I spent years thinking I just needed a better diet.
A better plan. More structure. More willpower. If I could just find the right set of rules and actually follow them, I’d stop pulling into the Wendy’s drive-through on the way home after a brutal shift. I’d stop demolishing whatever snacks showed up in the call room at 2am while I waited for a delivery. I’d stop ordering pizza the second I walked in the door because cooking anything felt completely impossible.
But here’s what I know now that I didn’t know then: I wasn’t failing the diets. The diets were failing me — because they were the completely wrong tool for the problem I actually had.
If you’re a woman physician who feels out of control around food, this is the most important thing I can tell you right now. Diet culture has been handing you the wrong answer. And until you understand why, you’re going to keep feeling stuck, keep blaming yourself, and keep wondering what the hell is wrong with you.
Nothing is wrong with you. Keep reading.
Why Diet Culture Was Never Built for This
Diet culture is built around one question: what should you eat?
Low carb. Low fat. Intermittent fasting. Mediterranean. Whatever is trending on TikTok this month. The entire industry is focused on food — what you put in your mouth, how much, when, in what combination.
And here’s the problem: stress eating, emotional eating, and binge eating are not about food.
They are about your brain using food to solve other problems.
Think about the 3pm cookies in the break room. Those cookies didn’t get more delicious at 3pm. They’ve been sitting there all day. What changed is that you’ve been going full tilt since 7am, you haven’t had a real break, you’re dreading the stack of charts waiting for you, and your brain is done. Your brain has learned — correctly — that going to get those cookies gives you a little break, a tiny hit of dopamine, a quick burst of energy. It works. In that moment, it genuinely works.
Your brain is doing something wrong. The problem is that it’s a band-aid. It covers the real thing for maybe 20 minutes, and then the band-aid falls off and everything is still there — the exhaustion, the overwhelm, the charts. But at the moment, your brain can’t see that far ahead. It just knows: food helped.
Diet culture has absolutely nothing useful to say about any of this.
The Iceberg Nobody Talks About
I think about stress eating like an iceberg.
The eating itself — the cookie, the drive-through, the half bag of chips — that’s the tip. It’s visible. Easy to see. Easy to target. But underneath? There’s a massive amount of stuff that’s actually running the show. The chronic exhaustion. The emotional weight of carrying other people’s health all day. The unmet need for a real break. The stress you’ve been pushing down since your first difficult patient encounter at 8am.
Diet culture only looks at the tip of the iceberg. It sees the cookie and says “don’t eat the cookie.” It gives you a plan to avoid the cookie. And then when you eat it anyway — because of course you do, because the whole iceberg is still there — it tells you that you failed.
You didn’t fail. You tried to solve an iceberg problem with a tip-of-the-iceberg solution.
Why the Perfection Trap Always Breaks Down in Physician Life
Every diet is built on perfection and conforming. You succeed by sticking to it exactly. You follow the rules. You do it their way. And when you inevitably don’t — because you’re human, because your schedule blew up, because you had a brutal day — you’ve “failed.”
That moment of perceived failure triggers a spiral. “I messed up. I blew it. I have to start over. What is wrong with me?” And then — because you already “failed” today — you eat more. And then you feel worse. And then you eat more.
I think about this like those itchy wool sweaters you had as a kid in the 80s. You know the ones. You put them on and they scratch. They’re uncomfortable. They don’t quite fit right. You wined and complained but your mom still made you wear it.
That’s what it feels like to try to conform to someone else’s diet in your real physician life — the 7pm signout that turns into 9pm, the three patients squeezed in at the end of clinic, the lunch that simply didn’t happen.
How are you supposed to be calm and composed with perfect meal preparation in that mess?
The problem isn’t you. The sweater just doesn’t fit.
Why the Scale Makes Everything Worse When You’re Already Struggling
The third thing diet culture got wrong: making the scale the judge of everything.
I know you know this logically. As physicians, we understand that body weight fluctuates, that it tells us very little about body composition, that it’s one-dimensional data. I think about a scale number like a chest x-ray — useful in the right context, but it’s not the whole picture. You wouldn’t diagnose a complex pulmonary condition from one chest x-ray. You’d want more information.
But knowing that doesn’t stop a bad number from ruining your day.
And here’s the problem: when the scale ruins your day, what happens around food? If you’re already struggling with stress eating, that number makes everything harder. You feel like you’re failing anyway. The cookies feel more necessary, not less.
When you’re working on feeling in control around food, the scale is often not a helpful tool right now. What actually matters is stabilizing the eating first — understanding what’s driving the big swings, learning what you actually needed at 2pm instead of the 3pm cookies. Once you do that, your weight starts to respond naturally. Without the restriction. Without the white-knuckling.
What Actually Helps Instead
The thing that’s missing from almost every diet and weight loss program — including what we were taught in medical school — is this: understanding WHY you eat the way you do and HOW to change it.
Not what to eat. Why you eat.
When you understand what’s actually driving your eating — not from a place of shame and self-criticism, but from real curiosity — you can start to address it. You can look at the 3pm cookie pattern and ask: what did I actually need at 2pm? What was really going on? What would have actually helped?
And when you approach your eating with curiosity instead of judgment, things start to shift. The goal isn’t restriction. The goal is feeling in control. The goal is being able to walk past the nurses’ station without it taking any mental energy at all — not because you’re white-knuckling it, but because you genuinely just don’t need it right now.
That’s possible. I know because I’m living it. And I’ve watched the physicians I work with get there too.
If this resonates, listen to Episode 347 of the Thriving As A Physician Podcast below. And stay tuned for the next episode — I’m getting into exactly what to do and where to start.
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