Quick fixes are tricking your nervous system
Interviewer: A lot of clients probably show up to their first session at a breaking point in their relationship with food, ready to say enough is enough. How do you reconcile a person who wants to change their life as fast as possible with the reality that the work happens over the next 3 to 6 months, not the next week? What does that gap look like to you?
Emahlea Wilcher, MPH, RD, LD: As a dietitian, you have people showing up already pre-motivated. They’re often motivated from survival mode, though, and not from thriving mode. If they were motivated from thriving mode, they probably wouldn’t be showing up in the first place.
That’s the main thing to recognize as a medical professional: people don’t come to you because they’re well, they come because they’re unwell and want to become well. Their motivation is underlaid by survival mode.
So people want a quick fix, a crash diet, the easy route, because their nervous system is burnt out, exhausted, and overwhelmed. Something as basic as making themselves a meal or not bingeing can feel out of reach. If you’ve never had a consequential relationship with food, you don’t know this in your own nervous system, but the majority of human beings have had one. They tend to carry a survival mode approach to their relationship with food and with their body.
When your cortisol is high, your adrenaline is kicked up, and you’re overwhelmed, you look for things that perpetuate that feeling of overwhelm. You go for big quick fixes: I’m going to clean the whole house head to toe today, bake all the things, meal prep all the time, eat healthy all the time. It goes from zero to a hundred, and it’s never sustainable.
They get a little burst of energy from their burnout and spend it all in one place, and then they’re depleted again and can’t repeat the behavior. People often come to me and say, “I was doing so well. Yesterday was so good,” and then it all crashed at the end of the day.
More often than not, that’s because they used the little bit of energy they had to do more, when they could have used it to rest and recover. When you get a little bit of excess, it’s better to just be first. Then you start adding on as you feel more rejuvenated and rested.
The boring, consistent work is the one thing that works: slowly but surely, one little step at a time. You can build on habits, so if you start small, you can build on them and make things functional.
Interviewer: How long does it take to go from survival mode to the boring consistency outcome you’re looking for? What does it look like once a client makes that transition?
Emahlea Wilcher, MPH, RD, LD: It depends on where the client’s fear, ego, shame, guilt, and inability to identify their own signals and cues lie. I can’t give a specific amount of time. I can usually tell from our first session how long I’m going to have a relationship with them, as long as their insurance continues to cover things and they’re still able and willing to engage in treatment.
More often than not, the people who seek me out need at least 6 to 12 months of care before they’re truly thriving. I wouldn’t say it takes 6 months to pull them out of survival mode. People get out of survival mode anywhere from one session with me to 12 to 15 sessions, and then we can really start doing the work.
If zero is baseline, people start below baseline more often than not, and I have to bring them up to zero. Once they’re at baseline, we can start building beneficial behaviors on top. Until then, we’re mostly fixing the debt they built up before, whether you call it mental, emotional, spiritual, or physical. Then we can get to the boring, consistent things, because boring consistency doesn’t light up the nervous system of many of my clients. Their nervous systems are on fire by the time they come to see me.
Interviewer: Think of someone who has made a promise to themselves over and over, broken it, and no longer trusts themselves. They feel stuck in a never-ending state of survival. Not a “come work with me” message, but an overarching one: what would you tell them?
Emahlea Wilcher, MPH, RD, LD: Trust yourself to do what you already know is true. Let your fear, your pride, your ego, your shame, your guilt, and your overwhelm go enough that you can see the pattern and the loop for what it is, without having to continue on that pattern and that loop.
To put it short: if you feel like you don’t trust yourself, you’re not paying enough attention to yourself. That sounds terrible, but it’s true.
Interviewer: When people break their own trust, they start judging themselves, and the negative self-talk follows. Is there a way to talk to yourself without constantly judging?
Emahlea Wilcher, MPH, RD, LD: I encourage people to approach themselves like a journalist. Don’t put your f***ing opinion in it. Not a single opinion in how you judge yourself. Just the facts, ma’am. Then you can look at a pattern plainly for what it is, without judgments, preconceived notions, or thoughts and feelings.
You approach it neutrally, because you can’t get to a positive thought unless you’ve crossed through the neutral first. Sometimes the neutral is just: I have a habit of overeating at night. That replaces “Oh my God, I eat myself out of house and home every single night and it’s a disaster,” and it also replaces “Well, I was eating really healthy earlier today,” which is just the positive version of the same story. It becomes: I have this habit.
Then you can ask, how does this habit make you feel? Good, bad, or neutral? If you felt neutral about it, you wouldn’t be here in front of me. If you felt great about it, you wouldn’t be here in front of me. That leaves exactly one option.
Next: you have a habit, it makes you feel bad. Do you like feeling bad? Yes, no, or I don’t know. If the answer is no, do you want to change it? You break it down into simple yes or no questions until you find where the blockage is, where the person gets caught up, stuck, and running in circles, unable to bring themselves to implement step one.
Sources
Yau YHC, Potenza MN. Stress and eating behaviors. Minerva Endocrinol. 2013;38(3):255-267. PMID:24126546
McEwen BS. Protective and damaging effects of stress mediators. N Engl J Med. 1998;338(3):171-179. doi:10.1056/NEJM199801153380307
Levinson JA, Parker JE, Hunger JM, Tomiyama AJ. Dichotomous thinking about food as an understudied subclinical disordered eating cognition. J Eat Disord. 2025;13:224. doi:10.1186/s40337-025-01388-7
Polivy J, Herman CP. Overeating in restrained and unrestrained eaters. Front Nutr. 2020;7:30. doi:10.3389/fnut.2020.00030
Lally P, van Jaarsveld CHM, Potts HWW, Wardle J. How are habits formed: modelling habit formation in the real world. Eur J Soc Psychol. 2010;40(6):998-1009. doi:10.1002/ejsp.674
Singh B, Murphy A, Maher C, Smith AE. Time to form a habit: a systematic review and meta-analysis of health behaviour habit formation and its determinants. Healthcare (Basel). 2024;12(23):2488. doi:10.3390/healthcare12232488
Hills AP, Byrne NM, Lindstrom R, Hill JO. “Small changes” to diet and physical activity behaviors for weight management. Obes Facts. 2013;6(3):228-238. doi:10.1159/000345030
Khalsa SS, Adolphs R, Cameron OG, et al. Interoception and mental health: a roadmap. Biol Psychiatry Cogn Neurosci Neuroimaging. 2018;3(6):501-513. doi:10.1016/j.bpsc.2017.12.004
Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191-215. doi:10.1037/0033-295X.84.2.191
Sirois FM, Kitner R, Hirsch JK. Self-compassion, affect, and health-promoting behaviors. Health Psychol. 2015;34(6):661-669. doi:10.1037/hea0000158
Adams CE, Leary MR. Promoting self-compassionate attitudes toward eating among restrictive and guilty eaters. J Soc Clin Psychol. 2007;26(10):1120-1144. doi:10.1521/jscp.2007.26.10.1120
