Designed to help mental health consumers to find information essential to their continued good mental health related to binge eating disorders, emotional eating, compulsive eating disorders and obesity help.

Weight Management: It's Not Just What We Eat
by Mimi Rubenstein,

Too fat, or too thin, or just fine?

Daily we are bombarded with media reports that overweight and obesity are at epidemic proportions in the U.S.  The medical ramifications of obesity include heart problems, cancer, joint problems, diabetes, and respiratory problems just to name a few.  The litany of health concerns grows by the day.  They are all reasons to lose weight.

Our children's generation is doomed to developing weight issues and serious accompanying illnesses because of a sedentary lifestyle, lack of exercise, decreasing emphasis on physical education, unbalanced school lunches, sugary drinks, over-sized fast food portions.

We are shamed into thinness with pictures of stick-thin celebrities that serve as our models.  Celebrity award commentators are known to evaluate stars on how thin they are, correlating this with success, and comparing them on the weight continuum to appearances in previous years.  In addition, the tabloids feature candid pictures of high profile people with "unattractive fat deposits" and graphic pictures of a very overweight public as our warnings.  This generates a variety of quick fix solutions that are marketed to the public.  The media abounds in news stories and advertisements of fad diets: low-carb, low-fat, meal plans with prepared foods, meal-replacement drinks, fat-busting pills and quick solutions.  "Lose weight; join weight watchers; try our weight loss program; try our weight loss product; buy our weight loss pill, try this weight loss diet"--the list goes on and on.

It is important to note the extreme need or pressure to be thin.  There are reports of well-known people who are suffering from eating disorders such as anorexia and bulimia that make the headlines.  It helps make us aware of this significant issue.  The pressure to live up to the "thin" ideal has great impact on society.  This drive for thinness is a major problem that requires attention.  Anorexia and bulimia are serious disorders that can have major medical implications and require treatment.  "Lose weight; try weight watchers; try our weight loss program; try our weight loss product; buy our weight loss pill, try this weight loss diet"--the radio commercials play on and on.

With this barrage of information on fatness and thinness, we are overwhelmed.  We are deluged with extreme "do's and don'ts" regarding food and diet.  It's no wonder we are baffled about weight and about what is healthy.  It is a challenge to determine how to find balance in our lives.  "Lose weight; join weight watchers; try our weight loss program; buy our weight loss product; buy our weight loss pill, try this weight loss diet"--the TV commercials roll across the screen.

The diet-overeating cycle
and balanced eating

Overeaters are inclined to stuff themselves with food and then diet until they are seriously underweight and sometimes suffering from life-threatening malnutrition.  They lose touch with the biological cues of hunger and fullness that could guide them in knowing when and how much to eat.  Their emotional hunger leads them to eat when not physically hungry.  They may consume fatty, sugary "comfort foods" that soothe negative feelings. 

Dietary recommendations to eat plenty of fresh fruits and vegetables, whole grains, lean proteins, dairy and good fats are becoming common knowledge.   Some people can successfully rely on biological cues to fulfill sound nutritional needs while some overeaters must learn to recognize cues of hunger and satiety.  Others with weight management issues need help in determining an appropriate calorie range and creating a healthy diet of foods that are palatable and satisfying for them.  Becoming aware of reasonable menu plans and appropriate food portions are important tools. 

Although these tools are important, frequently they aren't enough to solve overeating and weight problems.  To break the common cycle of dieting oneself into deprivation then soothing oneself with excessive food, it is necessary to assess your patterns of eating.  Trying an extreme "diet of the day", or cutting calories drastically for long periods is doomed to failure.

Personalize the Issues and
Figure Out What Your Food Issues Are!

Many people who overeat have no inkling about how to cope with food, body image and emotional eating issues in a helpful way that addresses their particular issues.  There are diet plans and non-diet plans galore.  How is one to figure out healthy moderation if one is faced with one-size-fits-all approaches?  We each have different issues to contend with. 

Overeaters Experience Different Triggers
for Non-Hunger Eating

1. situational triggers--(being in a restaurant, seeing food advertisements, attending cocktail parties)
2. emotional triggers--(anger, anxiety, boredom, loneliness, fatigue)
3. cognitive (thought) triggers--(" I'm not good enough."  "I'll never be able to compete with him."  " I've already screwed up; I might as well give up.")

In our different family histories, food plays various roles, and children learn different eating habits.  Susan, as a child, may have been given home baked chocolate chip cookies by Mom, when she was hurt or sad, to make her feel better.  As an adult, she still eats emotionally, reaching for those cookies, associating them with the security of mom's presence and soothing negative feelings.  Or Mike, as a child, may have experienced times of celebration and happiness as a time to "throw caution to the wind" and party on whatever food he wished.  Today Mike still celebrates moments of happiness the same way.  

We have different life stresses that can be triggers for emotional eating.  One sometimes feels stressed in the work environment to achieve and meet deadlines.  Or perhaps you are pressured by your business or social network to join the group for pizza and beer in order to get a business deal, "be one of the boys" (or girls), and feel a sense of belonging. 

John has a common behavior chain that leads him to overeat:
•  His boss reprimands him for missing out--not getting an important business contract.
•  He feels hurt and his self-esteem plummets. 
•  He passes by Crispy Crème on the way home from work and buys a half dozen donuts.
•  He eats one, then two, maybe three, while in the car in heavy traffic.
•  He feels "like a pig."
•  He feels guilt and shame for stuffing himself.
•  He makes a resolution to go on a strict diet and eats a small dinner.
•  He skips breakfast the next morning.
•  He eats a little salad for lunch.
•  He's famished by dinner time and feels deprived.
•  He goes grocery shopping and buys a lemon meringue pie which he begins to eat as he unpacks his groceries.
•  He says, "I blew it, I might as well give up" and eats the whole thing.  

Can you see all of the triggers John encountered?  What triggers are likely to set off a chain of unhealthy eating for you?  To break the common diet-overeat cycle, you need to take the time to figure out your own, personal weight management puzzle.

Body image

Body image is an important area to address.  One may want to lose weight in order to be the "perfect size."  Anything less than one's ideal weight and size just won't do.  Although one may have made great strides in reaching a healthy, natural weight, one may look at oneself and be unhappy.  "I still feel fat",  "My hips are still huge", "I'm still not night-club material" may be thoughts that come into mind.  Working toward acceptance of oneself, what one has achieved, and the positive qualities that we all possess are important aspects of weight management treatment.  Media ideals are difficult and mostly unrealistic to achieve.

  The helpful role of exercise

We have different physical exercise habits; some of us being sedentary and not accustomed to exercise, and others using movement as a way to feel good or relieve stress.  Perhaps some people with weight issues will benefit from adding movement into their daily lives.  It can boost metabolism, alleviate stress, improve mood and address health concerns.  Bob may enjoy doing a daily trip to the gym;  Alice may enjoy a routine of walking with a supportive friend, exercising and combating feelings of loneliness; Joe likes to work in his garden and play golf with his buddies a couple of times a week.  Whatever exercise one does must meet one's needs and be experienced as a positive activity. An  "exercise because we should" attitude rarely leads to lasting lifestyle changes.  Getting moving in a way that fits your personality, gives you pleasure and can be adapted to your daily routine is ideal.

A program tailored to you

A balanced, healthy lifestyle and a reasonable weight should be based on an assessment of one's emotional and physical needs, not media influenced solutions.  To help you understand your patterns, seek counseling from a therapist/counselor who specializes in these issues and can help you evaluate your situation.  What is the role that food plays in your life?   Can you identify the emotional and situational triggers that cause you to overeat or eat when not hungry?  Are you prone to eat when under stress, angry, anxious, sad or bored? 

It is important that you figure out how you can cope with your feelings in more effective ways.  Food doesn't cure anger or hurt; it can only temporarily numb.  Are you accustomed to eating for celebration, or because you feel it's socially necessary, or part of the business scene?  Perhaps it's time to determine what is healthy and appropriate for you and how to assert your needs into without feeling awkward or selfish.  You are the only one who can care for your health and well-being.

A healthy, natural weight is a good goal to reach for.  Everyone has a different build and different genetics.  If one comes from a family that tends to carry more weight, and one has been on the heavier side for a lifetime, it is unreasonable to expect oneself to be at the low end of the standard weight ranges.  We all have different builds: lanky, stocky, and all the variations in between!  Modest weight losses of 5-10% have significant effects on one's health and well-being.  It is important to set realistic goals that are achievable for you and that you can maintain.

Achieving your dream weight may be difficult to do, or hard to maintain if achieved.  Your physician may be helpful in assisting you to determine an appropriate weight range and in monitoring any health/medical problems.

Weight issues and the bigger picture

Important questions that one should ask oneself are, "Why do I want to lose weight?"  What do I want to achieve by it?"  Loss of weight, in and of itself, is often not  the sole solution to one's problems.  Weight loss is not the solution to shyness, to feeling insecure about one's value or feeling that one "doesn't fit in."  Although weight loss may contribute to feeling healthier, and having better self-esteem, it must be combined with working on one's goals from other perspectives.  Working on self-care, addressing emotional issues, challenging negative thinking, adding exercise to one's life, and finding support systems. are all important parts of a well-rounded approach to Weight and Lifestyle Management.

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Mimi Rubenstein, MSW, LICSW, has a private practice in Weight and Lifestyle Management serving the greater Seattle and East Side on Mercer Island, Washington and can be reached at (206) 236-0707.  This document is Copyrighted© 2005 by CounselingSeattle.com, Floyd Else, Webmaster, and may not be reproduced, in whole or in part without crediting the author, source and site name. All rights reserved.

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Brain & Obesity: Bad News

In a study of 275 women, Swedish researchers found that a higher body mass index (BMI) was associated with more temporal-lobe atrophy, a shrinkage in brain volume that seems to lead to dementia. (The temporal lobe plays a key role in such functions as language, comprehension and memory.) Obesity could contribute to dementia in several ways. One theory is that excess fat leads to hardening of the arteries and impairs oxygen flow to the brain. Or the hormone cortisol, found in abundance in obese people, may be linked to brain atrophy. This research indicates that staying a health weight throughout life can slow atrophy and dementia. [Medical Update, Reader's Digest, February 2005]

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" Mirror, mirror on the wall, who's the fattest one of all?"

National Eating Disorders Association

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