Accessible Wellness for Neurodivergent Folks with Jackie Silver

This week I’m talking with Jackie Silver about nutrition and wellness. Jackie is a Registered Dietitian with a Masters of Health Science (MHSc) in Nutrition Communications. She has a firm belief that neurodivergent and disabled people deserve to live a healthy lifestyle but found the opportunities for these communities lacking, so she decided to start her own practice, Accessible Wellness. Her area of expertise is in working with kids, teens, and adults with autism, ADHD, and those with intellectual or developmental disabilities.

In our conversation today, we discuss strategies for making nutrition and wellness more accessible. We talk about some of the common challenges we can face while trying to feed ourselves with ADHD, like irregular eating, difficulty with meal planning/prep, and poor interoceptive skills. We look at how we want simplified, tailored strategies to help people where they're at, rather than simply overwhelming them. We also go into some of the dangers of diet culture and the need to have compassion for ourselves when trying out new strategies.

https://jackiesilvernutrition.com/

https://www.instagram.com/accessiblewellness/

The Hunger-Fullness Scale

Neurodivergent-Friendly 30-Minute Meals

10 Principles of Intuitive Eating with a Neurodivergent Twist

Forget to Eat? A Guide to Mechanical Eating for Neurodivergent Adults

William Curb: Thank you for coming on the show. Could you do a quick introduction of yourself and tell me a little bit about accessible wellness?

Jackie Silver: Thank you so much for having me. I'm very excited to be here. My name is Jackie Silver and I live in Toronto, Ontario. I'm the founder of Jackie Silver Nutrition. My Instagram account is called Accessible Wellness. Formal business name is Jackie Silver Nutrition. And there's different wings to my business. We are primarily a private practice. I'm a registered dietitian. I have a master's of health science in nutrition communications from Toronto Metropolitan University.

In my practice, we're a group practice of two dietitians. And we support neurodivergent clients. So we work with kids, teens and adults who have ADHD or are autistic or have intellectual developmental disabilities. And we support them with their nutrition and health, with a weight-inclusive approach. We also have an Instagram account, Accessible Wellness. And we have a very active blog that's SEO Optimized that has quite a lot of traffic with articles about relating to nutrition and neurodivergence. And we're going to be launching a course, an online course in January on meal planning for neurodivergent adults, which is really exciting.

William Curb: Awesome. I think it's all sounds really great. Like the idea of accessible wellness, because oftentimes when I see these things, it is not accessible for a lot of people. Here's how you do this stuff. And I'm like, well, that's never going to happen for me. Especially with ADHD autism, doing the things that are good for our health is hard.

Jackie Silver: It is. Yeah. I try not to recommend expensive things. I don't recommend super complicated recipes. I'm all about simplifying things as much as possible and meeting folks where they're at. So for some people, that means, honestly, I've seen some clients who eat once every few days. So for them, it's just eating something at least once a day. You know, that's meeting them where they're at. And that's helpful to them.

William Curb: Yeah, I can have some trouble with my hunger cues and stuff where I'm like, it's not specifically with my stimulant medication that I've noticed it, but just in general, my interoception is fairly poor and it will be not days, but, you know, hours after I should have eaten that I notice.

Jackie Silver: Exactly until you get to the starving point. That's super common.

William Curb: Yeah. And then I'm grumpy and I just want to shove chocolate chips in my mouth. And as tasty as chocolate chips are, it is not a full meal. Yeah. So like one of the things I found often works for me. It's like actually like having that on my calendar when I need to is like, I'm going to have lunch. I need to remember to stop to do that.

Jackie Silver: Yes. That's what my clients also usually find that helpful. I often recommend set like blocking out the time to have lunch in your calendar. Some people like setting alarm. Some people like placing their food out somewhere visible where, you know, it's in sight. They'll remember it. Those strategies are really essential.

William Curb: And it doesn't feel good at first, for me at least, because I was like, I should be respecting my body cues and stuff from like what I've been reading online and I'm like, my body cues aren't telling me.

Jackie Silver: Exactly. Yes. That's an interesting point you bring up. And also it's OK to have a mix of both, you know, you could have a mix of what we call mechanical eating, which is eating on a schedule and intuitive eating, which is listening to your body cues. There is a way to blend both of them and actually have an entire blog post on my blog about that that maybe you can share in the show notes.

William Curb: Yeah, absolutely. And it's I just think that something that I have often dealt with with my therapist is my black and white thinking on these things where it's like, you either listen to your cues or you do this or you do the mechanical eat. And I'm like, oh, yeah, you can do both.

Jackie Silver: Yeah, you can have a mix of both for sure.

William Curb: One of the things we talked about before the show, too, is meal planning, which I find very valuable, but very difficult to do. Could you talk a little bit more about meal planning?

Jackie Silver: Yes. So that, I would say, is the number one struggle that my clients struggle with is being able to meal plan and prep things ahead of time. My clients will often, you know, they'll come to me and say, you know, I have no appetite during the day because of my meds and then I don't eat. And then my meds were off at night and I'm starving. And that's when I binge and snack or they'll say there's times of day when I want to eat something, but I don't have anything prepared and I have no idea what to eat and I get so overwhelmed.

So then I either just don't eat or I order takeout. So my approach is to start with eating on a schedule because I find that once folks start eating more regularly during the day, it's going to reduce the nighttime snacking and binging. Because at night when the meds were off, their appetite comes back. They haven't eaten during the day. Their body is saying, I need food.

I need to eat whatever I can get my hands on. It's your body trying to nourish yourself. So once we eat more regularly throughout the day, that's when the nighttime binging reduces. In the beginning, I always say, I don't care what you're eating. I just care that you are eating, which probably a lot of dietitians wouldn't. I don't know, maybe they wouldn't agree with me on that.

Yeah, I just want them eating. And then then we work on the what and we work on how to make nutritionally balanced meals and snacks. And we come up with strategies that will make it as simple as possible. So for some folks that is coming up with cheat sheets, that's a big thing that I do. So we'll come up with snap cheat sheets, lunch cheat sheets, dinner cheat sheets and make a list of five or six different simple meals that they can choose from. So that when they know, OK, it's lunchtime, maybe eat something, but I don't know what on earth to eat.

They look at their menu, so to speak, and choose something from that menu. That works for a lot of people. Another strategy is we reduce as many barriers to cooking as possible. So that is relying on frozen veggies, frozen fruit, baby carrots, you know, veggies that you don't need to chop, apples, pears, nectarines, stuff that you don't need to chop. You don't need a peel instant oatmeal, pre-sliced bread, crackers and using those components to make really simple meals and snacks. And then another strategy is we work on prepping things in advance in very large batches and store them in the freezer and then take it out. Microwave, you'll have a meal ready in two minutes.

William Curb: I know come lunchtime, I'm usually not in the best state to make decisions on what I want. So knowing that I have something available and that it is not going to be it's very easy for me to come up with excuses on why I don't have the energy to do something. And so it's just like, OK, I just pop this in the microwave and five minutes will be ready. That's great.

Jackie Silver: Yeah, it is.

William Curb: It is surprising in the moment how easy it is to come up with those excuses. And then like later, you're like, I could have done that.

Jackie Silver: Yeah, it's true.

William Curb: Yeah, it's really important that we're just making sure that we're eating because when we're being judgmental of the kind of food we're eating, I find that it's very, when I'm trying to like increase the nutrition of what I'm eating and then also feeling low energy, it can lead to me be going, I'm just not going to eat because it seems like too much.

Jackie Silver: Yeah.

William Curb: Which is not a great place to be in when I'm hungry. And then that's not going to fix the issue.

Jackie Silver: No, exactly. You're going to be angry. You have a hard time focusing, be tired. Your body needs something. Something is better than nothing. That's what I always tell my clients.

William Curb: We also talked a little bit about mindful eating. You tell me a little bit more about what we mean when we're talking about mindful eating.

Jackie Silver: Yes. So mindful eating is a component of different things. I would say it's being present in the moment and paying attention to your food, to all the sensory components of food, of your meal, the taste, the smell, really savoring and enjoyment and getting pleasure from your eating. It's also learning to tune into your body's internal hunger and fullness cues as a way to guide when you start and finish eating and a way to learn more about your body and what it's telling you and be more in tune with that.

William Curb: So one of the things that I think I at least have a misrepresentation in my head of is that when I hear that what my brain goes to is that when I'm eating, the only thing I should be doing is eating. But that also tends to lead to me to being under stimulated. And so then I'm not I'm either eating very quickly or I'm just zoning out, thinking about something else. I'm not hitting any of the mindfulness cues there either.

Jackie Silver: Yeah, so we have a blog post on intuitive eating with a neurodivergent twist. So I would recommend posting that in the show notes as well. But essentially sitting and eating and not having anything around you, probably not going to work for a lot of neurodivergent folks. And that's OK. You know, I think that you could still have the TV on and be mindful of your food and enjoy it and savor it while you have that stimulation around you.

William Curb: It's like if you're having dinner with someone else, you have that conversation going in that is, you know, can be enough stimuli. My children don't always agree with that. But like, when can we get up from the table? Okay, fine, you guys are done. But I do think it's important to get to realize that, because when I first started looking into intuitive eating, it was something I was like, this seems very interesting, but I don't feel like I can approach it the same way that a neurotypical would.

Jackie Silver: Mmmm And you don't have to.

William Curb: Yeah, like you're like, you'll just do this and I'm like, I don't think I'm going to.

Jackie Silver: Yeah, exactly. It's neurotypical advice. It's advice for neurotypical brains.

William Curb: Yeah. And that's like one of the things that I've always ended up coming back to with my show is that like, neurotypical advice is fine, but it needs to be fine tuned for our brains because otherwise it's going to be doing the wrong things.

Jackie Silver: Exactly.

William Curb: Because the other side of it is like, I often will be like, oh, that's for neurotypicals and then just toss that advice out. I'm like, that's not the right idea either. Mm hmm. Like how can I modify it for me?

Jackie Silver: I personally am disabled. I'm an above knee amputee on my left leg. And so I still do workout classes as an example, like Pilates yoga, but I modify it for my needs. So and that's exactly the attitude that I bring in in my work as a dietitian is the

William Curb: Awesome

Jackie Silver: Being creative, finding solutions, reducing barriers and simplifying things and finding what works for you.

William Curb: Also, in your introduction, you also had this interesting point about having this weight inclusive lens, which I feel is important, but also is not something that I often hear about. Can you talk a little bit more about that?

Jackie Silver: Yeah. So what I mean by weight inclusive lens is that in my work with clients, I don't focus on weight as a measure of success or a measure of health. I don't ask them how much they weigh. We don't set weight loss goals. I don't ask them to weigh themselves.

In fact, usually I'm asking them to stop weighing themselves. So we focus on making long term sustainable behavior changes independent of weight. And we focus on positive health outcomes that are also independent of weight. So that could be, you know, if you start eating regularly throughout the day, a positive outcome could be you have more energy, you're not as tired, your binging or nighttime snacking goes down.

Maybe other measures are cholesterol levels improving, blood sugars improving, because those metabolic metrics can improve with dietary changes, even if weight does not change, they're not dependent on weight, being able to spend less energy planning and prepping your meals so that you have more time to go out and enjoy life and do activities that you want to do. That's a huge measure of success.

William Curb: It feels like something that's like, oh, I should just be able to do this. But it is a knowing how to do that is a skill, and it takes time to build those skills.

Jackie Silver: Oh, absolutely.

William Curb: Just a reframe that's happening in my brain right now. It's like, oh, yeah, that's not took me a while to learn how to do my calendar. That was a skill. And meal planning is also a skill that will take time to develop and be get to a place where it's more natural and less forced. One of the things we talked about before was just this idea of like how the actual benefits of like weight loss and how it's kind of a little bit more murky than pop culture will have us assume.

Jackie Silver: Yes, definitely. And BMI is not a measure of health. I want to be clear about that. I do not use BMI with my clients. It's bullshit. In my opinion, to be frank, when you talk about weight loss, you have to talk about diet culture. Because diet culture is everywhere.

That is our, you know, the media, celebrities, the news, everything in our food products, diet products, everything telling us that life will be better if we shrink ourselves and if we live in smaller bodies and if we lose weight. And that culture is extremely toxic. It increases disordered eating patterns. It damages our mental health. It's really toxic. So a lot of the work I do is also letting go of these food rules that people form based on diet culture and unlearning them and trying to tune out the toxic diet culture.

William Curb: Yeah. When I think about what would be the end goal of weight loss, because it feels like it would always be more. There would never be a point where I'd like look and be like, you've done it.

Jackie Silver: Exactly. It's never going to be enough. I've had clients say, I lost my goal weight, I got to my number, but then I wasn't happy. I wanted more. I wanted to lose more. And that is what happens. You know, our bodies fluctuate. Like if we're sick, our bodies are going to fluctuate. If folks are pregnant, their body's going to change. If you have surgery, your body's going to change again. It changes through the phases of life it ebbs and flows. And it's not super productive to be very hyper focused on a number on the scale.

William Curb: Yeah. I mean, it should be said to her, the audience too, that it is one thing to know that and another thing to embrace that because it is, I grew up in the 90s.

That was terrible. I was talking with the friend to the other day and we're looking at pictures of ourselves from when we were in middle school and high school. And we're like, I knew that at that age, I felt fat. And then I look back and I'm like, wow, I was not.

Jackie Silver: Yes. To your point, I want to validate that it is okay to want to lose weight and it is okay to want to look different. You could still work towards rejecting diet culture and being weight inclusive while still wanting your body to look different.

William Curb: Yeah. If you're like, goal is to be, you know, do something in sports, you know, that feel like that would be, I want to run faster. It will be easier to run faster if I train and carrying less weight with me while I'm running. But again, that becomes a very nebulous goal too. Like, can't run faster forever.

Jackie Silver: If they focus on running faster, but they don't lose weight, they will probably still run faster.

William Curb: Yeah. Because all the benefits of weight loss come from doing exercise and eating better. And those things are the real targets that are going to create the benefits that we need.

Jackie Silver: Those sustainable behavior changes. Yeah. That can be positively impacted regardless of what happens to our weight.

William Curb: I would love to learn more about fullness and hunger cues.

Jackie Silver: So that is also a big thing of what I work with my clients with ADHD. And like I said earlier, you can learn to focus on your hunger and fullness while practicing mechanical eating, eating on a schedule. So usually I encourage eating on a schedule, getting that down pat and consistent first, and then moving on to learning about hunger and fullness. So what I usually do is I'll show people, have you ever seen a hunger fullness scale?

William Curb: I believe I have a few refreshments would be appreciative.

Jackie Silver: Yeah. So it's a chart that goes on a scale of one to 10, one being extreme levels of hunger. And 10 is extreme fullness. So I like to call it Thanksgiving dinner-full or Christmas dinner-full. And then all the variants of hunger and then fullness in between, people find it helpful because it describes different levels of hunger and levels of fullness. So from just starting to feel hungry, my belly is starting to grumble to I'm irritable, I'm tired, I can't focus. Same with fullness, like, you know, you start to feel a little bit bloated, or you stop thinking about food that could be a sign you're full. And there's varying degrees of it.

What I encourage folks to do is to pay attention, maybe once a day, twice a day, pay attention to how hungry they are when they've started to eat, and pay attention to how full they are after. I'll give you an example. Recently, I've worked with a few clients who have said, well, actually, this is common. So a lot of my clients with ADHD, and you had mentioned this earlier, they'll go, you know, six, seven hours without eating, and then they feel absolutely famished. And they don't really feel the hunger up until that point. So we want to work on starting to eat before they are famished.

So we want their hunger level to be a bit more in control. So instead of, you know, super famished, I can't make decisions, I'm going to be, I have to just eat whatever is in sight to, okay, I'm starting to notice those hunger signs in my body, I'm starting to get a little bit tired and not focused, I'm starting to think about food a bit more. Okay, this is a sign that my body's telling me I need to eat right now.

So working on training that. And then at the opposite end with fullness, a lot of my clients will say they haven't eaten all day, and then dinner time comes, and they feel so full, like not good, it's uncomfortable, uncomfortably full, I could see your eyes.

William Curb: Yeah, I've done that.

Jackie Silver: Yeah, I have to, it's not super pleasant. So we work on checking in with themselves and their bodies while they're eating so that they can end their meal before they get to that uncomfortably full point.

William Curb: Specifically with foods like pizza, I will be like, want to eat more, even if I'd like, I can check in, I'm like, I feel full, but I see the pizza and I want to eat more of it.

Jackie Silver: Yeah.

William Curb: Recently it's been easier for me to be like, okay, well, that's going to make me feel bad if I do that.

Jackie Silver: Yeah.

William Curb: So let's not give into the like, who's there, must stick it in my mouth.

Jackie Silver: And what about saying if the pizza that I save can be my lunch the next day? I'll have another meal out of it. And one thing about the hunger fullness is in neurodiverse folks, those interceptive skills, interceptive awareness is not as in tuned, I would say, like the, it's harder to recognize those hunger fullness cues. What I have seen with a lot of folks is that once they start eating more consistently throughout the day, their hunger cues actually start to come back. And then they start to feel hungry again for breakfast, which they really enjoy.

So that's another way that they could, they could start coming back. And it is, it is a practice. And, you know, like you said, it's a skill. It's honestly a lifelong skill. I always tell people, do not judge yourself for, or don't tell yourself that you've quote unquote failed with recognizing those cues, because it's always a learning experience, you know, like, like, for example, with the pizza, maybe one time you have three slices and you notice you feel sick, then that's a really good learning opportunity to try maybe two slices next time and notice how you feel.

Or, you know, if like, you notice maybe you waited too many hours to start eating and you're super hungry, you could say, okay, you know what, next time I'll try eating maybe an hour earlier and see how I feel with that.

William Curb: Yeah, developing the skills to realize that when you're starving, that that isn't the hunger cue. Like when you have headaches and feel like passing out, that's not the hunger cue. They're not even realizing that they're having hunger cues because they think hunger is this symptom of having not eaten of, you know, being, you know, maybe feeling lightheaded or something like, oh, I feel lightheaded. That must mean it's time to eat.

Jackie Silver: Well, lightheaded can be a sign of hunger.

William Curb: Yeah, like it is technically a hunger cue, but it is not the first hunger cue.

Jackie Silver: I would say it's an extreme hunger cue.

William Curb: Yeah.

Jackie Silver: The earlier signs are probably going to be your stomach grumbling, you start to think about food more.

William Curb: All right. Well, before we wrap up here, is there anything you'd like to leave the audience with?

Jackie Silver: Be gentle with yourself. Don't judge yourself. Focus on very small changes at a time, you know, one thing at a time. These skills that we've talked about, meal planning, recognizing hunger, fullness, eating consistently throughout the day, they are skills that you can work on. Be gentle with yourself.

William Curb: All right. Well, thank you so much for coming on the show. I'll be sure to include a bunch of links for people on the show notes page, though. They should go to the show notes page.

Jackie Silver: My pleasure. And also, I just want to say, feel free to check out my website, jackiesilvernutrition.com, which I'm sure you'll put in the show notes. Feel free to check out my Instagram, my ad accessible wellness. And like I said, we have a very active blog. We have lots of awesome content for neurodivergent folks. We have recipes. We have educational blog posts. We have roundups. So yeah, please check the blog. We also have a free download, neurodivergent friendly meals.

So feel free to download that to get started. And then you'll be added to our monthly email list, where we also share more tips and tricks. And stay tuned for our meal planning course for neurodivergent adults coming in the new year.

William Curb: Awesome. Well, thank you so much for coming on the show.

Jackie Silver: My pleasure. Thanks for having me.

This Episode's Top Tips

  1. Common challenges we can face when dealing with ADHD and food are irregular eating, difficulty with meal planning/prep, and poor interoceptive skills - that is recognizing when we are hungry or full or somewhere inbetween. To help combat this we can use strategies like eating schedules, snack cheat sheets, batch cooking, and using hunger/fullness scales to help build up that interoception.

  2. We can work on practicing mindful eating by paying attention to tastes, textures, and fullness cues even when we have distractions around. Remember that we want to focus on meeting ourselves where we’re at and doing things that work with our brains.

  3. It’s important to be compassionate with ourselves and focus on small, sustainable changes rather than demanding perfection.

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