This post was co-authored with Dr. Gabriela Ghisi.

When you are diagnosed with a chronic disease, you will be advised to follow a healthy diet to help manage it. Indeed, patients who have heart disease and follow a Mediterranean diet lower their chances of further heart problems. But we need to talk about what happens when this goes too far, often due to “diet culture” in society and the thinness ideal for women. In this post, we will talk about ways to keep your approach to eating and body image healthy.

The focus on physical appearance and how it might be altered through food and calorie restriction is everywhere — in the news, on billboard signs, and in social media. Women are often the target of this messaging. The images generally all look the same — young, white, thin, able-bodied women. It is hard to keep remembering when we are bombarded with this, but women come in all shapes and sizes. Often these images are altered, such that not even 1% of the population would have the size or shape depicted!

This can lead to low body image. In fact, studies suggest discontent with body image is sadly now the norm for women. A negative body image can put you at higher risk of certain mental health conditions, including depression and disordered eating. Research has shown that more women are starting to develop eating disorders at the time of menopause. If you are struggling with your mental health in relation to eating, please reach out to a mental healthcare provider such as a social worker or psychologist.

The thinness ideal can also result in women spending a lot of mental energy thinking about their weight, shape, clothing, food intake and exercise. Contrary to what you might think, all this negative thinking doesn’t result in healthier eating; self-compassion and self-care do. Body image can also negatively affect how you behave as a result of your thoughts and feelings. Think about how that physical and mental energy could be better directed to improving your health, investing in your cherished relationships, or engaging in other activities that give your life meaning.

There is also a lot of focus on trying specific diets, or buying products or foods to achieve this cultural ideal. Please know it is better to get local foods in season or some fruit and vegetables in your grocer’s freezer aisle than spending money on the latest fad. Consult with a dietitian about any diet-related messaging you might come across to help you make sense of what is hype versus what is a sensible approach for your health.

We also know that diets often don’t work. With calorie restriction through any diet — be it keto, paleo or low-carb for example — people can lose weight in the short term. Your body wants to achieve homeostasis, however, so will adjust your metabolism over time to get back to the weight it was. Moreover, following menopause, women’s shape often changes; we can develop more fat around our bellies, which frankly can help to protect our internal organs. We can’t fight biology, so rather than spending your energy depriving yourself, focus on fueling your body so you can feel your best and optimize your health.

When you set your goals for cardiac rehab or managing your diabetes or autoimmune disease, for example, you may have thought about trying to lose weight. This is likely the thinness ideal subconsciously talking! It is very reasonable to have as a goal to gain function and vitality to engage in the activities you enjoy and that bring your life meaning. Women do often feel more toned, and may lose some “waist” rather than weight through resistance training programs in rehab.

Most people realize as they get older that how you look is only one part of who you are. So, rejoice in your body and how it helps you go about the daily activities that bring you joy and meaning. Surround yourself with people of all shapes and sizes who can support you in your chronic disease management. Aim to feel comfortable in your body, as you work towards a healthy diet in moderation. You can find a video from cardiac rehab summarizing these ideas at the Cardiac College for women website here: https://www.youtube.com/watch?v=s3tajxQBR4k.

Dr. Gabriela Ghisi is an Affiliate Scientist at the KITE Research Institute, University Health Network. Her research focuses on patient education for chronic disease management.