An interview with Dr. Antonie Post, anti-diet nutritional therapist, author and podcaster.
Dear Antonie, you are an anti-diet nutritionist, a doctor of nutrition, a book author, podcaster and mother of two children. And I am very happy that today we are talking about diet culture in the context of pregnancy and the postpartum period. Let's start from the very beginning: What is diet culture?
Diet culture means much more than just being on a diet. It is more a set of beliefs that make value dependent on appearance and that make being slim, looking youthful and having a fit and toned body a status symbol. This is seen as something better than, for example, being fat or otherwise falling outside the framework of "social acceptance". Behind this is the rather toxic belief: if my body looks perfect, then I am a better person. In other words, the belief that some bodies are better than others. And of course we behave accordingly in this society.
And what does anti-diet nutritional counseling mean in this context?
In anti-diet nutritional counseling, we do not focus on body weight. I do not tell my clients what to eat or how to exercise, but we always look at the individual life situation, the possibilities, the resources, the capacities and the mental health. And only after this inventory do we decide together (!) what we can do to live a more health-oriented life. And we ask ourselves questions like: How can I make my diet more varied? How can I rediscover the joy of exercise? How can I practice good stress management? How can I perhaps sleep better?
What I explicitly do not offer is active support in weight loss. But of course weight is an issue because we live in the society described above, in which a slim body is seen as "better". And many of my patients still want to be slimmer - more than understandable given the background described above. But we still do not try to manipulate body weight.
Thank you for these explanations. In our view, everything you have described becomes even more pronounced in the context of pregnancy and the postpartum period – this time is really special, especially in terms of the assessment of body shape and weight. On the one hand, because there are suddenly so many new dietary recommendations – and on the other hand, because the body is so much in focus. People are often weighed during examinations, which is a new experience for many people. The body is supposed to change, but only within certain conditions. And then, once the birth is over, it should look like it did before as quickly as possible. You are a mother of two children yourself – how did you experience the pregnancies and the postpartum period?
I was a little overweight when I got pregnant - but still "socially acceptable", even if that's a terrible term. What I mean by that is that I wasn't insulted on the street for my weight and clothes fit me in shops - so I lived in a body that still had a lot of privileges. And yet I was in full diet mode. I thought that I absolutely had to be a slim mother to be a good mother. Spoiler: That completely changed after I got involved in the anti-diet movement. Today I know that I am a good mother - also because I model a very relaxed relationship with food for my children.
But back to pregnancy: I got pregnant pretty quickly and that was a completely new experience for me. Suddenly I was "allowed" to have a belly. And it wasn't just allowed to be there, it was praised and admired. And it was the first time in my life that all these external "rules" no longer mattered: I was suddenly able to listen to my body and for the first time had the courage to trust my body. It was so beautiful! And then, in the 36th week of pregnancy, there was suddenly a small red spot on my belly - and 24 hours later my entire belly was covered in large, purple-red stretch marks and I was crying my eyes out. And the whole beautiful feeling was gone - and I could hardly enjoy the last few weeks of pregnancy because I felt so awful and ugly.
Then my child was born and for a few weeks these critical thoughts disappeared. But they quickly came back and I started to look at myself critically in the mirror. Of course, it didn't take long before I started dieting again: I ate too little and breastfed fully. And I exercised even though I should have been resting. And I was just so sure that I was doing the right thing for my health. I had the image in my mind that after the birth I would rise like a phoenix from the ashes and then be admired by everyone. What stress! Looking back, I have to say that the entire first year after the birth was actually nothing but stress - not only, but to a large extent because of my supposedly bad body. And I really regret that from the bottom of my heart.
That sounds super sad from today's perspective and at the same time so familiar to me. Did things get better with the second child?
Unfortunately, it wasn't much different with my second child and I still remember quite vividly a situation in which my child was already showing signs of hunger and I still wanted to do HIT training and the milk was already running out of my breasts - completely absurd. When my younger child was one and a half years old, I developed health problems (regardless of my weight) that prevented me from dieting or doing such strenuous training - and that was the moment I started to look into anti-diet nutrition.
Wow, thank you for your openness. I can identify with a lot of what you're saying - I always thought that I had to be a slim mother to be a good mother. And I've learned in recent years that I'd much rather be a mother who shows her child a good relationship with food and her own body.
Yes, modeling self-care is so important! Children see how their mother fights against her body and ignores their needs. They also see a lack of trust in their body because, for example, she doesn't eat when she's hungry or cooks differently for herself or devalues other bodies - children see that! And that's something I don't want for my children.
Totally, I can only agree. Back to diet culture: I was shocked myself at how present diet culture is in all these advice books, among midwives and doctors on the topics of pregnancy and the postpartum period. It's about how much weight you "can" gain, pregnant people are classified as being at risk just because of their weight, births are induced, etc. How do you see this from your expert perspective?
I see all of this very critically - and that is also the basis of my work: I want to solve the connection between weight and health. This always comes down to one difference: correlation vs. causality. That sounds technical at first, but it is very easy to explain: studies show, for example, that a higher body weight is linked to a higher risk of certain diseases. But that's about it. The study design is such that we cannot say what the cause is here - so is the high body weight really the REASON for the diseases? Or could it be the other way around - or could the disease even be caused by completely different factors that either were not measured or cannot be measured at all.
My favorite example is yellow teeth. People who have yellow teeth have an increased risk of lung cancer. We know this from studies that have exactly the same structure as studies on weight and health. And what do we draw from this result? Yellow teeth cause lung cancer. Or do they? Isn't there perhaps another explanation? Perhaps that people who smoke are more likely to have yellow teeth - and therefore also have an increased risk of developing lung cancer.
Applied to the connection between weight and health, this means that people with larger bodies have an increased risk of certain diseases. But no study can show whether weight is really the CAUSE. And it becomes particularly absurd when you make the opposite conclusion, which almost always follows when it comes to weight: we don't know exactly whether weight is the cause, but we tell everyone that it is. So if you lose weight, your problems and diseases will go away. Applied to the teeth example, this would mean that we only need to whiten our teeth, which would reduce the risk of lung cancer. Absurd, right?
Completely absurd. And isn't it also true that very few people are able to maintain a lower weight permanently after intentionally losing weight?
Yes, exactly. And that brings us to the weight recommendations during pregnancy: a BMI is calculated - which is a completely outdated and inaccurate figure anyway - and then recommendations are made that relate solely to weight. What is not taken into account is that this information can, for example, put a lot of pressure on you, which in turn causes stress. Or it can lead to unhealthy behavior, such as restrictive eating, skipping entire meals, etc. This is also pure stress for the body - and whether all the nutrients that are important for pregnancy are absorbed under such conditions is, in my opinion, at least questionable. The fact that stress has a massive impact on sugar levels is, for a change, really well documented - but is completely ignored here.
If I could, I would definitely change the recommendation here: to focus on healthy behavior. On enjoyment, on satiety, on having fun with exercise, on getting enough sleep and on not having too much stress. Why is it still recommended as it is in the guidelines and where do the guidelines for the "maximum permitted" weight gain come from? Unfortunately, that is completely unclear and is not supported by any sources in the guidelines.
Thank you for this comprehensible explanation, Antonie! It almost sounds as if someone had made up these numbers - scary. And really astonishing because the numbers are so concrete. And if this really isn't proven, then in my opinion that's negligent. And quite apart from that, there are also reasons for the weight gain, such as water retention, which have relatively little to do with how I behave or eat, but which simply happen physiologically and are reflected in the weight, but cannot be influenced at all.
In this context, I would like to briefly return to the topic of weighing yourself and make it clear: it is not compulsory! I recently spoke at length about this with a midwife who explained to me that weight monitoring is primarily there to detect sudden water retention. These can be signs of serious complications, so it is really important to know. And I think this is so important to know because it puts the whole weight issue in such a different context: it is actually not about recording your weight in minute detail, but rather looking at it in relation to it. So more as a diagnostic tool than as a means of pressure. And against this background, you could then consider together with an open-minded midwife or gynecologist whether the "public" step on the scales is really necessary and what alternatives are possible if it is too much of a trigger. For example, not having your weight told to you (if that is the trigger) or getting on the scales yourself at home (if the scales themselves are the problem).
Yes, totally. And here too – why isn't this explained? And wouldn't it also be possible to monitor other symptoms of sudden water retention, for example in swollen hands and feet? But unfortunately I often hear from my patients that all of this doesn't always work so well. That it really takes a lot of convincing in the practices to get this accepted.
Yes, unfortunately. In addition to weighing yourself, you are often confronted with statements, comments and recommendations before and after the birth that can be attributed to diet culture. What advice do you give your clients in such situations?
I once did a whole podcast episode on this because I think the topic is so important. Basically, there are always several options: For example, you can leave the situation, but of course that doesn't always work. In the relationship between doctor and patient in particular, there is a dependency relationship, so it can be difficult. Another option is to say that you don't want to talk about it and refer to your history of eating disorders, for example. It is also possible to explain that these statements are causing a huge amount of stress, which is not good for your unborn child. Overall, it can be about making the other person aware of your own situation. Or you can be confrontational and ask very clearly for sources for these statements - because there are usually none. But of course, all of this is exhausting and really not easy. Especially when you are pregnant and perhaps feeling particularly vulnerable anyway.
I would love to talk to you about the topic of body image - and also about accepting your own image after giving birth. What do you think can help you accept and experience your body in its new limits?
Yes, such an important topic! Many people don't even realize that they have a negative body image, even though in many cases this is the reason for dieting.
It is also relatively easy to recognize whether someone has a negative body image - for example, if they repeatedly engage in "body checking" behavior, i.e. checking their reflection in shop windows. Or if they miss their "old" body very much and compare their current body with other bodies or their own previous body. Avoidance is also a strong sign: it means that they don't want to touch themselves at all, for example to apply cream. And of course: negative self-talk. Of course, changing this doesn't happen overnight and takes a lot of practice, especially negative self-talk.
But the first step is also about recognizing that you have a negative body image - that is really the basis. And when the negative thoughts come, the first exercise is to distance yourself. For example, when you walk past a shop window: you see yourself, have a negative thought about your body and then you distance yourself from it: "I'm just having the thought that I'm ugly. It's not me who's ugly, it's me just having this thought."
It is also extremely important to change your viewing habits. Our brains are wired in such a way that they think what we see often is normal. And if, for example, we only follow people on social media who have perfect bodies and perfect eating habits and the perfect apartment, then we believe that this is normal and compare ourselves to them. My recommendation is to really surround yourself with more reality - including on social media. Then your brain will learn: Ah, that's normal. And it's OK to be like that.
You can find Dr. Antonie Post on her website and on Instagram . Her book “Health Knows No Weight” was published by Südwest .
