Note: this transcript has been edited for clarity, grammar, and flow.

Steph: You can stick with rigid types of meals, food groups, or calorie limits, but at what cost? What do you want to do with your life?

Hello and welcome to episode three of the InsideOut Institute podcast. My name is Steph Boulet, host of the podcast, and for this episode, I had the honour of speaking with one of Australia's leading eating disorder dietitians, Fiona Sutherland, also known as The Mindful Dietitian. We touched on a lot during our chat, including mindfulness and yoga and how they relate to food and eating. We spoke about so-called normal eating, intuitive eating, diet culture, and dealing with excessive hunger.

But before we get to that interview, we’re going to hear from someone with lived experience - Jenny. Jenny developed bulimia nervosa around the age of 10 and struggled with an eating disorder for the next 50 years before finally getting the help she needed.

Jenny: The eating disorder was all about survival. It's not a lifestyle choice; it's a coping mechanism. Something was going very badly wrong inside. The way I’ve always described my life, until a year or so ago, was that I was an eating disorder. Everything else, whether it was being an occupational therapist, a mother, or a wife, wasn’t really me, because at my core, I was the eating disorder. Yes, I could do all the good things that a mother does, but I didn’t truly own being a mother. At the end of the day, my world revolved around food and vomiting. That’s how I got through everything.

The biggest impact was on my relationships. I couldn’t connect with people on a true level because I was so ashamed and disgusted with myself. If we were going out for dinner or a party, all I could think about was what I was going to eat. It was that constant sense of not fitting into the world. My husband and I moved here two years ago, and I looked around for help. I found an eating disorder day program that ran two or three times a week, with one-on-one sessions with a psychologist and a dietitian. That was brilliant because, for the first time in my life, I spoke to someone else who had an eating disorder, and by that point, I was nearly 60.

I had always thought, This is my fault. I truly had no idea that an eating disorder was an illness. And to be honest, I still struggle with that idea. I thought I should just stop and stop feeling sorry for myself. I never felt safe telling people. But being in a dedicated eating disorder recovery program, surrounded by professionals who understood, was completely different. You didn’t have to explain yourself. You could spend that time actually looking at what was going on - why it was happening, how you could do things differently. I learned about food and, more importantly, how not to be afraid of it.

I used to wake up in the morning already freaking out about the day ahead: what was on, what I was going to eat. Now, if I start feeling anxious, I just sit down and do a meditation, and it grounds me. I have flexibility. I eat when I’m hungry. I don’t have to be home to eat. I can go out for coffee with people, I can go out for lunch, I can go out for dinner and that is a big step. I’m really excited because, for the first time, I actually own all the things I do. I’m no longer just an eating disorder. Yes, I might still have struggles, but I am a mother, and I have a great relationship with my children. I can’t make up for what happened in the past, but I can fully embrace my life now.

Steph: Our guest today is the brilliant Fiona Sutherland. Fiona is an accredited practising dietitian from Melbourne with around 15 years of experience in eating disorders and body image. She is a non-diet and Health at Every Size (HAES)-aligned dietitian and a self-described diet culture disruptor. She is the Director of both The Mindful Dietitian and Body Positive Australia and hosts The Mindful Dietitian Podcast - so definitely go and have a listen. It’s fantastic.

She’s also really into yoga. She’s been practising for 10 years and teaches a weekly yoga class. That’s where we started our chat, talking about how yoga and mindfulness inform her work as a dietitian.

Fiona: Mindfulness, for me, really invites us to be present to whatever is, whether that’s an internal experience, my environment, other people, my energy, or even my thoughts - which, oh my God, is so hard. It’s not as simple as just saying, Be present. No, actually being present is something we need to practise, and it’s very intentional.

I always joke about sitting on your yoga mat and just Namaste-ing the crap away but it doesn’t work like that. Our Western culture is so productivity-based. It’s always do, do, do instead of be, be, be. But mindfulness is an invitation to be with, especially to be with the uncomfortable.

Now, we don’t like that. None of us like the uncomfortable. But that’s the other thing about yoga, the way I understand it, yoga is a way to honour our humanness. It’s a way to honour our wholeness. We are not broken. We are not here to be fixed. Yoga invites us onto the mat to connect with our whole self and make room for it, exactly as it is.

I think what’s not spoken about enough is that mindfulness and yoga can be really hard. They can challenge us in so many ways. And yet, as a practitioner, an eating disorder specialist and yoga teacher, I can’t express enough how instrumental my yoga and mindfulness practices have been to my work with people, whether individually, in groups, or within our broader community.

Steph: So how can someone who’s interested in becoming more mindful or even practising yoga get started? Is it as simple as popping on a video on YouTube?

Fiona: I don’t think it’s as simple as just looking it up on YouTube and following along. We need to be thoughtful about things like injuries, vulnerabilities, and most importantly, our reasons for doing it.

For example, if someone has a very busy, highly-strung lifestyle (what we might call a yang personality or type A) where they’re always on, always doing, always anxious, then doing more of that same energy through fast-paced, intense yoga isn’t always helpful. But those are exactly the types of people who tend to gravitate towards it. Instead, what they actually need is more yin - more introspective, restorative, and calming forms of yoga. Yoga works in fascinating ways on our nervous system, which is particularly relevant in eating disorder recovery.

In the eating disorder space, we work with a lot of people who have experienced trauma, whether that’s complex trauma, PTSD, or even just the trauma of living in this world. You know, being exposed to diet culture, to Instagram, to constant comparison - it’s exhausting.

Steph: Yeah, we’re constantly being challenged. And as a diet culture disruptor, why is it so hard for people to eat? Why is it so confusing? There’s micros, macros, clean eating, intermittent fasting…

Steph: Yeah, big breakfast, clean, unclean. I can’t keep up. Can’t give up. Why have we made it so hard for ourselves to know how to eat?

Fiona: I actually think it’s because we’ve become so disconnected from each other as humans, from our communities, from our families, and from ourselves. And I really try to hold that with compassion. Because if we’re feeling disconnected, dieting or strict food rules can be a way to feel some sense of connection to ourselves or to others.

If you're at a gym, for example, you can join a challenge and suddenly feel like you’re part of something, like you’re achieving something. And let’s be honest, that can feel pretty good for the ego.

Steph: Yeah, right. So how does all of this play a part in eating disorders?

Fiona: Oh my God, it’s so intertwined. The way I think about it is as a spectrum. Anyone who’s dabbling in dieting or engaging in disordered eating is only a vulnerability away from a clinical eating disorder.

I really believe it’s a matter of risk and protective factors. It’s like playing with fire; some people get burned, others don’t.

It’s not that everyone exposed to diet culture or the thin ideal develops an eating disorder because if that were true, everyone would have one. But the more we engage in disordered behaviours, the more vulnerabilities can emerge.

And then, of course, life changes play a huge role. A sudden change in body shape or weight, whether from puberty, menopause, a diagnosis, medication, injury, or illness, can trigger disordered behaviours. And there’s actually a specific uptick in eating disorder onset during major body changes, particularly for women.

Steph: That’s really fascinating. Let’s talk about recovery. A common question is, What is normal eating? and How do I get there? How do you direct people back to normal eating?

Fiona: Oh my God, even the phrase normal eating has become so loaded; it’s almost synonymous with normalising disorder now. But if we’re talking about natural eating, I’d describe it as nourishing your body with a wide variety of satisfying foods on a regular basis. And, equally important, feeling positive about your relationship with food and eating.

So there are two parts - there’s the behavioural side (eating enough, regularly, and with variety), and then there’s the emotional side (having a calm, positive relationship with food).

It also means being flexible, enjoying food when it’s pleasurable but also accepting that sometimes, food is just… boring. Like eggs on toast on a Sunday night. Boring as hell, but God, it’s quick.

Steph: Right! It’s about food serving its place in your life.

Fiona: Exactly. And part of that is honouring hunger and fullness, but also honouring your body’s needs, including medical needs.

For example, if you have coeliac disease, I wouldn’t say, Eat everything, including gluten! That wouldn’t be honouring your health. The goal is to eat in a way that supports your wellbeing, physically and emotionally.

Steph: So is intuitive eating the gold standard?

Fiona: Well, in a way, yes because intuitive eating is about honouring both what we want and what we need. Those are two different things. What we want is tied to pleasure, connection, and enjoyment - the things that actually enrich our lives. What we need is about fuel, nourishment, and physical wellbeing.

So, to live a full, recovered life, we need both. It’s not just about getting enough nutrients; it’s also about enjoying food. And sometimes, that means surprising ourselves… or even feeling disappointed. And that’s okay, too.

But you know, both are fine. Both are fine.

Steph: Mindfulness and practical tools. So, for someone who has struggled with eating, how can they return to that place? For example, is there a place for meal plans in recovery?

Fiona: Yes! Okay, so yes, there is. For anyone who identifies with Health at Every Size (HAES), a non-diet approach, or intuitive eating, you might see those words on websites, Instagram, or wherever. And I want to be really clear - these approaches are not anti-weight, anti-weight loss, or anti-meal plans.

We, meaning non-diet eating disorder recovery dietitians, get into tough conversations that are critical for recovery. We don’t take a cookie-cutter approach. We don’t just apply the same formula to everyone. Meal plans are a critical part of establishing stability, rhythm, and consistency in eating disorder recovery. So, if you're in recovery, you need a dietitian on board, no matter what model of care you're using. Dietitians are the specialists who can assess what your body needs and hold that space with you because eating differently, feeling new sensations in your body, and seeing your body change can be terrifying.

Steph: And the body is changing.

Fiona: Exactly. So to make that process less overwhelming, having a team of people around you - people who aren’t giving you false reassurances, like “Oh, it’ll stop in exactly six weeks” is so important. Because when you're deep in an eating disorder, your brain doesn’t believe reassurances that feel too good to be true.

I describe meal plans like scaffolding. A scaffold holds up a building, but it’s not a permanent structure. It provides stability so that we can do the healing inside.

Think of it like a cathedral restoration. First, you fix up the bricks, you fill in the gaps, and then, part by part, you remove the scaffolding. It’s not a Band-Aid ripping-off kind of process.

That said, some people do go “all in” with recovery, meaning they abandon all eating disorder behaviours at once. But for most people, structure is essential.

So, we build up first, then gradually remove the scaffolding, handing back control to the person. That’s when you start making autonomous decisions for yourself and that’s the exciting part.

Steph: Yeah, that’s the exciting part! You're listening to the InsideOut Institute podcast: rethinking eating disorders from the inside out.

A lot of different themes come up in recovery, especially for dietitians. Some of the biggest questions are: Am I eating enough? Am I eating too much? How do I know what’s hunger and fullness?

Fiona: Yes, exactly: hunger and fullness. When I hear those questions, I always think: What’s informing that question? My goal is to open up a conversation about confidence because often, it's not just about food, but about trusting yourself.

Are you feeling confident in your ability to listen to your body? And, more importantly, do you feel capable of responding to what your body is telling you?

Steph: Right, because it’s two steps. First, being able to tune in, and second, being able to respond.

Fiona: Exactly. You can feel hunger, but unless you're willing to respond to that hunger, nothing changes.

Steph: That makes sense. But what if someone's hunger and fullness cues are all over the place because of their past eating disorder behaviours?

Fiona: Totally! That’s where I often reframe “meal plans” as guidelines.

With a dietitian, it’s not about rigid rules, like “Eat this at this exact time”. Instead, we work within flexible guidelines, offering variety and choice while moving towards sufficiency.

Fiona: Whereas if someone is at the stage where they’re starting to tune in a little more to the nuances of appetite, then we can experiment with that a little more. And honestly? That takes a lot of courage. It’s a big step, a brave step. It’s also essential. But if you feel safe with a meal plan or guidelines, how do you take that step out?

This is a question I ask people: You are more than welcome to use this meal plan for the rest of your life if you want to. You can stick with rigid meals, food groups, calorie limits, or whatever it is you feel safe with.

But then I ask: At what cost? What are your values? What do you really want to do with your life? Because, yes, you could stick to the meal plan and survive, but at what cost?

What does a full, rich, and meaningful life look like? What does it sound like? What does it feel like? If you were really embracing all that life had to offer (the full spectrum) what would you be doing?

Because life is not just the good stuff. It’s not just pleasant, fun, and joyful. It’s also disappointing, sad, and mundane. There’s grief, boredom, frustration and everything in between.

And that’s okay. It’s a big, brave step to let go of rigid control, but I fully believe it’s worth it.

Steph: I loved your latest Instagram post, where you shared:

"Six ways to start addressing feeling out of control around food"

1. Feed
2. Yourself
3. Enough
4. Satisfying
5. Food
6. Regularly

This is the exact opposite of what diet culture tells us to do. Can you explain why regular eating is the answer, and not more restriction, when you feel out of control?

Fiona: Yes! I just think that if you speak to anyone who experiences binge eating, and you ask them, What is more distressing: binge eating or emotional eating? Or, you know, however they frame their experience, whether it’s through dieting or restriction, they’ll almost always say, not always, but almost always, that the binge eating or emotional eating is the worst part. I just can’t stand it. I hate it. I feel ashamed. I feel so guilty. I feel so bad about it. But if I could just sustain the diet, I’d be okay.

And so part of my role is to hold space for a conversation around this: What if binge eating and emotional eating were actually very effective and well-intentioned coping strategies? What if they weren’t the problem? What if the real problem was dieting itself but we’ve all been led to believe it’s the other way around?

People have mixed reactions to this. Some feel relief - like, Oh, now I see why this cycle keeps happening. I’ve been putting my effort into the wrong thing. They realise that trying to stop binge eating while still maintaining restrictive dieting is what’s actually keeping them trapped. It fuels the cycle.

Others, quite understandably, feel sadness or even anger. It’s like, Are you seriously telling me that I’ve spent X number of years, often decades, barking up the wrong tree? I don’t think I’ve ever heard someone say it in those exact words, but that’s when the tears come. That realisation - I’ve been duped. I’ve spent years believing that if I could just control my food, my eating, and my body shape, life would open up and everything would be better.

But that never happens. And when people realise this, it’s devastating. It makes me angry too. And that’s why I do this work - because it’s unfair. And not just unfair; it’s deeply unequal.

Diet culture affects all of us in some way across different ages, genders, body shapes, and sizes. It pushes this idea that we all need to be something different. For women, that usually means smaller. For men, that usually means bigger. Not always, of course, it varies but those are the dominant messages.

Where I get particularly frustrated is that while these messages impact everyone, the people who are most harmed are those living in larger bodies. They are deeply stigmatised, not just socially, but within our healthcare system. Even within eating disorder recovery.

There are so many ways in which their needs are ignored. They’re not just told they should be losing weight; our health system actively reinforces this. Instead of offering real support, it keeps perpetuating harm.

So how can we push back against this? What can we do as everyday people to help fight against diet culture?

Well, we could start by burning it all down. That would be a great start! Wipe the slate clean and start fresh. But realistically, I think the most important thing is that we keep talking about it. We need to keep these conversations on the table and stop acting like diet culture affects everyone equally, because it does not.

Diet culture inequitably harms certain groups. It affects transgender people, it affects people in larger bodies, and kids are especially vulnerable. Women, particularly as they age, are vulnerable. It’s not something that impacts everyone in the same way, and we need to stop pretending that it does.

So, the first step is acknowledging that reality and making sure we put resources and support where they’re actually needed.

We also need to stop confusing eating disorder recovery with dieting. If someone in a larger body has an eating disorder, their recovery should never include so-called "helping" them lose weight. But too often, that’s exactly what happens. And it’s not okay.

We either support full recovery for everyone, regardless of their body size, or we admit we’re not actually helping. Those are the only two options. Otherwise, we’re just reinforcing harm and if that’s the case, maybe we really should go back to Plan A and burn it all down.

This is so important.

Steph: For people recovering from being underweight, what’s your message to them, especially if they’re gaining weight and experiencing excessive hunger?

Fiona: That’s such an important question and, honestly, a scary one if you’ve spent months or years suppressing your hunger. Here’s what I want people to know: Hunger is innate. It is hormone-driven. It’s not a sign that something is wrong. It’s actually a sign that your body is trying to heal.

And this isn’t something that happens only to people at very low weights. It can happen across the weight spectrum. Anyone who has chronically underfed their body, whether visibly underweight or not, can experience a strong surge in hunger during recovery. And that’s normal.

It can last for several months, sometimes longer. And if no one has ever told you before that you will be okay, let me be the first to say it: You will be okay. You can trust your body. You can build new skills that help you take care of yourself in a way that doesn’t rely on restriction or denial.

And most importantly, you don’t have to do this alone.

Find a team - people who will hold space for you, support you, and reassure you when you feel scared. Because there will be moments when it’s really scary.

And in those moments, you need people around you who can say:

"We’ve got you. We know you’re scared. And we are right here with you."

And you know, I often say to people if your team is offering you lots of reassurance, not just "things will be okay," but specific reassurances like, "Oh, this will stop in X amount of time," I think we really need to question that. Because the truth is, nobody can guarantee exactly when things will get easier.

But if you have someone who says, "I can see how painful this is for you. I can see how tough this is. I’m so sorry, this is a really sucky time, and I’m here with you," - that’s a completely different approach.

It’s the difference between false promises and true support. It’s like saying, "Steph, I know this is really hard. And I know this sucks. But I’m not going to tell you it will disappear overnight. What I can tell you is that this is part of the process, and I will be here with you through it."

Steph: That’s a bigger life lesson, too, isn’t it? Because you can’t always say, "Everything's going to be fine."

Fiona: Exactly. You can’t stop the hard things from happening. But what you can do is build your skills so that you can ride the wave. You can build resilience. You can surround yourself with good people - people who, when the really serious stuff happens, are still there, saying, "We've got you."

Steph: Thanks for listening. If you’d like to find out more about Fiona Sutherland, visit her website: themindfuldietitian.com.au. She’s also on Instagram and Facebook as The Mindful Dietitian, and of course, her podcast is called The Mindful Dietitian Podcast.

For more on Fiona:

• Website: themindfuldietitian.com.au
• Instagram: @the.mindfuldietitian
• Facebook: @themindfuldietitian
• Twitter: @FionaBodyPosAus
• Podcast: The Mindful Dietitian Podcast

Other relevant links:

• Training for dietitians: Dietitian Essentials: The Treatment of Eating Disorders
• Resource: What is Normal and Natural Eating?
• Blog: What is Normal Eating?
• For more information about InsideOut, visit insideoutinstitute.org.au.

If you or a loved one needs support, visit www.insideout.org.au or call the National Eating Disorders Helpline at Butterfly on 1800 ED HOPE (1800 334 673).