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.
[No unsolicited guest blogs accepted, thank you]
Karen's Blogs
I’m disturbed whenever I meet with a client who’s had difficulty with the medical community due to being higher weight. That’s because there’s such rampant fat bias and weight stigma among these professionals. To remedy that situation, Paige O’Mahoney, MD, and I wrote Helping Patients Outsmart Overeating: Psychological Strategies for Doctors and Health Care Providers a review of which can be found at https://www.karenrkoenig.com/blog/my-new-book-is-out-helping-patients-outsmart-overeating. Study after research study provides evidence of doctors, nurses and health providers offering inadequate treatment to higher-weight patients. Some admit to their bias about people they consider to be “fat” or “obese” and some fail to recognize their prejudice while it continues to inform their practice and harm their patients mentally and physically. Common problems include blaming the patient for being high weight and for their health problems; expressing patronizing, condescending, and contemptuous attitudes toward them; and misdiagnosing medical conditions based on the assumption that if patients...
One of my clients made an amazing discovery I want to share with you. Her worries about food began as a child when her mother insisted that the family eat totally clean and she was forbidden to eat sweets and treats. When she wasn’t thinking about food—what she should and shouldn’t eat—she was thinking about weight—how much she’d gained or lost. Eventually, she began to rebel against her mother’s rigid food rules while thoughts about food and weight consumed most of her mental energy. Fast forward to today when she’s evolving into a “normal” eater. One day in therapy she shared an ah-ha moment: She’d spent most of her life obsessed with either eating or weight. During non-diet times, she fantasized constantly about cravings and what foods she wanted to binge on and berated herself after emotional eating. When dieting, she rarely thought about food because she knew exactly what and...
I heard that Weight Watchers has had a makeover. Disclaimer: I’ve never been to a meeting but am blogging about them anyway. What I have to say isn’t based on firsthand knowledge, but on what I’ve read about the new “WW” and heard from numerous clients over the decades. The company started in 1963 and has touted itself as a weight-loss program ever since. Many of you probably are familiar with their philosophy and practices because you’ve gone to meetings, used their online services or know Weight Watchers’ members. The group is known for its eating plan which assigns points to all foods and drinks to help members make “healthier” choices and eat smaller portions—to lose weight. According to “Before and After” (The Economist, 10/20/18, page 61-2), Weight Watchers officially became “WW” as part of rebranding itself after a steady decline in memberships and profit for years. Claiming to encourage “beyond...
I have several friends whose eating style involves “cheat” days. In fact, I’ve heard that there are diets that promote food restriction during the week and cheating on the weekends. As an eating disorders therapist, the idea of cheat-eating has always seemed like an unproductive idea and encouraging it as a way to pull us farther away from, rather than closer to, “normal,” regulated, appetite-cued eating. The main reason is that the word cheating makes us feel as if we’re bad and doing something wrong. That perspective assumes that eating a slice of chocolate cake, enjoying a few potato chips or enjoying a buffet dinner is akin to sinful. What does that tell our poor brains? One thing it does is confuse them. It makes us think that some foods are bad and others are good and that we are bad or good for eating them. Mainly, it makes eating feel...
Here’s a newspaper headline that’s a prime example of why people have difficulty becoming “normal” eaters: “A party menu that won’t ruin your diet!” This makes it sound like a diet is something you’re on temporarily as if you might give up a diet someday, like an escalator on which you step on and off. Instead, lifestyle is a moving sidewalk you stay on to move forward and keep moving forward. The idea is not to think of eating a particular way as temporary, but as permanent. Let’s just get rid of the word diet or dieting, period, and talk about what we’re really looking at: a lifestyle change, a new habit. It’s ongoing, not on and off. It’s forever, not for the moment. This is an example of how diet (versus) lifestyle thinking goes: Say, your friends all order dessert after a restaurant dinner. Diet-think would go something like this:...
Though I’ve treated hundreds of clients who are recovering from chronic dieting, it wasn’t until one remarked on her decades of restrictive eating making her feel as if she had Post-Traumatic Stress Disorder (PTSD), that I recognized their similarities. Recurrent restrictive eating may, indeed, feel traumatic and recovering from dieting—not just from emotional or binge-eating—may have lingering traumatic effects. Decades recovered from restrictive eating, the memories of those awful years are still painfully vivid: the deprivation I felt from saying no to food while others ate whatever they pleased, my obsession with thinness and the intensity of shame and self-hatred I felt after my relentless bingeing, my focus on what and how much I ate above all else that sorely needed my attention, and my low self-esteem because I couldn’t seem to feed myself well no matter how hard I tried. Trauma has varying definitions, but we generally view it as...
For all of us who have dieted and for those of you who frequently or occasionally feel tempted to restart a diet, here’s a simple explanation of why most people cannot keep weight off by weight-loss dieting. It makes perfect sense. Your mind might want to be dieting (although most minds sensibly dislike giving up culinary pleasure), while your body inevitably starts to fight back when you deprive it of calories on a regular basis. It’s time to face facts and recognize that learning to be a “normal” eater is the only way to become healthy and fit, establish a comfortable weight for life, and enjoy a positive relationship with food and your body. Here’s the skinny on why diets don’t keep weight off long-term according to “How Did We Get Here? Explaining the obesity epidemic” by Kevin Hall (Nutrition Action Healthletter, July/August 2018, pp. 3-5). Describing the results of a...
I’ve blogged about psychology professor Dr. Traci Mann’s well-researched book, Secrets from the Eating Lab, and recently came across an article summarizing her findings. Honestly, though, she writes so well and with such laugh-out-loud humor, that I recommend reading her entire book. I read it cover to cover when I was delayed at an airport and couldn’t believe how quickly the time past. Her article is entitled “Why do dieters regain weight? Calorie deprivation alters body and mind, overwhelming willpower” (Psychological Science, May 2018, accessed 5/29/18, http://www.apa.org/science/about/psa/2018/05/calorie-deprivation.aspx). Here are some excerpts from it. I refer you to the article itself for citations. • “…weight regain is the typical long-term response to dieting, rather than the exception.” • “…calorie deprivation leads to changes in hormones, metabolism, and cognitive/attentional functions that make it difficult to enact the behaviors needed to keep weight off.” • “…after sufficient calorie deprivation, weight is lost, and therefore...
Recently I’ve been thinking how curious it is that most of us have such a challenging time going from chronic dieting and overeating to “normal” eating. I include myself as one of those people. Yes, habits die hard, but dieting has its own unique challenges and is—pardon the pun—no picnic, so why do we fight so hard to give it up? Imagine if you were a “normal” eater and forced to restrict your food intake, that is, to eat when and how much someone else wanted you to eat and to forget about your own appetite cues. This person would boss you around and tell you how much and when to eat or not eat. No matter what you felt like eating, Bossy Pants would insist that you override your cravings and partake of what he or she wanted you to eat instead. Want a piece of pie at Thanksgiving? Too bad:...
I had a long discussion with a client about what a comfortable weight for herself would be. Having spent time years before engaged in anorexia, bulimia and binge-eating, it made sense that she didn’t know, now that she was eating more “normally,” what a healthy weight would feel like. I understood. This is an issue for many women I treat. Honestly, it doesn’t seem to be as much of a quandary for my male clients. We looked at this issue from several angles. First, we talked about cultural pressure to look a certain way. For those of you who are young, please know that it wasn’t always this way, and that now there’s almost no escaping it. My grandmother, who was considered a great beauty in her day and who buried two husbands and then had a boyfriend in her eighties, would have been told she had a too high BMI if...
I love to blog because I love to write. However, I find it daunting to talk about weight and weight-loss because I’m concerned about my comments may come across. Aside from being scrupulous about not using weight in a stigmatizing way, I also want to address readers’ concerns on the subject and be careful not to bum them out by what I say. Every time I post a blog or an article describing scientific evidence that weight is strongly genetically based, I get a pang of discomfort. If I write that obesity is highly heritable, I worry that readers will feel pessimistic and lose interest in taking care of their bodies, thinking “What’s the use?” If I write that most people who lose weight regain it or, often, regain more than they originally lost—I fear that I’m blowing someone’s day and that they’ll feel frustrated and helpless to ever find a sustainable...
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.
