Registered Dietitians get a bad rap for being the “food police”. People think that all we do is help people lose weight. Neither of these things are true! There are dietitians who offer weight loss support; people do tell me their not-so-great past experiences where they felt judged. Even worse, that their concerns were dismissed.

As a registered dietitian and healthcare provider, I aim to give clients an experience that is non judgmental and honors a client’s autonomy. I maintain the mentality to meet clients where they are at. We discuss their goals, health, and experience with curiosity, not judgement. 

My actual job as a dietitian is to use evidenced-based treatment options. These are backed by credible scientific research, to help identify and improve nutrition-related issues. To be honest, half of my time in post secondary education was spent learning how to read and interpret research.


So, what are you supposed to do? When there is research to both support and discourage weight loss as a treatment?

Here is the thing about research – it takes a lot more than one paper to confirm an idea. Like whether weight loss is or isn’t helpful. We’ve got to compile all the credible research. Then weigh the pros and cons of all of them. This is challenging for a lot of reasons. The two biggest reasons are:

  1. this is extremely time consuming
  2. researchers (and the people who fund them) tend to be biased

When looking at the evidence it does seem to indicate that weight loss is beneficial – in the short-term. The problem is that weight loss research tends to neglect long-term results. These studies usually last between 6-52 weeks with almost no follow-up with participants. Then there is the flip side of the coin. Health at every size (HAES) research shows that weight loss is rarely maintained past 1-2 years. Maintenance of weight loss being almost nonexistent 5 years post initial weight loss. 

Additionally, people who have a history of dieting and weight cycling (losing and gaining weight over and over) tend to have a higher body weight in the long run. This is compared to when they first started intentionally losing weight. Ultimately this leads to worse health outcomes compared to people who maintain a higher body weight long-term.

HAES research has also found that improving health through diet, exercise, and other factors without weight changes still provides the same health benefits as the weight loss; but in a way that is sustainable.

It seems obvious when looking at the data to go with a weight-neutral approach.

so why is weight loss still so highly promoted by healthcare providers and the media?

Unfortunately, weight bias, healthism, fatphobia, and sizeism are rampant in North American society and they tend to be highly profitable. Much more funding goes into weight loss research. This includes:

  • new diets
  • exercise programs
  • pharmaceuticals
  • surgical interventions
  • and many other types of treatment

While in comparison HAES or weight-neutral research is growing more slowly. This is likely a result of the length of time covered (decades vs 1 year).

I opt to follow HAES and use a weight-neutral approach. The evidence points to this being the best course of action for my clients’ health and well-being in the long run. The intent to lose weight can harm your mental, social, emotional health; as well as your physical health. There is also the fact that our body size is largely beyond our individual control. Body size is strongly controlled by genetics; similar to height, and the Social Determinants of Health.

Focusing on factors outside of weight loss can still allow you to achieve your health goals. This will be more likely impact our overall health in a positive way.

Setting goals for your health that have nothing to do with weight (weight-neutral) are less extreme because we aren’t striving for weight loss. We can still improve your blood sugar, blood pressure, and lipid levels without weight being a factor.  There are other ways to help reduce the risk of chronic disease and treat GERD without considering weight loss. There’s no need to slash your current diet with a machete to improve your health. Instead we can add in foods and address eating behaviours to improve your specific health concerns.

Where does that leave us?

The approach I use is far more sustainable and achievable. Especially compared to trying to completely overhaul a client’s life to lose weight. We want to ensure we aren’t damaging your mental, emotional, or social health while aiming to improve your physical health. This includes discussing:

  • stress
  • sleep
  • your relationship with food and your body
  • social support networks

This eliminates any other underlying issues affecting your eating. If there are, we will address the issues we can and look for additional support for the issues we can’t. We work together so you can reach your goals and know your efforts can benefit you for life.


**Please note at this time we do not have a Dietitian at the clinic. We are always looking for new providers to serve our community; if you know someone or would like to join us please use  the Join Our Team link.

The public is becoming more aware of the benefits of pelvic floor physiotherapy (PFPT). When we first opened in Warman in 2014, about 20-25% of people had even heard of PFPT! Now there appears to be an assumption that leakage or pelvic floor pain issues ONLY happen to people that have had kids. That it can’t happen for those who have never been pregnant or given birth before – but that is not the case!

Pelvic Floor Dysfunction

There are people of all backgrounds and ages of any gender, who suffer from pelvic floor problems. There are many different reasons for why this may be the case. First, here are some issues that are common symptoms:

  • low back or hip pain
  • leaking of urine (or stool)
  • pain (with intercourse or otherwise)
  • night wetting (or waking to void)
  • constipation
  • hemorrhoids
  • pressure/heaviness (feeling like things will fall down/out)
  • tailbone pain
  • pelvic girdle pain (SIJ, hips, pubic symphysis)


Some of the reasons for pelvic floor dysfunction include post op complications or side effects from surgeries performed in the abdominal or pelvic region, radiation therapy to the pelvis due to pelvic cancers, prostate issues, and menopause. Stress, anxiety, and overall pressure system problems can also be an underlying cause.

Weigh the Risk

There are some risk factors that may contribute to leakage of the bladder including:

  • chronic strain to the pelvic floor from a persistent cough (ie smoking or asthma/COPD)
  • chronic constipation
  • highly athletic populations (especially with a vagina)
  • individuals that have obstetric injuries
  • someone that has had trauma to the pelvis
  • anyone that has received abdominal surgery

Our athletes in particular may have some leakage issues or heaviness/prolapse symptoms. This may be associated with heavy lifting or running/jumping sports due to the strain that can be placed on the pelvic floor with these activities. The exercise itself is unlikely to be the culprit, but the strategies being used may be contributing.


The Pelvic Floor and What you Consume

There are some behavioral components that may impact urinary leakage as well including:

  • consuming or drinking caffeine(!!) and carbonated beverages
  • spicy foods
  • citrus foods
  • alcohol (red wine in particular!)


Our Pelvic Floor Helps us Compensate

Sometimes anxiety can have a role as well if we have a tendency to hold too much tension in the pelvic floor muscles. This in turn can contribute to pelvic pain or incontinence issues – or even constipation!

People with chronic pain conditions such as:

  • endometriosis
  • irritable bowel syndrome
  • inflammatory bowel diseases
  • interstitial cystitis

…for example may have tightness in their pelvic floor muscles which may be contributing to some of their pain presentation. Sometimes back or hip pain can actually be originating from the pelvic floor. When someone has had “problems forever” and they haven’t seen a PFPT – this is often a good place to start.


How does PFPT Help?

A PFPT can be helpful as part of the medical care team in addressing pain that may be contributed to by the pelvic floor muscles. PFPT utilize various techniques, either with internal manual therapy techniques or external techniques. If the client is comfortable with internal, this via a vaginal or rectal exam. Some people are not comfortable and we can proceed with education and exercises for relaxation/stretching of these muscles.


If there is urinary leakage then there can be behavioural techniques that a pelvic floor physiotherapist can teach to help address these issues. This is especially true if there is leakage preceded by a strong urge to pee. Should there be weakness of the muscles then this can contribute to leakage of the bladder or bowel as well. Although this weakness is not a common finding, it can happen post operatively in the pelvis or abdomen. Regardless of the reason, a PFPT can be helpful in teaching specific exercises to address the issues.


If you are having problems with any of these issues seeing a pelvic floor physiotherapist may be beneficial:

  • leaking with laughing/coughing/sneezing
  • leaking due to urgency of the bladder
  • chronic constipation
  • pain with intercourse
  • pelvic pain/low back or hip pain (especially if addressing the back and hip tissues with prior rehab does not appear to be resolving the issue)

If you are finding yourself worried about what to expect as an adult coming for a first appointment, check out this blog!


Ready to take control? Book your assessment today in Warman HERE and in Saskatoon HERE


December is a time for being with friends and family and usually losing your regular routine for a while. That’s okay, even if that means your eating changes. Many people tend to both look forward to and dread the food that comes with the holidays. Here’s why you should just eat the cookies without feeling bad.


Foods we eat during holidays or family events are generally not foods we eat all the time. This is a special time with your family and friends and the food served tends to follow suit. It’s also special. The holidays can bring guilt and shame and other uncomfortable feelings for a variety of reasons, but food should not be one of them. Do these foods have more fat, sugar, and dreaded calories than your normal diet? Probably. Could you end up gaining a few pounds? That’s a possibility. If thinking about these things makes you nervous you need to ask yourself why. 


A cycle to break

A few weeks of eating special foods may lead to a few extra pounds, but a few weeks of getting back to your normal routine will have your weight back to normal. This may not be the case for everyone though, especially if you have an all-or-nothing mentality around diet, have a history of dieting or restricting foods, or are planning to lose weight in the new year. All of these reasons can lead to bingeing which can start, or continue, the cycle of restriction and bingeing which leaves people in worse health than when they started. 


If you are wondering if you are at risk for this kind of behaviour, consider how you feel about these special foods. Do they bring up more uncomfortable emotions than comfortable ones? Are you considering what actions you will have to take after eating this food, like skipping meals, severely increasing your movement, starting a new diet, or only eating low calorie foods after the holidays? If so, you may need to change your mentality around food, diet, and body size. This sounds like a lot of work and it is. Thankfully, there are a lot of resources to help.

Changing the status quo

Changing your mentality and doing all of that work has a lot of benefits. When it comes to the holidays, the negative feelings concerning all the special food you and your family and friends lovingly prepared will be heavily outweighed by nostalgia, joy, comfort, and pleasure. The food at these events may be culturally important, time consuming, or expensive to make but they are served because they represent something to the people present, something that often equates to love.

This holiday, just eat the cookies, the ham, the yams, the latkes, or the stollen.




Check out what I do in our previous blog for more information!


**Please note at this time we do not have a Dietitian at the clinic. We are always looking for new providers to serve our community; if you know someone or would like to join us please use  the Join Our Team link.

Pelvic floor physiotherapists are physios who have had additional training to perform external and internal pelvic exams in order to treat a variety of pelvic floor disorders. Among those disorders include some that pertain to the dysfunction of the bowel – your behind. These anorectal disorders may include

  • Leaking of stool from the rectum (fecal incontinence)
  • Inability to control flatulence (being unable to hold back a fart)
  • Chronic constipation
  • OASIS (obstetric anal sphincter injuries) which include 3rd or 4th degree perineal tears sustained during labour and delivery, rectocele, rectal prolapse, and pain disorders of the anus
There is something we can do to help!

Fecal incontinence refers to the uncontrolled passage of fecal material (aka poop) in individuals who are 4 years old or older. There can be various reasons why fecal incontinence may be present. There may be damage to the internal or external anal sphincters during OASIS. Radiation therapy for certain pelvic cancers may have reduced the ability of the rectum to stretch contributing to incontinence, stool consistency may be too liquid making it difficult for the sphincters to stop the feces from exiting the anus (possibly due to partial bowel resection surgery due to various medical conditions. Food intolerances/poor diet may also cause stool consistency to be too loose. There may be some weakness in the external anal sphincter muscle or the puborectalis portion of the levator ani muscle (the main pelvic floor muscle group) contributing to leakage of stool.

Some leakage can be due to nerve disorders (example multiple sclerosis). Sometimes even chronic constipation can be a source of loose stools leading to fecal incontinence!


What does it mean to have a 3rd or 4th degree tear during labour and delivery?

A 3rd degree tear is a tear into the external anal sphincter and a 4th degree tear includes tearing into the internal anal sphincter. These two sphincters are what control the exit of the stool and gas out at the anus from the rectum. When there is a tear in the sphincters, the scar tissue that forms from the injury may cause problems. Common issues to these injuries include having pain during bowel movements and it can contribute to constipation. There can also be low tone of the IAS or EAS (internal or external sphincters) or weakness of the external anal sphincter that may cause fecal incontinence or difficulty with controlling an unwanted fart. Fecal urgency can also be a symptom following 3rd or 4th degree vaginal tears.

Even if there is no bowel dysfunction in the post partum period following labour and delivery with a 3rd or 4th degree tear, having a pelvic floor physiotherapist examine the pelvic floor and provide an individualized home exercise program to optimize the scar tissue mobility, pelvic floor mobility and strength, and provide education on optimization of defecation strategies. This can be very helpful as sometimes occult injuries (meaning those without obvious injury to the anal sphincters) are present. They could result in symptoms like fecal urgency and loss of control of farting or fecal incontinence later in life (post menopausal).

Proactive treatment can be beneficial in these cases!

Chronic constipation is often characterized by:

  • having a bowel movement less than 3 days/week
  • and/or a stool consistency on the Bristol Stool Chart of Type 1 or Type 2
  • history of very large bowel movements (plugging the toilet for instance)

A pelvic floor physiotherapist can be helpful in providing various strategies to assist with the evacuation of the bowels. Some basic recommendations may include:

  • general advice on fibre and fluid intake recommendations for optimal stool consistency
  • activity recommendations
  • manual therapy techniques to assist with motility of the stool through the rectum
  • education on various physical evacuation strategies
  • breathing techniques to assist with optimal bowel evacuation
  • minimization/elimination of straining




For those suffering from prolapse, a physiotherapist can help by teaching optimal defecation techniques to reduce strain to the area, thereby reducing strain to the tissues. There may also be too much tension in the pelvic floor muscles or there may be scar tissue present from obstetrical or other surgical injuries which can lead to pain in the pelvic floor or anus with or without having a poop.

Struggling? Book online with a physiotherapist today in Warman at Warman Physiotherapy & Wellness or Saskatoon, at Warman Physio Saskatoon. Don’t see a spot that works? Add yourself to the waitlist! You can even select if you have a therapist, location, and day/time preferences!



This post was created by Maja Stroh MPT and pelvic health physiotherapist at Warman Physiotherapy & Wellness

Jessica Braun Dietitian

Hi, I’m Jessica the dietitian. I’m a private practice dietitian which means I don’t work for the Saskatchewan Health Authority (SHA). I see clients both in-person at the clinic and virtually. Clients are usually looking for a private practice dietitian because their doctor told them to see a dietitian and the SHA dietitians are all booked up or not accessible to them. They often feel like they have no idea what to eat. Or they are sick of trying to lose weight and want to find an alternative to improve or maintain their health.

My appointments generally run from 45-60 minutes. This may seem long but we go over so much information and get into a lot of detail to find the best path for you. Don’t worry about trying to remember everything though! I send post-appointment summary emails along with any resources you may need. 

I see clients of all ages for a wide variety of reasons:
  • type 2 diabetes
  • heart health
  • digestive conditions and gut health
  • disordered eating
  • food allergies and intolerances
  • reducing disease risk
  • learning how to meal plan and incorporate new foods into your diet
  • introduction to solids
  • picky eating

After all of that you might be wondering, “but, what don’t you do”? I’m glad you asked. There are a couple things: weight loss, diagnosed eating disorders, and type 1 diabetes. I also don’t create meal plans but I can teach you how to make your own.

Telling people I can’t help them lose weight often leaves them confused. That doesn’t mean we can’t reach your health or eating goals! I’m a weight neutral dietitian meaning weight is not a factor in our discussions or goals. I won’t ask you how much you weigh, we won’t talk about BMI, and I won’t ask you to track your weight. We brainstorm strategies that have nothing to do with weight loss, creating goals that are tailored just for you and sustainable for the long-term


Check out this blog on Halloween candy for a little more information about how I work, or check out my social media on Facebook, or IG (@jessicabraunrd)



**Please note at this time we do not have a Dietitian at the clinic. We are always looking for new providers to serve our community; if you know someone or would like to join us please use  the Join Our Team link.