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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Health Goals Are More Important Than Weight-Loss Goals

Most dysregulated eaters find it difficult to give up weight-loss goals, even when they know intellectually that this pursuit, per se, is not the strongest motivator for becoming a “normal” eater. What  about you? What if you could enjoy greater mental and physical health benefits yet your weight stayed the same or didn’t drop as much as you’d like? An article in Obesity, “Mindfulness-based stress reduction in women with overweight or obesity: A randomized clinical trial,” (by Raja-Khan, Katrina Agito, Julie Shah, Christy M. Stetter, Theresa S. Gustafson, Holly Socolow, Allen R. Kunselman, Diane K. Reibel, and Richard S. Legro, abstract, 7 Jul 2017, DOI: 10.1002/oby.21910, accessed 7/21/17, http://onlinelibrary.wiley.com/wol1/doi/10.1002/oby.21910/abstract) concludes that a trial of mindfulness-based stress reduction (MBS) in higher weight women “improved mindfulness, significantly decreased perceived stress,” and that “there was significant reduction in fasting glucose.” However, the study saw no change in women’s weight. In “6 Scenarios Where Intentionally Changing Your Weight...
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You Can’t Hate Yourself Thin

If you follow my blogs, you’ll know that I sometimes remark upon how themes emerge during any given day or week in my practice. During one summer day, it seemed a series of eating dysregulated clients were into vilifying their bodies. They had all somehow reached a boiling point of frustration with their overeating, leaving them mired in disappointment at themselves and bashing their bodies to beat the band. It occurred to me at some point that they were trying their darnedest to hate their bodies thin, and I realized that this is what many people who are dissatisfied with their weight do. As if hating their bodies hard enough would somehow produce the “normal” eating behaviors they longed for. This dynamic made no sense to me then, nor does it now, but I do recognize the pretzel logic behind it: don’t dare accept, love or value your body because if you...
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Be Aware of Thin Privilege

We hear a good deal about white and male privilege, both of which are alive and well and living in the U.S., but we don’t hear much about thin privilege. If you’re reading this blog, you might be all too aware of the benefits and rewards of thinness in this culture and how higher weight people are covertly and overtly effected. You probably recognize on a gut level that thin privilege exists. In case you’d like to learn more or educate others about it, here are some great examples of what it encompasses. According to Everyday Feminism (everydayfeminism.com/2012/11/20-examples-of-thin-privilege/, accessed 6/13/17)), “If you’ve been a ‘normal’ size your whole life, you may have never thought of the benefits of being thin. But sizeism is very prevalent, and it’s one of the most accepted ‘isms’ in our society. And this assumption that you need to be thin in order to be okay and normal...
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What If You Never Lose the Weight?

A topic that has cropped up with clients recently is the question of what to do if they keep trying to eat more healthfully, exercise and take better care of their bodies and still don’t lose weight. Clients dance around this question and I suspect I do too at times. They want reassurance that if they finally “do things right,” good things, aka weight loss, will surely follow, but are terrified that it won’t. And I can’t make any guarantees. The fact is that, even after working with hundreds of dysregulated eaters for three decades, I cannot tell you, a specific person, if you will lose the weight you would like to lose. I’ve had clients lose no weight, some weight, or a great deal of weight. I’ve had clients leave therapy unhappy at their same weight and get in touch down the line (months or years later) to say that the...
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Why Pressuring Yourself to Lose Weight Makes You Want to Eat

A client recently told me about what an odd occurrence that she didn’t understand. She’d just received an invitation to a friend’s wedding that she wished to attend, which made her think about wanting to lose weight which, in turn, made her want to eat. “What,” she asked, “is that about?” It’s about a common paradoxical phenomenon if there ever was one. I hope that understanding this cause-and-effect dynamic will help reduce or prevent it from occurring, while moving you toward a more sane relationship with food and the scale. To understand what’s going on, you’ll want to examine your relationship with dieting and with weight loss and regain. Ask yourself: “What emotions come up for me when I think or talk about wanting to lose weight?” Try to be as specific as possible. I’d wager that the subject prompts fear, frustration, despair, failure, or other negative emotions from your previous experiences trying...
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Bring This Information to Your Doctor, Therapist or Health Care Provider

The White Paper below explains the importance of language in talking about eating disorders, especially about weights at the higher end of the spectrum. Read it over and see what you think and talk with your health care providers about it. WHITE PAPERThe Language of Eating Disorders: What the ED Professional Needs to KnowAddendum: Language Directed to Binge Eating Disorder (BED), CompulsiveOvereating (CO) and People of Sizehttps://www.iaedp.com/Language_of_EDs_Addendum_BED_17.pdf PurposeThe purpose of this addendum is to increase the awareness and educate theprofessionals who work with, treat, or educate, patients with BED, CO, and people of size on the “language” appropriate for this population. Note: The above diagnoses are clearly defined and the professionals working with these patients should be aware of and understand these clinical parameters when using terminology within the patient conversation with insurance reviews, general writing, article submission and presentations at all levels. IntroBinge eating disorder (BED), compulsive overeating (CO), represent the largest population...
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Why Giving Up the Goal of Weight Loss Can Be Hard

Of all the discussions I have with clients, the most difficult for both of us, it seems, is talking about their desire to lose weight. The topic comes up often—for some clients, in nearly every session—and its exploration never gets any easier. I sometimes feel as if I’m being drawn down into a quagmire with every word I utter and believe that my clients feel similarly. Why is it so tough to talk about the perils of a weight-loss focus? First off, clients seem to feel as if I’m trying to snatch something away from them. I even get the feeling that they think I’m a little crazy to be suggesting that weight loss isn’t a great long-term motivator or goal. After all, their doctors and doctors’ nurses, dieticians and, well, just about every health professional they encounter is telling them just the opposite. And then there are the barrage of daily...
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Hefty and Healthy is Possible

Every time I attend a performance by Sarasota’s Westcoast Black Theatre Troupe, I’m impressed by the dexterity, prowess, and showmanship of their dancers. And I’m struck by the fact that if you passed some of them on the street, you might not imagine that they’re the excellent performers that have been wowing audiences since 1999. Rather than being willowy or svelte, several of the dancers are what our weight charts would probably call fat or overweight. Their size certainly doesn’t stop them from singing and dancing for nearly two hours straight (okay, there’s a 15-minute intermission) and entertaining audiences with some complex maneuvers—nothing you’d ever want to try at home. As a tap aficionado myself, I know the intense, sustained energy it takes to do my 45-minute weekly advanced beginner class routine. I can’t imagine doing swing or Broadway show dancing or the like for going on two hours with only a...
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Couples and Weight Loss

Most of you know that I deliberately don’t focus on weight loss in my books. Teaching intuitive eating and improving life skills has a far better long-term payoff, and weight-loss goals function as a barrier to enduring health and fitness. However, I recognize that many troubled eaters wish to shed pounds and that the majority of my blog readers are probably weight conscious. I imagine that a subset of these people are part of a couple who are trying to lose weight and thought an article I read might shed some light on this process (“A few ground rules for weight-watching couples” by Jae Berman, Sarasota Herald-Tribune, 2/28/17, E24) The article makes some great points. Don’t compare weights. If you and your partner are looking to lose weight, don’t compare pounds shed if you’re of different genders because men tend to lose weight more quickly than women do. If you’re a...
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What Label Can You Live With?

For my new book due out in January, Helping Patients Outsmart Overeating: Psychological Strategies for Doctors and Health Care Providers, my co-author, Paige O’Mahoney, MD, and I struggled to find the best ways to describe the patient population we were writing about as well as their concerns. We received input from the Health at Every Size movement (found at HAES) and sought out current research on the subject. One study, “The impact of weight labels on body image, internalized weight stigma, affect, perceived health, and intended weight loss behaviors in normal-weight and overweight college women” (Essayli, Murakami, Wilson, and Latner, Am J Hlth Prom 1-7, DOI: 10.1177/0890117116661982, ajhp.sagepub.com, 2016) explains that there has been a substantial scientific challenge to use of the BMI-related weight labels of “normal, overweight, and obese” because “it does not reflect differences in muscle mass, age and race.” The study’s “results provide initial support for the hypothesis that...
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High Weight Does Not Equal Disease and Death

It’s about time that we start to see articles in major newspapers like this one by Carrie Dennett in The Washington Post, “Does obesity automatically mean poor health” (10/4/16, http://www.heraldtribune.com/news/20161004/does-obesity-automatically-mean-poor-health). We’ve been scolded for decades about fat equaling an unhealthy body and mind and putting those of high weights onto a path that leads to an early death. That’s mainstream media for you, often lagging behind reporting on cutting edge research (described in Body Respect by Bacon and Aphramor or Secrets from the Eating Lab by Mann) that draws surprisingly different conclusions. Dennett writes: “For every study suggesting that as body mass index increases, the risk of chronic disease and early death also increases, there are others demonstrating that people can be healthy—or unhealthy—at almost any body weight.” One such study describes how “‘metabolic health’ was more important than BMI when it came to estimating future health risks.” The truth is that...
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Dieting Is On the Decline

Some of the best news I’ve read in a long time came out in July and didn’t make the headlines. But good news it is indeed. According to “The diet industry is dying as a new mentality takes hold in America” (Business Insider, Mallory Schlossberg, 7/10/16), Americans are shifting from a diet mentality to a healthy mentality. If you’ve stopped joining diet/weight-loss programs or buying “weight-loss” foods, you’re a part of making this happen and should be proud of yourself for taking part in this sea change. It appears that counting calories and deprivation are on their way out, and a focus on eating for health is moving in. An October 2015 report from the market research firm Mintel noted "the diet industry faces downward pressure as US adults also remain skeptical of the ingredients in diet-specific products and their effectiveness in managing weight…Though calorie restriction remained the most popular methodology...
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A Higher BMI May Actually Be Healthy For You

Next time your doctor or health care provider admonishes you for carrying extra pounds, you might want to mention that it could actually improve your health and longevity. The debate about higher weights being better than lower ones for some health markers has been raging for a while. Here are conclusions from some recent scientific studies. “As a group, overweight people are living the longest nowadays, researchers reported in the May 10 JAMA. And obese people seem to be at no higher risk of dying than those of normal weight.” (“‘Overweight’ may be healthiest BMI,” Science News, 6/11/66, p. 6) The conclusion is based on a nearly 40-year Danish study of more than 100,000 adults. “BMI as a number alone may not be sufficient to predict health and risk of death. It has to be taken within context.” It’s worth noting what scientists have known for a long time: BMI itself...
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Dangerous Diets

“How to tell when you’re dieting dangerously” by Cara Rosenbloom (Sarasota Herald-Tribune, 5/24/16, E8) tells it like it is: “It doesn’t matter whether you eat clean, follow a vegetarian diet or eschew carbs; when choice and flexibility turn into obsession and rigidity, an issue is brewing.” This warning flies in the face of the barrage of advice we get every day to watch out for carbs, eat clean, eliminate red meat, ditch fats, and reduce portion sizes. In my book, those well-meant suggestions have a name: dieting. The problem is that we think we’re doing something healthy for ourselves when we live by rigid eating advice—no carbs, only fruits and vegetables, and portions that would leave a child hungry. We’re in trouble when we view such recommendations as edicts that we must adhere to rather than as suggestions that we can use as a general guide. Use your critical thinking skills....
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How the Weight-inclusive Approach to Health Can Help You

I bet you haven’t heard of the weight-inclusive approach to health. Whereas a business-as-usual weight-normative approach puts “an emphasis on weight and weight loss when defining health and well-being,” a weight-inclusive approach puts “an emphasis on viewing health and well-being as multifaceted while directing efforts toward improving health access and reducing weight stigma.” (“The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss” by Tylka, et als., www.hindawi.com/journals/jobe/2014/983495/, 2014) Here are the article’s conclusions: “The weight-normative approach is not improving health for the majority of individuals across the entire weight continuum. Weight is overemphasized for higher-weight individuals (i.e., assumptions are made that they are unhealthy) and underemphasized for lower- or ‘average’-weight individuals (i.e., assumptions are made that they are healthy). Furthermore, we know that weight loss through dieting is not sustainable over time for the vast majority of higher-weight individuals and is linked to harmful...
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What to Do When Diets Fail

If you’ve heard the “news” that diets don’t work long-term and actually may make you fatter, you may be feeling really glum. It’s bad enough that you sort of guessed from experience that they weren’t succeeding, but now you know it’s not your fault and why lost weight has the tendency to creep back on. If you somehow missed this “news,” read my blog, Why "The Biggest Loser" Participants Are Now the Biggest Gainers, and these articles, After “The Biggest Loser,” Their Bodies Fought to Regain Weightand Why You Can't Lose Weight on a Diet, and you’ll be up to speed on the subject. Many clients have shared their disappointment about the failure of diets with me. They’re relieved to hear they’re not to blame for being unable to slim down or keep weight off and will now, hopefully, stop beating up on themselves for lack of willpower and self-discipline. But,...
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Why the Biggest Loser Participants Are Now Big Gainers

I never watch “The Biggest Loser,” the hit TV show. It has always made me cringe and want to cry. Why? Because eating and weight is my field, I’ve known for decades that diets don’t work long term and can actually make you fatter. In fact, it may surprise you to learn that science knew about the dangers of dieting since long before I began my clinical practice 30-plus years ago. Research on the subject started during World War II! Science writer Gina Kolata and researcher Tracy Mann wrote about the failure of diets in their respective books Rethinking Thin in 2007 and Secrets from the Eating Lab in 2015. My guess is that neither book did as well as whatever bestselling diet books came out in those years. There have been journal, newspaper, and magazine articles written for decades about the disappointing results of dieting and here we are, again,...
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What Is an Effective Way to Measure Health?

First it was the tape measure and the number on the scale. Then came Body Mass Index (BMI)—both measurements that purport to tell you how healthy you are. Surely, if doctors and fitness trainers are using these tools, they must be effective. Right? Wrong! No wonder we’re confused about how much we should weigh to get and stay healthy. “A healthy weight isn’t…a number on a scale, a category in the BMI, a specific shape, [or] fitting into specific size clothes,” says Marsha Hudnall, MS, RDN, CD of Green Mountain at Fox Fun, a non-diet weight-loss retreat. (“Defining healthy weight: what it is and what it isn’t,” http://www.fitwoman.com, 1/18/06) Rather, a healthy weight must be decided through a person-by-person assessment, not by across-the-board measures. But, what about BMI? Don’t those calipers accurately measure body fat? Hudnall says, “The BMI derives from an almost 200-year-old classification system that was initially intended to...
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Why It Can Be Hard to Lose Weight

With diet programs, plans and pills touting quick and easy weight loss, you might feel there’s something wrong with you if pounds are dropping off slowly—or not at all—even when you’re eating “normally.” The truth is that weight is easy to gain but not to lose, especially as you age. Don’t blame yourself. There are reasons behind the difficulty. A York University study described in the journal Obesity Research and Clinical Practice focused on “dietary and exercise data for tens of thousands of Americans over the past four decades. It found that even when eating the same diet with an equal activity level, “a given adult in 2006 had a higher BMI than a counterpart of the same age in 1988.” (Sarasota Herald-Tribune, 10/6/15, E48). Co-author of the study, professor Jennifer Kuk of York University, attributed the difference to several factors. Americans sleep fewer hours than they used to—“in 2013, 40%...
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Food, Eating and Weight Myths Debunked

Sometimes the science of food and eating moves along so fast that it’s hard to keep track of it. However, here are two myths that have been debunked and are worth noting. “Will smaller plates lead to smaller waists? A systematic review and meta-analysis of the effect that experimental manipulation of dishware size has on energy consumption.” It has been suggested that providing consumers with smaller dishware may prove an effective way of helping people eat less and prevent weight gain, but experimental evidence supporting this has been mixed. The objective of the present work was to examine the current evidence base for whether experimentally manipulated differences in dishware size influence food consumption. We systematically reviewed studies that experimentally manipulated the dishware size with which participants served themselves at a meal with and measured subsequent food intake … With all available data included, analysis indicated a marginal effect of dishware size...
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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.