While visiting a friend, she mentioned being happy about having lost weight and asked how much I weigh. I said I didn’t know, at which point she asked if I wanted to use her scale, perhaps thinking the reason I don’t know is because I don’t own one. I politely declined, saying that I know what I eat so I don’t need to know what I weigh.  On the drive home, I was thinking about our interaction. My first thought, quite frankly, was that what I weigh is none of most people’s business. I grew up at a time when the scale was not an obsession and I don’t recall general discussion of body weight until I was a teenager and had begun dieting and binge-eating.    My second thought about the interaction was curiosity: Why would someone want to know what I weigh? I think my friend was comparing her...

What an interesting discussion I had with a client about why she weighs herself. It turns out the answer is more complicated than either of us expected. It seems like there are two possibilities: one is to see if weight-loss progress is being made and the other is to enjoy a reward for the work put into becoming a “normal” eater. Naturally, it’s important for people to feel they’re moving toward success. In terms of progress, there are many ways to measure advancement. Why we choose the scale rather than other methods is more about culture than anything else. We’ve been told by society over and over that low weight equals beauty and by the medical establishment, that weight equals good health and that we should weigh ourselves often. The scale has long been judge and jury on those subjects, the arbiter of whether you were good or bad, healthy or...

Some of my most difficult moments as a therapist come from discussing weight with high-weight clients who continue to hold fast to yearning to shed pounds. It’s a touchy subject which I wrote about recently in the Gurze-Salucore newsletter in an article entitled “Navigating Weight-loss Discussions with Higher Weight Clients”:   “I confess: Although I’ve been an eating disorders therapist for 30-plus years, have written eight books on eating, weight and body image, posted more than 1,600 blogs, and am recovered from binge-eating disorder for half a lifetime, I still find it daunting to talk about weight-loss with higher weight clients. These discussions rarely seem to go well, no matter that I’ve had hundreds of them.  Here are two examples. When Leann, in her late fifties, called me for help managing her eating, she was in the midst of moving abroad where she’d also be deepening a serious romantic relationship. During...

When clients tell me they’re desperate to lose weight, they usually mean to go on some sort of diet and restrict calories. When I ask them what happened after they dropped pounds in the past, they often think a moment and restate their goal: they don’t want to lose weight; they want to lose it and keep it off. Ah, I tell them, no wonder they’ve had trouble in the past, because the latter is a different skill set than shedding pounds. To lose weight, clients tell me they need to exert self-control, deprive themselves of foods they love, say no to food more often than they say yes to it, constantly monitor their weight, never overeat, consume only healthy foods, obsess about what goes into their mouths, and constantly think about food. This process likely sounds familiar to you.  The problem is that most people (about 95% of us) can...

If you’re a regular reader of my blogs, you know I don’t write about ways to lose weight because a scale focus is bound to sabotage learning to eat “normally.” However, a recent article, Our Food Is Killing Us, presents such compelling facts about how ultra-processed food makes us fatter, that I couldn’t not write about it. It also speaks to how food manufacturers intentionally load up these foods to make them super appealing and habituating and how their production is geared to put weight on anyone who eats them. For more information on processed foods see my previous blogs about its dangers.  Here's how ultra-processed makes us fatter. Fructose, the commonly sweetener in our foods used in high concentrations, “destroys or inactivates several key enzymes needed for the healthy function of mitochondria . . . which causes a backlog of unprocessed glucose to circulate in the bloodstream and store it...

I’m sure I’ve had conversations with clients about falling off the proverbial wagon before, but a recent one really got my dander up. Where does this analogy come from and how come we use it so much? Is it helpful to think of recovery with wagon analogies or might the concept actually be hurtful? Can you guess where I stand on the idea? The phrase came into usage around the end of the 19th century and referred to people who said they preferred to drink from a water wagon than imbibe alcohol. The analogy has been used freely in the field of addictions ever since though it’s actually a dangerous concept implying, as it does, the tight control one needs to remain on a moving wagon and the disaster it would be if one fell off one.  There is no wagon when it comes to recovering from an eating disorder because...

Sadly, because society is not giving up on stigmatizing higher weight people any time soon, if you are higher weight and want to live without feeling its oppressive impact, you’ll need to stop believing that being unable to lose weight or keep it off is a moral failing. There are people fighting to eradicate weight stigma, but change takes time. In the meantime, you can buy into the lie that there’s something dreadfully wrong and defective about you for being higher weight or you can stop internalizing this falsehood.  The results presented in “Living With Obesity: Expressions of Longing” or even reading the abstract describing this study (V. Ueland, PhD, RN, E. Dysvik, PhD, RN, B. Furnes, PhD, RN, 1/22/20, https://doi.org/10.1177/2377960819901193) are enlightening and provocative. They conclude that many higher weight individuals believe that their size is a burden to them and others. They’re “subjected to a cultural understanding that obesity...

There’s been a debate raging for centuries about the role that nature versus nurture play in how we turn out. One aspect of this dispute is whether it’s socialization or biology that turns us into dysregulated eaters and people who carry high weights. Although I can’t settle the debate for you, I can provide scientific information for you to decide yourself. “Obesity is in the genes” by Jeffrey M. Friedman, MD, PhD (Scientific American, 10/31/19, https://blogs.scientificamerican.com/observations/obesity-is-in-the-genes/, accessed 11/8/19,) explains why a weight-loss focus will likely fail. Here’s some of what it says about eating and weight:  “In aggregate, the genes that control food intake and metabolism act to keep weight in a stable range by creating a biological force that resists weight change in either direction. Moreover, the greater the amount of weight that is lost, the greater the sense of hunger that develops. So, when the obese lose large amounts...

Clients who struggle to keep their weight down often ask me how they can burn more calories and boost their metabolism. They’re not asking about exercise. They’re looking for a quick fix—pharmaceutical drugs and illegal methamphetamines to help them lose weight or keep it off. Back in my dieting days, I recall taking some over-the-counter pills myself for that purpose, but all they did was to keep me awake when I wanted to sleep. Devotee of science that I am, it amazes me that people get away with making false or unproven claims that their process or product will boost metabolism. And, let me tell you, these top selling books do better than mine do which are about learning how to eat in tune with appetite. I understand why, but it still makes me angry because desperate people are getting duped into something that doesn’t work. Says Michael Jensen, director of...

Many people with eating problems have other addictions as well, such as spendingmore time on the Internet than they’d like or is beneficial for them. In fact, weight-lossdieting and Internet usage have a great deal in common. To learn how, read on. David T. Courtwright, author of “Caught in the Web” (Newsweek, 6/14/19, pp. 12-13),says that designers format games to hook you in and ensure you’ll come back formore—like how food companies whip up combinations of sugar, fat, and salt to ensureyou can’t eat just one. Gamers get hooked on 1) “goals just beyond the user’s reach; 2)unpredictable but stimulating feedback; 3) a sense of incremental progress and hard-won mastery; 4) tasks or levels that gradually become more challenging; 5) tensionsthat demand resolution; and 6) social connections to like-minded users.” Sound like weight-loss dieting? Many are designed to keep you hooked on them, not tohelp you become happier or healthier. Forget...

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...