpretation of that term evidence-based means there's been some research that shows. And we know that research, while it has a lot of importance in our world and importance for us as clinicians as scientifically sound or giving scientifically sound recommendations, that we also need to look at the context in which that research was done. Human beings that are imperfect humans are doing this research. We all come to the world with our own lens and our own implicit biases that exist. And if the design of that study wasn't very intentional about accounting for some of those biases, there can be some question marks that remain. And then again, the people that are in the study, is it a representative sample of the population? So without getting too into the nitty gritty, evidence-based means there's some evidence behind it, but just because there's 99% chance of something happening, if you're the 1% that it doesn't happen to, it didn't happen to. So that evidence isn't applicable to 100% of people.
Ellie Pike:
But it's funny how it becomes absolutes at times. If you're not walking 10,000 steps a day, you're failing. Messages like that where it's like, wait, who even came up with 10,000 steps a day? And some people walk big steps. Some people walk small steps. It seems like this very arbitrary thing.
Adee Levinstein:
So when it comes to the 10,000 steps, the evidence behind it is an evidence. It was an advertisement starting in Japan years ago that the Japanese character actually looks like a person engaging in activity, and that's where the character for 10,000. And so that's where that number even came from.
Ellie Pike:
What? That's just bizarre. So there's no evidence based that you actually need 10,000 steps for any specific reason?
Adee Levinstein:
No, I think our human brains just really like round numbers. They really like black and white things that we can hold onto. And that is what is now we're still talking about to this day.
Ellie Pike:
That is so fascinating. Yeah, because that's not a distance. It's not a speed. It's just a random, like you're moving your body, which in some ways could actually serve someone well. If you're only thinking about, "Well, I'm just moving my body as the goal," versus the specific amount of time or how fast you have to be or anything like that. So I think the message here is some of those trending headlines like exercises as effective or more effective than antidepressants. Maybe for some people that is the case. And it's always important to slow down, think about what evidence-based looks like, what did the study actually look like if you want to look into it?
But even if you don't look into it, something that I do is just kind of hold it with open hands being like, "Well, maybe, but also maybe not. Let me think about how this applies to me. Do I have an injury? Am I sick today? Do I have the caloric energy in my body to actually do exercise? Is that healthy for me?"
And so for those of us who are able to engage in exercise and where it's physically okay for us to do so, would you mind running through some of the things that we should be aware of?
Adee Levinstein:
I think first and foremost, it's asking the question of the why behind, what's the intention behind this movement. Am I looking to meet a certain goal as far as I really want to be able to hike this really challenging hike, or I'd like to engage in this maybe race with a friend? Am I doing this in a way that feels supportive for my life? It's not coming at a cost of, I'm not getting any sleep, or I'm doing this instead of making social connections, or it's coming at a cost to my mental health.
One of the things that I really think about a lot with any of these health promoting behaviors is what kind of effect does it have on the person's nervous system? If this is a dysregulating activity, if it causes a lot of stress to think about, it causes a lot of stress to engage in it, and above all our kind of at baseline, it's really creating more distress in our lives, then I would venture to argue it's not a super health promoting behavior, supportive behavior.
Now on the flip side of that, if it's something that really gets you excited and it gets you connected and it really supports being able to focus better throughout the day and really helps regulate that nervous system, then it probably is a supportive activity to engage in.
Ellie Pike:
So I'm trying to put this into perspective with my life. If I'm going to engage in an activity, but I have to rush somewhere to get there, to get to this class on time, for example, and then it lasts a whole hour when I don't really have a whole hour, but I want to engage in this class and then I have to rush home. Sometimes I notice at the end of it all, I'm like, well, I got some physical movement in, but I feel mentally stressed and then my body physically feels more stressed. My cortisol levels really have increased versus a time where I might notice that my mental health feels a lot more okay is when I'm more realistic with my time and not rushing in that process, also not punishing myself to get something done.
So instead, it might look like going on a walk with a friend and connecting and my body is moving, I'm getting sunshine, I'm not rushed for time, I don't have to stay for a whole hour. And that to me makes a difference where I can create this flexibility and what that looks like for me day to day. And I've seen it for other people where punishment could be part of this too. Exercise becomes really stressful because it becomes a punishment. It becomes about numbers. It becomes about black and white thinking. So maybe you have some examples of that that you could call out just for us to be aware of so we can look for those.
Adee Levinstein:
If it's one of those things that you have this routine and you really enjoy it and you'd be able to be flexible, right? I like to ask people, "What would happen if you can't engage in this movement?" Or something came up, someone asked you to go get ice cream or someone asked you to come over to help them with something around their house. And if this is the kind of utmost thing that I must always do and it feels really rigid, I would ask some questions. I'd be curious around that and why that feels like it needs to happen and that it can't change. Whereas if it's something that really adds to your life, and like you were saying so beautifully, it doesn't have to be a certain number of minutes or this like, I have to feel depleted at the end for it to, quote-unquote, count.
It is something I move my body, maybe I got some mobility and my body feels less snap crackle poppy when I move my joints, that's lovely. Being able to do some stretches, being able to do things that feel really aligned. I love the including connection, social connection and movement. Can we go out on a walk together or even meet someone for a class if that feels accessible. But the mental health piece or the mental kind of overshadowing of, "I must do this and if I don't do this, then all these X, Y, Z terrible things about me are true," really the self berating, punishing kind of mentality. A lot of times overshadows and even kind of cancels out the benefits that we do see from that really supportive, hopefully positive relationship with movement.
Ellie Pike:
Or to add to that, maybe someone has a, quote unquote, great workout, therefore I notice sometimes folks saying, "Well, now I get to eat X, Y, and Z, that's different." So using a workout as permission to eat or not is not healthy. If we're using that to bargain with how we live or if I'm allowed to engage with things that should be normal, that is also another sign of, let's slow it down, maybe exercise is not doing the right thing for me today.
Adee Levinstein:
Definitely. We eat to live and if we want to move our body, then we absolutely need to nourish that intentionally, fuel that movement. But at baseline as human beings, we all deserve to eat and there is nothing that we need to do to earn that food or to be good enough to eat that food. And so it's not a moving so we can eat, but it's actually eating to live. And if part of our living choices are moving our body, then we want to make sure we're eating enough to support those decisions as well.
Ellie Pike:
So what are some questions that you like to give people so that they can self-reflect as they think about engaging in exercise or movement?
Adee Levinstein:
Yeah. So one that I'd already mentioned was something to reflect on of if I couldn't engage in this movement, what would happen? Would I be, cool, moving on with the rest of my day, I'm going to prioritize something else today, tomorrow I might have another opportunity for movement, or do I now have to start changing the way that I eat, or I have to make up for it tomorrow, or I can't be flexible with my schedule and have to do this movement? So that what would happen if I can't, would be one.
And then I also like to ask people, if you knew for a fact you were going to engage in this movement and it would not change the way that your body looks, would you still do it? If the only reason we're engaging in activity is for this diet culture message around, it'll change the way that your body, it'll tone, it'll make you lose weight, gain muscle, fill in the blank here, we might want to consider if that's the movement that we want to be engaging in. Are there other benefits to the movement like head space that's available like connecting with others, like feeling empowered, feeling strong, connecting with our body in a way that's different day to day, then that would be another thing to maybe think about.
Ellie Pike:
I really appreciate that dietetic perspective because I think sometimes we all need permission to think differently than diet culture tells us to think. Because if you pay attention, diet culture is only talking about shaping your body, about losing weight, honestly about punishment and like you're better or you're good enough when you get to this X, Y, Z point. And instead, what if we just had this much more lighthearted, flexible way of thinking? It could actually feel a lot more fun to do movement and to think about, "Well, it actually helps my body feel good. I feel more flexible. I feel more energetic. I feel like I get this high of having energy and a mood boost." Those are all positive things.
Adee Levinstein:
Absolutely. The term joyful movement or intuitive movement can, some people can take that to an extreme might create a whole new set of rules around that because for example, and I'm sure my physical therapist would love that I'm saying this, but here we go, right? We all know that doing something like physical activity is not the most exciting and maybe joyful thing and it's still intentional and functional in the sense I'm doing this so that my body can have more longevity in it, that I can be more mobile if that's one of your goals or I can be stronger or I can recover from this injury more quickly or more safely intentionally.
And so this intuitive movement or joyful movement is also that what are the benefits that it's giving me because it's important to me as a value and not because I saw on social media somewhere that this is the exercise I must do to fill in these gaps for diet culture reasons.
Ellie Pike:
Well, I think really what we're pushing here is take a minute, have autonomy. Think about what works for you and noticing your own physical and mental health is really important instead of taking advertisements or social context for face value.
Adee Levinstein:
Exactly. Beautifully said.
Ellie Pike:
As I was processing what this interview was going to be with my husband, he had a great question that maybe we don't always bring up and his question was really thoughtful. It was about for that person who maybe finds the idea of exercise really overwhelming or daunting, or maybe they have reasons that are legit for why it's hard for them. Maybe it's a mobility challenge or something along those lines, or maybe there's depression, we all know depression just tells us to not really keep moving, like slow it down even more. What are some ways that someone could think through that process just to get started, just to get moving to a certain degree that might actually be beneficial to them physically and mentally?
Adee Levinstein:
A lot of these principles still apply of looking at what is doable, what is accessible. It might not be go get a gym membership now and then I feel really overwhelmed because there's 7,000 machines and also people are looking and I don't want them to see that I don't know what I'm doing. I think if you have a friend that you can go on a short walk with even on the block and come back if that's accessible or there's so many, honestly, one of the greatest things about technology is a lot of access to some YouTube videos. It can be a five-minute chair yoga stretch, figuring out how do I even feel in my body. Sitting and taking some intentional deep breaths, that is even a step towards connecting, being present in your body and seeing maybe where are some spots that are tight or that I could stretch or try to do something different.
And so I think there's kind of depending on your goals as a person, being able to really boil it down to what's one step I can take. Can it be I'm going to get off my couch and walk across my apartment and come back and sit down and see how that feels. It doesn't have to be, I'm now going to start and it's going to be six times a week and it's going to be this many minutes and this level of intensity. Can literally, what's one thing I can do tomorrow and be curious around how it feels and then where do we want to progress from there?
Ellie Pike:
I really appreciate that you brought up the mindfulness piece and mindfulness in my mind, it's just being aware. And so for someone that doesn't even want to step outside or go on a walk, I'm going to use my children as an example because once they're out there, sometimes they love it. But the idea of activating something new or changing or transitioning feels hard.
Sometimes what I do is think about what is it that they value more than actually going on a walk or moving their body. They might value looking at birds or seeing if they can find the first buds of spring or just paying attention to something else. Maybe it's the noises, like can we go out at night and see if we can hear an owl noise? And before you know, you're out maybe walking, maybe 20 steps, maybe more. It doesn't really matter, but just the idea of being outside and moving or inside and moving. But the value that we place on it might actually be on something else and that's okay. And I think it can get really creative and really fun and in that way, really support our mental health too.
Adee Levinstein:
Absolutely. And I think this is where therapy really comes into the nutrition world too, that nutrition therapy piece of what are your values, what's important to you? And that can really help that direction of what type of activity might be values aligned for me. If I really value connection, then sitting alone in my apartment and trying to engage in physical activity might not be the most values aligned type of activity. It might be, can I find a meetup if I'm a social butterfly. Or if I'm more of an introvert, but connection still really feels important. Is there someone I trust that I could ask, "Hey, can we do this activity? I've never tried it before. Can we try it together?" Or reaching out to a professional if that feels more supportive and a more hopefully judgment free zone of, "I have no idea where to start. Can you help me with do this? Can we do this one-on-one?"
And so there's so many different ways, if a value is nature, a value is being able to really make our decisions based on what is important to us.
Ellie Pike:
And I think about where it could be a double-sided sword, like the value of achievement, for example, can be kind of tricky when it comes to exercise because that can lean into black and white thinking or pushing our body maybe further than what it's meant to do. And so even that, we could shift. If my value was achievement, maybe I'm achieving listening to the end of a podcast while I'm walking or doing some kind of exercise. Maybe the achievement has nothing to do with the actual amount of exercise or weight or calories or et cetera. It could be about something that I really could just enjoy and think about it in a different way.
Adee Levinstein:
Yeah.
Ellie Pike:
So what would you say is the main takeaway that you really do hope that folks heard?
Adee Levinstein:
I would say really tuning in to what feels supportive for you at being curious around what's happening. We talked about some mindfulness, we talked about some values, but really knowing that evidence-based, the things that are out there and kind of circulating doesn't necessarily mean best for me or most supportive for me as a human. So I think tuning into what your nervous system feels like, how regulated, dysregulated things kind of make you feel, can then be a really great compass for where to move forward from there. Another thing that we could look at with achievement as a value is are we looking at achievement in a variety of aspects of our life?
And one thing humans are not really great at in general is rest, but rest is also something that needs to be intentional and happening. I used to have written on my whiteboard that diet is a noun and rest is a verb. Diet is the things that we eat, not the way that we change the things that we eat. And rest is something we need to do intentionally. Typically in our busy hustle, bustle life doesn't just kind of come naturally. And so can we achieve a space where we're more intentional or more aware of what our body's telling us? Can we achieve spaces where we actually are intentionally resting in addition to being intentional about moving our bodies?
Ellie Pike:
Thank you so much. This has been a lovely conversation.
Adee Levinstein:
Thanks so much for having me. I love chatting about this stuff and love chatting with you.
Ellie Pike:
If this conversation sparked some curiosity about your own relationship with movement, let's go back to Adee's suggestions for self-reflection. Why this activity? Why today? If you didn't do this exercise, what are the consequences? Would you still move this way if it didn't change the shape of your body? Health promoting behaviors aren't one size fits all, and sometimes the most supportive thing we can do is move with intention, question the narratives we've inherited, and remember that rest is part of the practice too.
Thank you for listening to Mental Note Podcast. Our show is brought to you by Eating Recovery Center and Pathlight Mood & Anxiety Center. If you'd like to talk to a trained therapist to see if in person, virtual treatment, or a relapse prevention program is right for you, please call them at 850-7199. If you need a free support group, check out eatingrecovery.com/support-groups or pathlightbh.com/support-groups.
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Mental Note is produced and hosted by me, Ellie Pike, edited by Carrie Daniels and directed by Sam Pike. Until next time.
