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Karen's Blogs

Blogs are brief, to-the-point, conversational and packed with information, strategies, and tips to turn troubled eaters into “normal” eaters and to help you enjoy a happier, healthier life.Sign up by clicking "Subscribe" below and they’ll arrive in your inbox. 

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Body Compassion

Body Compassion
Working on a new book, I’ve been struggling to find the best word to describe how I wish people with body shame would feel about their bodies. Helping clients feel better about their bodies is one of the most difficult parts of my job. As I’ve blogged previously, making peace with a body that you’ve hated for a long time takes some doing, but is crucial to becoming a “normal” eater and engaging in self-caring practices.  Many words are used to describe the positive feeling we want to have about our bodies and none seem quite right. One is “loving” your body. But, I understood when clients counter that saying they love something they don’t want feels inauthentic and like a lie. Another word is “accepting” your body. Clients’ objection has been not wanting to say “it’s okay” to something they want to change. Although I’ve tried to explain that we...
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Try Body Neutrality

Try Body Neutrality
One of areas in which I get the most push back from clients is when I talk about body positivity. The idea of loving a large body which everyone in the world seems to hate is just too much to take in for many higher weight clients. It’s also difficult for people who would like to stop dieting and eat more “normally,” because of their terror of gaining weight and becoming like the people, fat, that is, that they’ve learned to hate.  If you’re in either group, Sonalee Rashatward, social worker and activist, has a message for you about substituting the quest for body love and acceptance with body neutrality. (“What We Can All Learn From the Fat Sex Therapist” by Alexandra Jones , https://www.phillymag.com/be-well-philly/2019/09/18/fat-sex-therapist/ , Philadelphia, 9/18/19, accessed 9/20/19). While fighting fat phobia and weight stigma and many other prejudices, she makes the point that: “. . . those struggling to...
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Why It’s Hard for People to Give Up Weight Shaming

Why It’s Hard for People to Give Up Weight Shaming
Although I usually enjoy comedian Bill Maher’s humor on his show Real Time, I was appalled and disgusted at his misinformed fat shaming monologue in September. Just like “obesity,” fat shaming is a complicated subject and there’s no simple answer for it. But there are five reasons that it occurs.  Lack of civility People fat shame because we live in a highly uncivil culture where everyone thinks they have the right to say whatever they want to everyone else. Due to the advent of social media, very little is kept private anymore. There was a time (younger folks will need to trust me on this) that people, for the most part, kept their religious and political opinions to themselves. Of course, humans always have gossiped, but that was the point—it was done privately, one-to-one or in a small group, not blabbing our judgments to hundreds or millions of people. We say...
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It’s Time to Stop Our Body Critiques

dance class
I have eyes, ears, a nose and a mouth that all are in decent working order. I proclaimed this aloud one night after waffling about whether I looked okay to attend an evening dance class of people I’ve known for years. My proclamation was my way of saying I’m done worrying about how I look. I really want to be free of this ridiculous pre-occupation. As I tell clients, sometimes we just need to get fed up with our own silliness. Especially as women, we need to stop our obsession with self-grooming. Because I don’t think in all-or-nothing ways, I’m not suggesting that we give up caring about our appearance. It’s fine to care but, as with eating, we need to be able to say when enough is enough.  We acquire this mistaken idea that we need to look a certain way from our personal family experience growing up and from...
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My Article on Weight Stigma

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Weight stigma may be more dangerous for higher weight people than carrying around a great deal of weight. Culturally generated, fat blaming and shaming have reached the heights of hysteria in this country. Whether you carry a higher weight or rigidly restrict food or purge in terror of weight gain, it’s crucial that you understand the health and mental health damage that internalized weight stigma poses.  Here’s a recent article I wrote for therapists on treating internalized weight stigma. (“Three Steps to Challenge Internalized Weight Stigma” by Karen R. Koenig, LCSW, M.Ed., https://www.socialworktoday.com/archive/exc_0719.shtml , accessed 7/12/19) As an eating disorders therapist, I treat many high weight clients. Some are 40 pounds heavier than they would like to be, while others weigh over 300 pounds. In either case—in fact, in most cases—clients who weigh more than the norm have internalized culturally-induced weight stigma which is damaging to both their physical and mental...
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Can a Genetic Score Predict High Weight—and Do You Care?

Studies
Watch out for studies that predict “obesity.” There’s science on both sides of the question, but other issues to consider. One is a person’s reaction to what weight they’re predicted to be. Telling people that they’re genetically inclined to be of high weight, can backfire and cause them to throw up their hands and think “Why bother eating healthfully or exercising? I’m already doomed.” Moreover, shouldn’t we be focusing on health rather than weight, since people can be healthy at different weights?  Researchers such as Amit Khera of Massachusetts General Hospital and the Broad Institute of MIT and Harvard and his colleagues studying obesity prediction do so in the “hope that the score will help erase the stigma associated with obesity and shed some light on the biology behind the condition. Although people with high genetic risks may have a harder time avoiding weight gain or losing weight, they also might...
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Watch Out for Internalized Weight Stigma

Watch Out for Internalized Weight Stigma
Many higher weight clients feel ashamed of their large bodies and what they perceive as their failed attempts to trim them down. However, some high weight clients don’t feel that way at all. They understand that a complex, partly random, combination of factors, including, paradoxically, their considerable and repeated efforts to lose weight through dieting, have contributed to their size. The difference between the two groups of clients is that one internalizes weight stigma and the other doesn’t. Weight stigma is the culturally-induced perception that being high weight is bad and that someone is bad because they are higher weight. According to the Binge Eating Disorder Association, weight stigma—aka weight bias or fat bias or weight-based discrimination—is discrimination, negative judgment, shaming or stereotyping based on a person's weight, size or shape. Such prejudice may happen in dating, health care, education, friendships, employment and in any aspect of life.  Such judgment is...
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Weight Stigma and the President

  I try not to wade into political waters on Facebook or in blogging, but Donald Trump has stepped onto my territory and my job of addressing weight stigma and fat-shaming. His comments at an August rally are perfect examples of fat bullying, groupthink, and the psychological defense mechanism called projection. Here’s what happened. Reports CNN, “At a 2020 campaign rally in New Hampshire on Thursday night , a protest broke out. A Trump supporter sought to remove the protesters. And as that was happening, the President of the United States yelled this into the microphone: ‘That guy's got a serious weight problem. Go home. Start exercising. Get him out of here, please. Got a bigger problem than I do. Got a bigger problem than all of us. Now he goes home and his mom says, 'What the hell have you just done?'” (“Donald Trump bullied a man as overweight, then...
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Body Acceptance Doesn’t Mean Not Wanting to Change

Whether you have pain that’s short-term, say a severe headache or a broken bone, or chronic and long-term, as can happen with fibromyalgia or neuropathy, you may be using food as a crutch to get you through the day. Being in pain can steer you toward the refrigerator in several ways, but you can learn not to let it do so—and improve your health at the same time. You may turn to unhealthy food: · For comfort from pain because you hurt badly and wish to feel better. Who could blame you for that? However, food is not meant for comfort, except occasionally. Especially if you’re suffering is ongoing, you may be telling yourself it’s okay to eat lots of sweets and treats because you feel so miserable. Or because life’s not fair. But, it’s not okay to mistreat your body when it’s already feeling awful. It’s far better to find...
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More on Self-objectification

“Self-objectification occurs when women view their bodies as objects, existing for the pleasure of others” and “… is associated with an increased risk of poor body image.” ( Dryden, C., & Anderson, J., 2019. “The dark triad, trait-based self-objectification, and body image concerns in young women.” Personality and Individual Differences, 145, 1-8. DOI: 10.1016/j.paid.2019.03.015, accessed 3/23/19) Another definition is that “Self - objectification occurs when individuals treat themselves as objects to be viewed and evaluated based upon appearance. ( Chiara Rollero and Norma De Piccoli , “ Self-Objectification and Personal Values: An Exploratory Study” ( Frontiers in Psychol ogy, 2017; 8: 1055, doi:  10.3389/fpsyg.2017.01055 , accessed 3/23/19) Though self-objectification is primarily a problem for women based on society dictating that female beauty means having a certain shape and size, it’s also a problem for some men. It occurs not only due to approval-seeking and people-pleasing but to fear that others will...
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Self-objectification

Self-objectification is common among people who turn up in my office. It involves internalizing “an observer’s perspective” about ourselves. More specifically, body self-objectification is an unhealthy way of viewing our bodies through the values of others or of society. “Self-objectification is associated with increased risk of poor body image, depression, and eating disorders” and, when studied, “was most consistently and positively associated with neuroticism, perfectionism, and narcissism across multiple studies.” (Carrotte, E., & Anderson, J. R. (2018). “A systematic review of the relationship between trait self-objectification and personality traits.” Personality and Individual Differences, 132, 20-31. DOI:10.1016/j.paid.2018.05.015). Of the three traits listed above, neuroticism and perfectionism are the ones I see in most dysregulated eaters. Neuroticism is seen in a personality tendency toward guilt, shame, anxiety, self-doubt, and self-deprecation. Neurotic clients do a great deal of putting themselves down, feeling insecure about decisions, ruminating about the past, obsessing about the future, worrying...
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What If You Didn’t Care So Much about Your Appearance?

What if you didn’t care so much about your appearance? What if you could flip to the other side of the continuum about your looks and feel a decreased sense of their importance to you? What if you could expend less time thinking about your face, body, and hair because you hate how it eats up so much effort and energy and simply don’t want to live with such a spirit-killing pre-occupation. Before you insist that this metamorphosis could never happen to you, take a deep breath and just consider “What if?” Ask yourself: What if I could care less about my appearance? What if I could change? You know how to do it: You used to adore certain friends and now don’t, were wild about particular songs and no longer listen to them, or were fiercely wedded to political or philosophical ideas and now wouldn’t be caught dead believing in...
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What Higher Weight Adult Children Want Their Parents to Know About Them

Some of my most heart-breaking work is with higher weight adults and their parents, usually mothers. The pain of both child and parent is evident, as is their frustration, confusion and helplessness about how to discuss matters of weight. I write this blog to give guidance to both parties partaking in this family therapy experience. Generally parents (usually Mom) and adult children (usually Daughter) haven’t been in therapy together, but sometimes times they have a long, unhappy history of family therapy. In either case, here’s what each typically feels as therapy begins. My higher weight client feels highly vulnerable speaking directly with her mother about such a tender subject, for the first or umpteenth time, expecting to be blamed and shamed. Equally, Mom (or Dad, or Dad and Mom) come in feeling frustrated, helpless and guilty. Most often Mom is also worried about her child’s health which adds to the difficulty...
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The Destructive Power of Internalized Weight Stigma

Many higher weight people think that weight stigma may only affect their self-perception and self-esteem. Not so. It may also negatively impact their health. According to research (Himmelstein, M. S., Puhl, R. M., & Quinn, D. M. (2017, November 9). Weight Stigma and Health: The Mediating Role of Coping Responses. Health Psychology. Advance online publication. http://dx.doi.org/10.1037/hea0000575 , accessed 11/17/17), “A large and methodically diverse literature links exposure to weight stigma to a range of poor health outcomes including obesity, weight gain, metabolic syndrome, physical activity avoidance, heart disease, stress, and depression.” For this reason, “…it may be useful to address weight stigma and coping in the context of weight management and obesity treatment programs, to help protect individuals from negative health effects of experiencing weight stigma.” If you have depression, anxiety, low self-esteem or difficulty accepting your body at a higher weight, weight stigma may be having a negative impact on...
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Time to Give Up the Body Shame

While reading our local paper, I came across a photo captioned “Dancing to support first responders” which really caught my eye. The photo was of a couple dancing the tango. Each was what our culture might call “overweight” or what I prefer to call on the higher end of the weight spectrum. The pose they struck showed their grace and dancing prowess. The story accompanying the photo was about why they chose to be in a charity dance competition to benefit such an important cause.   I immediately thought back to the two clients I’d seen the day before who’d complained that they were too large and embarrassed to be seen exercising. Both came from highly judgmental families, but neither was of such a high weight that she couldn’t jog, dance, or exercise. I’d seen both bound up the path to my office when they were running late for a session,...
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Big Can Be Beautiful – Only You Can Change Your Body Image

STRONG WOMAN KK
Image by Debbie Digioia     No matter what our weight, too many women (and men, to a lesser degree) think it’s natural to vilify fat and, if you’re of a high weight, that you need to feel badly about it. Can we all agree that we live in a fat phobic, thin-obsessed society—and it’s been that way for far too long? It’s so normalized into our society that fat is out and thin is in that you may not know that there was a time, as I do nearing age 70, when norms were otherwise, back in the days of zaftig beauties like Marilyn Monroe and Jayne Mansfield.   I discuss body image often with clients and sometimes with friends, and have come to recognize two unequal perspectives about being large in our culture. The first is to shrug and say that these are the norms and that all we...
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What Are We Really Afraid of in Becoming Fat?

When clients talk about not wanting to be “fat” or become “fat,” I ask them what exactly that means to them. What images do they conjure up, what do those images say about them and the society we live in, and what is having a “fat” body all about for them, whatever their current weight? Does “fat” mean the same thing to men and women, young and old, all races and ethnicities? Fat used to mean having accumulated enough money to eat well and was a sign of wealth and status. Just as lawns were a (status) symbol of having excess land beyond what a person needed to farm and grow food or raise livestock, fat was a way of indicating that you had plenty, in fact, more than you needed. In a world of food scarcity, it was a way of flaunting excess and success. In my middle-class childhood, being...
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How to Talk with Young Girls about Weight

You may think that, because of your own eating struggles, you know how to talk with your daughters (or nieces or granddaughters) about weight. Or, never having had eating or weight concerns, you may not pay much attention to what you say about their bodies or their eating. Either way, here’s the latest research on the subject. You Can't Talk to Girls About Their Weight by Carleen Wild (LifeZette, retrieved 6/17/16, http://www.lifezette.com/healthzette/you-cant-talk-to-girls-about-weight/ ) is based on research by Brian Wansink, PhD, who was inspired to study this subject because he has three daughters. His take home message is that parents need to be extremely careful about what they say to their female progeny about their bodies. “His team found that women who recall comments from their parents about their weight are more prone to being overweight as adults and less satisfied with their weight than other people.” Of course, this is...
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5 Ways to Help Stop Fat Shaming

No matter what your size, gender, or age, you can play a part in stopping fat shaming—whether it’s done privately by someone you know or publicly by someone like Donald Trump shaming a former Miss Universe contestant’s weight gain and opining that a recent hacking of the Democratic National Committee could have been done by “somebody sitting on their bed that weighs 400 pounds.” (“The shame of fat shaming,” by Gina Kolata,10/1/16, http://www.nytimes.com/2016/10/02/sunday-review/the-shame-of-fat-shaming.html?_r=0 ) Science writer Gina Kolata describes studies on the impact of weight stigma on children and adults. The effects are real, harmful, and they’re lasting. Finally, fighting discrimination against higher weight people is becoming a major issue in this country and the movement behind it is growing stronger. It’s taking its rightful place next to movements to end prejudice against people of color, women, gays, lesbians, transgendered people, and the physically challenged. What are you—yes, you in particular—doing...
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Body Image and Fear of Rejection

One of the most debilitating issues about having a high weight is the stigma attached to it by this culture. The debilitation comes in great part from fear of social rejection. My hunch is that how you feel about rejection in general is a major factor in how you perceive negative reactions to your weight or body size in social situations. In “Unpacking the psychological weight of weight stigma: a rejection-expectation pathway” (Journal of Experimental Social Psychology, vol. 63, 3/16, pp. 69-76), authors Blodorn, Major, Hunger and Miller studied expectations of social rejection in women and men who had various body weights and BMIs. No surprise that “Men’s responses were largely unaffected by body-weight” in the dating context of the experiment. However, the study concluded that, “As predicted, high body-weight women reported increased expectations of social rejection…which in turn predicted decreased self-esteem, increased self-conscious emotions, and increased stress.” Of course, culturally...
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This website is owned and operated by Karen R. Koenig, M.Ed., LCSW. It contains material intended for informational and educational purposes only, and reasonable effort is made to keep its contents updated. Any material contained herein is not to be construed as the practice of clinical social work or of psychotherapy, although adherence to applicable Florida States, Rules, and Code of Ethics is observed. Material on this website is not intended as a substitute for medical or psychological advice, diagnosis, or treatment for mental health issues or eating disorder problems, which should be done only through individualized therapeutic consultation. Karen R. Koenig, LCSW disclaims any and all liability arising directly or indirectly from the use of any information contained on this website. This website contains links to other sites. The inclusion of such links does not necessarily constitute endorsement by Karen R. Koenig, LCSW who disclaims any and all liability arising directly or indirectly from the use of any information contained in this website. Further, Karen R. Koenig, LCSW, does not and cannot guarantee the accuracy or current usefulness of the material contained in the linked sites. Users of any website must be aware of the limitation to confidentiality and privacy, and website usage does not carry any guarantee or privacy of any information contained therein.  Privacy Policy