Breaking-up with Dieting (For good.)

dieting, weight loss Starting a new diet can feel like starting a new romantic relationship—exciting, hopeful, and thrilling at first. Dieting promises that when the weight is lost, life will really begin.

The reality of dieting.

Just like a new relationship, starting a new diet usually feels really good. There is ease in following a new diet because you don’t have to feel preoccupied about what to eat.  While there is effort in planning meals, there is this sense of relief that goes along with it. This dieting euphoria can last for a while. Just like a new relationship, starting a new diet usually feels really good.Continue reading

The (Biological) Dilemma of Dieting & What You Can Do About It

dieting We forget that food is necessary to survive. Food is not optional. Dieting makes us think we can go without carbohydrates, fats or other food groups. But, we just can’t. Food and eating are not about willpower, it is about biology.

Dieting leads to food preoccupation

The most basic function of our brain is to keep us alive. When our basic needs are not being met, our bodies experience stress. Our brain sends us alerts to get us what we need. Most diets aren’t sufficient in energy (calories) or macronutrients (carbohydrates, protein & fat). Therefore, our brains alert us that we need to eat.
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Weight Stigma Awareness Week 2015

According to an on-line dictionary stigma is defined as “a mark of disgrace associated with a particular circumstance, quality or person”.  Synonyms of stigma include shame, disgrace and dishonor.  Weight stigmatization is essentially shaming and blaming people about their body weight.

In efforts to promote awareness and ultimately prevention of weight bias in our culture, The Binge Eating Disorder Association sponsors a week long Weight Stigma Awareness Week annually in September.  This year’s theme, held September 21st through 25th, is “Bias and Bullying: Weight Stigma in Diverse Communities.”

Studies suggest that weight bias may actually INCREASE the likelihood of obesity, binge eating and staying obese.

Weight BiasWeight stigma is wide spread throughout our society including areas of employment, education and health/mental health care.  Studies indicate that weight stigma is on the rise in our society.  Weight stigma often is internalized by individuals which can lead to shame, hopelessness, isolation, etc.

A recent study published in Pediatric Obesity (July 2015) found that weight-based bullying is the most prevalent form of bullying in our youth.   This study found that more kids are being teased about their body weight than academic ability, physical/cognitive disables, sexual orientation, race & ethnicity or religion.  According to the Yale Rudd Center for Food Policy and Obesity, the consequences of weight-based bullying increases our children’s risk for depression, anxiety, low self-esteem, poor body image, suicidal thoughts, poor academic performance and avoidance of health promoting behaviors.Continue reading

New Year’s Resolution: Ditch the Diet

New Year's ResolutionYes, that is right.  Set a New Year’s Resolution NOT DIET in 2015 (or really ever again).

Why you ask?  I will give you five good reasons:

1.  Dieting doesn’t work for long-term weight regulation.  Scientists don’t have any good data that shows dieting works consistently in reducing weight, long-term, in populations of people.

2. Dieting can lead to weight gain.  Dieting can produce short-term weight loss, but more often than not, it leads to regaining of lost weight and sometimes even more.  Some clinicians argue that the losing/gaining weight cycle (sometimes referred to as weight cycling) is what causes health problems in overweight and obese individuals (Versus elevated body weight.).

3.  Dieting is a known risk factor for developing an eating disorder.  The causes of eating disorders are very complex and researchers have identified several risk factors for developing an eating disorder which include dieting, temperament, gender, etc.  Not to say that all people who diet will develop an eating disorder, but it may increase your risk.

4.  Dieting can make us feel a little crazy.  At the start of a diet there is promise that the diet will bring control over eating (and sometimes our lives).  But, ever notice when you are dieting that you spend more time thinking about food?  Or that when your dieting you begin to feel very uncomfortable around food?  Maybe you avoid certain social situations because you are dieting.  I would argue that dieting leads to more preoccupation with food, weight/shape which leaves less head space to think about other things.

Additionally, when we aren’t able to follow our diet (Not because of laziness or lack of will power by the way, see 1#.) it can lead to an increase in feelings of shame and failure. These feelings can often drive us further from self-care and in some people it can lead to OVEREATING.

To learn more about the psychological effects of food restriction click here.

5.  Dieting doesn’t equal improved health. See #1, #2, #3, #4

In my next few posts I will discuss further reasons why dieting doesn’t work and what one might do as an alternative to dieting.

An ED Professional’s Opinion on FDA’s Requiring Calories

Food LabelingI feel so so very torn about the FDA’s new requirement of putting calorie counts on menus of restaurants, movie theaters, amusement parks, etc…..I do not recommend people tracking their calories to regulate their weight or for health reasons as it gets us away from eating intuitively.

Calorie counting promotes dieting behavior (which we know doesn’t work for long term weight regulation).  Dieting is a known risk factor for developing an eating disorder (ED).  And calorie counting may exacerbate eating disorder symptoms in someone who is in recovery from an ED.

And to my knowledge, the jury is still out if putting calories on menus is helpful in improving overall health.

On the other hand, I do think we need to improve the quality of our food in this country in order to promote the health of our nation and our environment.  I wonder if requiring food establishments to be transparent about calories, if it would force the food companies to improve overall food quality???

I am the first one to admit I don’t have the answer to our dilemma, but I do feel like Life Time Fitness may be onto something here…  In their magazine, Experience Life, in their recipe section they do not include nutrition information (calories, carbohydrate grams, etc.) . Unlike other popular “health magazines”.

Not only does Experience Life magazine exclude nutrition information of their recipes, they go the extra mile and provide a health promotion message instead.  Here is their explanation as it appears in their recipe section of the magazine:

“Why No Numbers?

Readers sometimes ask why we don’t publish calories, carb and fat counts with our recipes.  We believe that if you’re eating primarily whole, healthy foods (array of sustainably raised vegetables, fruits, nuts, seed, legumes, meats, fish, egg, whole-kernel grains, and healthy fats and oils), you really don’t need to stress about the numbers (which are often inaccurate or misleading anyway).  We prefer to focus more on food quality and trust our bodies to tell us what we need.”

Sounds good to me.  Folks what do you think????

Medical System: Friend or Foe in Reducing Body Shame?

Aren’t we suppose to feel good about the medical care we receive?  Don’t we want to feel empowered by our medical team to improve our health?  And we certainly don’t want to feel ashamed of our bodies when we visit a medical provider.  Unfortunately, body shame and frustration is what some feel when they leave their providers office.

It has been my clinical experience that people often feel shame about their weight when going to the doctor.  I think this is particularly true for those with larger bodies.  According to a 2012 Rudd Center for Food Policy and Obesity policy brief titled “Weight Bias: A Social Justice Issue” indicates that in a study of 2,449 overweight or obese women, 69% experienced weight bias by doctors.  And 52% indicated that weight bias had occurred on more than one occasion.  Rudd Center’s policy brief indicates that weight bias in medical practices is a deterrent for seeking medical and preventive care.

Weight Stigma Awareness week sponsored by the Binge Eating Disorder Association (BEDA) was last week .  I was glad to see that BEDA had an information sheet (Toolkit ) on how to talk with your provider medical about weight.

Unfortunately, well meaning and highly qualified health professionals including doctors, can sometimes be a barrier to patients accessing medical care.  Part of the work that I do with clients is to help them navigate the health care system in such a way that feels empowering vs. demoralizing.

Here are tips to help feel empowered, not shamed, about body weight at medical appointments:

Before going to the doctor take stalk in how you feel about your body.  Do you feel as though your body weight is affecting your health?  Do you believe that you have to be a certain size to be healthy?  Have you experienced bullying from family or friends about your body?  Are you comfortable in your body?  Do you have a distorted body image?  Getting clear about your own experience and beliefs about your body may make it easier to communicate with your healthcare team around body image.

Remember we are health care consumers.  Just like we shop around for a new car-visit different dealerships, test drive different makes and models-we can shop around for medical providers.  For example, if trying to find a new primary care doctor schedule an initial appointment with the sole purpose of assessing if the doctor is a good fit for you.  Think of it like taking a car for a test drive.

Before visiting your doctor think about how you want the discussion of body weight to go.  BEDA’s toolkit suggests encouraging  your health care team to “focus on health vs. weight”.  Imagine yourself saying something like,”I know body weight is one component of my health.  I am here today to talk about how else I may improve my health, besides focusing on my weight.”  Or, “I am looking for a new primary care doctor that I can collaborate with.  My last doctor ridiculed me about my weight.  How can we make that different in your office?”  If you are not ready to have a discussion with your doctor about your body weight then state that.

Write down questions ahead of time.  And if comfortable, bring a friend or family member along to the appointment.

Click here to read the toolkit from the BEDA.

 

Today Kicks Off Eating Disorder Awareness Week

February 23rd through March 1st, 2014 is National Eating Disorder Awareness Week.  The National Association of Eating Disorders (NEDA) sponsors a week long event to raise awareness of eating disorders.

This year’s theme is “I Had No Idea”.  Key points, taken directly from NEDA’s website, of this year’s awareness week include:

Eating disorders are serious illnesses, not lifestyle choices.

Eating disorders are complex illnesses that arise from a combination of long-standing behavioral, emotional, psychological, interpersonal, biological and social factors. As our natural body size and shape is largely determined by genetics, fighting our natural size and shape can lead to unhealthy dieting practices, poor body image and decreased self-esteem. Body dissatisfaction and thin ideal internalization are both significant risk factors for the development of eating disorder behaviors like restricting and binge eating. While eating disorders may begin with preoccupations with food and weight, they are about much more than food. Recent research has shown that genetic factors create vulnerabilities that place individuals at risk for acting on cultural pressures and using food to feel in control or manage overwhelming emotions.

In the United States, 20 million women and 10 million men suffer from a clinically significant eating disorder at some time in their life, including anorexia nervosa, bulimia nervosa, binge eating disorder, or other specified feeding or eating disorder (OSFED).

 

Education, early intervention, and access to care are critical.

Early diagnosis and intervention significantly enhance recovery. If not identified or treated in their early stages, eating disorders can become chronic, debilitating, and even life-threatening conditions. A review of nearly fifty years of research confirms that anorexia nervosa has the highest mortality rate of any psychiatric disorder . As a culture, it is time for all communities to talk about eating disorders, address their contributing factors, advocate for access to treatment and take action for early intervention. You can make a difference: do just one thing to initiate awareness, education and discussion about eating disorders in your community. If we all do something, we’ll have a tremendous impact!

Help is available, and recovery is possible.

While eating disorders are serious, potentially life-threatening illnesses, help is available and recovery is possible. It is important for those affected, and their loved ones, to remember that they are not alone in their struggle. Others have recovered and are now living healthy fulfilling lives. Let the National Eating Disorders Association (NEDA) be a part of your network of support. NEDA has information and resources available via our website and helpline:  www.NationalEatingDisorders.org, NEDA Helpline: 800-931-2237.

 

 

Part 2: How an Eating Disorder (May Have) Saved Your Life

“Your eating disorder kept you a float when drowning,” Dr. Anita Johnston, author of Eating in the Light of the Moon.

In my last post I discussed that eating disorders can often be understood as a coping skill.  That is, the eating disorder may help one deal with the ups and downs of life.  Of course the problem with having an eating disorder as a coping skills is that it reeks havoc on ones health, personal life, occupation, etc.  I am not proposing that if you have an eating disorder that recovery should not be a goal.  However, I believe that seeing an eating disorder as a coping skill can help provide a framework to more effectively move through recovery.  How does your eating problems help you cope with life?

In Dr. Anita Johnston’s video “The Log” offers viewers a metaphor for the eating disorder that offers this perspective.

How an Eating Disorder (May Have) Saved Your Life

 

How-to-Use-Emotion-Regulation-Coping-Skills-300x300

I am being dramatic in saying that your eating problems saved your life, but my point is that your eating disorder or eating problem may have helped you in some way despite all of the pain it has caused you and your loved ones.   Please don’t misunderstand me I am not suggesting that you stay in your eating disorder if you are currently struggling with one.

Eating disorders do have many negative consequences, some that are life threatening.  And most likely your eating disorder in some way has helped you cope with life, hurt, family issues, trauma or other types of pain or discomfort.

In the world of psychotherapy we talk about coping skills, tools to use when life gets uncomfortable.  Coping skills that are encouraged are ones that help us through life’s challenges and that have few or no negative consequences.  Examples include hobbies, talking to friends, meditation, exercise, journal writing, etc.  Conversely coping skills that are discouraged, because they usually are associated with negative side effects, include things like excessive spending or drinking, avoidance, withdrawing, substance abuse, over or under eating, purging, over exercising etc.  What I am suggesting is that your eating problems or eating disorder may be helping you cope with life in someways.

Most of us are familiar with the negative consequences of say binge eating or purging, but don’t realize that these behaviors may also provide a short-term relief from anxiety or stress.

Seeing eating problems or eating disorders as a coping skill offers perspective and can help reduce feelings of shame and guilt often associated with eating disorders.  I am not proposing that those who suffer from an eating disorder should continue with their eating disorder, I am simply saying it can help to see the disorder for what it is and can be a powerful step in healing from eating problems.

It can be empowering to say “Yes,I have an eating disorder and it helped me in a lot of ways, but now I want to learn new ways to cope with life”.

In my next post I will share a wonderful video clip of Dr. Anita Johnston who uses a metaphor to further illustrate this idea.