One of the reasons clients have difficulty eating nutritious food is that it feels as if they’re dieting. Instead of thinking, “Hey, this is a yummy, healthful food for me to nourish my body,” they grumble inside about being stuck eating something low-cal or low-fat—again. You can see how this mindset would prevent you from making wise choices. Of course, you can’t change the eating until you change the beliefs behind it.   Take a minute to consider whether nutritious food equals diet food for you. What foods fit into this category: salad, anything low-fat or low-cal, vegetables, fruits? Ask yourself what would make an item a diet food or, well, a regular food? Is there really a distinction or is it something artificial that keeps you in a diet mentality? What are your beliefs about diet foods versus healthy ones? Here are some possibilities: Salad is diet food and I’m...

I don’t think I’ve blogged about weight-loss surgery before, or at least not in a long while, and I’m not sure why. Perhaps because I don’t have extensive medical knowledge about it. What I do have is experience with clients who have had bariatric surgery, but who still sought me out to resolve post-surgery eating problems. Although I’m not totally against it, I believe it should be an intervention of final resort. Here’s why. The post-surgery clients I’ve treated continued to have disregulated eating problems decades later. Some remained morbidly obese while others were some 20-50 pounds overweight. As one client said, “My stomach is still big enough to eat a Snickers bar, and ice cream slides down real easy.” Each was an emotional eater with a history of food problems dating back to childhood, and although they had been on many diets, none had ever really explored why they ate...

Research says that thin people don’t see themselves as slimmer than most and average size folks often see themselves as fat. What about those of you who are overweight or obese? Read on and when you’re done reading, think about how accurately you assess your weight and why you think the way you do. No self-judgments, please! The following article is reprinted from the EDReferral.com Newsletter, October 2010. Overweight? Obese? Or Normal Weight? Americans Have Hard Time Gauging Their Weight. New poll finds 30% of those overweight think they are normal size. For many Americans fat is the new "norm." More and more people are unable to accurately describe themselves using their height-to-weight ratio—known as body mass index—the scale that determines levels of overweight and obesity, a new Harris Interactive/HealthDay poll found. The poll revealed that 30% of overweight people think they're actually normal size, 70% of obese people feel they are...

I was watching CSI NEW YORK recently and one of the characters, a black doctor, was confronted with slurs from a racist skinhead. The doctor didn’t fly off the handle, hurl an insult back at the skinhead, nor seem the least bit perturbed. Rather, he shrugged off the insult, explaining to another character that someone’s racist attitude wasn’t his problem but theirs. My first thought was, How can overweight people learn to respond in a similar fashion? Granted being born black and becoming fat are not the same thing. I get that. However, many blacks (and other people who’ve been stigmatized) have learned over time to handle hurtful comments well, and that makes their attitude instructive. Some may say that our culture is now what’s being called post-racist, but throughout history, people have had to contend with being picked on, excluded from the mainstream, and abused in various ways because of...

I don’t focus much on weight in therapy sessions because I believe that learning how to eat “normally” is more crucial than any number on the scale. In fact, I shy away from weight discussions with clients except when the subject comes up naturally, and hesitate to write much on weight because zeroing in on it, per se, doesn’t generally pay off but does get people anxious and upset. However, recognizing that folks who don’t want to put back the pounds need insights, information, and incentives, I (sigh) write this blog. According to the American Journal of Physiology (7/8/09), there’s more than one way that exercise helps prevent people from regaining weight they’ve lost or maintaining their “defended weight” (what a person weighs naturally). Of course, we could talk for eons about what an individual’s natural or defended weight should be—the weight you generally carry, the number on the scale when...

No surprise to me that there’s a high correlation between stress and weight gain. Slim folks get anxious and overwhelmed too—but don’t feel like eating. Unfortunately, stress and worry more often cause overeating, feeding into and off one another (pun intended), so that my work is to teach overweight worry warts how to scale back their agita to improve their relationship with food. “Stress can cause people who are already overweight to pack on more pounds,” says Jason P. Block, MD, MPH and colleagues (Tufts Health Letter, 10/09), concluding that “subjects with a higher body-mass index (BMI) at the start of [his] study ‘who reported greater psychosocial stress, gained more weight’, whereas this pattern was not evident for those with lower baseline body mass indexes” (American Journal of Epidemiology, 7/15/09). He also notes a difference between the kinds of stress encountered by men and women—males gained weight worrying about bills, lack...

A Newsweek article (4/6/09), “Tales of a Modern Diva,” made me sick to heart how women will ever shake societal pressure to be thin and beautiful. It describes how younger and younger girls are obsessively focused—moreover, being focused by the media and their parents—on their appearance. I’m not saying that men don’t have pressures to look good, too. They do, but nowhere near the burden that women feel. The article quotes Susie Orbach (former therapist to Princess Diana!), author of ON EATING and FAT IS A FEMINIST ISSUE (which gave a generation of women—including me—permission to stop dieting and listen to their appetite). In her new book (which I’ve yet to read), BODIES, Orbach maintains that, “…good looks and peak fitness are no longer a biological gift but a ceaseless pursuit. And obsession at an early age fosters a belief that these are essential components of who we are (ital mine).”...

A major disappointment and frustration for many overweight clients is working hard to eat “normally” without pounds slipping off quickly or at all while watching others lose weight more easily. Fortunately, science is beginning to give us answers to why some people lose weight more effortlessly than others. A report in Duke Medicine HealthNews, May 2010 details the discovery of a molecular mechanism that “controls energy expenditure in muscles and helps determine body weight.” Researchers from the Mayo Clinic, the universities of Iowa and Connecticut, and New York University found out that, “The mechanism is controlled by adenosine triphosphate (ATP)-sensitive potassium channels (KATP). ATP is the ‘energy currency’ used by cells in the body; the channels can sense ATP stockpiles and regulate heart and skeletal muscle performance accordingly. Animals which lack this mechanism burn more stored energy by dissipating more heat when at rest or when normally active. Excess energy from...

I admit, I’m fascinated by the science of eating and weight and thrilled at how far we’ve come from the simplistic notion that slimness is merely a matter of self-control and willpower. The newest headline to catch my eye is “Bacteria in Intestines Play Key Role in Weight Gain, Study Finds”( LA Times, 11/12/09). Its conclusions are enlightening. Reporting on the results of a study on mice in Science Translational Medicine, Thomas H. Maugh II says, “A high-fat, high-sugar diet…alters the composition of bacteria in your intestines, making it easier to gain weight and harder to lose it.” According to researcher Jeffrey I. Gordon, MD, of Washington University in St. Louis, 90% of the bacteria in our gut (needed to digest food) falls into two categories: lean rats have more Bacteroidetes and heavy mice have more Firmicutes. Because Firmicutes are more efficient at converting food into calories, mice with more of...

Was it really that long ago that experts insisted that weight maintenance was all about calories in and exercise out? That’s what I grew up believing. Now we know that the issue is incredibly more complex, and that weight programming involves genes, biochemistry, and—according to a 9/21/09 Newsweek.com article by science writer Sharon Begley, “Early Exposure to Common Chemicals May Be Programming Kids to Be Fat”—that even common chemicals in our environment may affect our weight. Begley writes that, “Evidence has been steadily accumulating that certain hormone-mimicking pollutants, ubiquitous in the food chain…act on genes in the developing fetus and newborn to turn more precursor cells into fat cells, which stay with you for life. And they may alter metabolic rate, so that the body hoards calories rather than burning them…” She quotes Retha Newbold of the National Institute of Environmental Health Sciences in North Carolina: “The evidence now emerging says...

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...

A Los Angeles Times article confirms what research has been saying for decades. In “In War on Waist, Any Diet’s A Winner,” writer Shari Roan talks about the diet wars and which diet comes out on top, then concludes (the envelope, please) that the answer is “any diet.” The article’s take away message—that it doesn’t matter what you call your eating as long as it reduces calories. No surprises there. Roan goes on to say that, “any diet that is low in calories and saturated fats and high in whole grains, fruits, and vegetables, and that an individual can stick with, is a reasonable choice for people who need to lose weight.” This conclusion is from a study—the biggest, longest and “most rigorous” of popular weight loss alternatives— published in February, 2009 by The New England Journal of Medicine. Although I’m thrilled folks are being encouraged to trust common sense, reduce...

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...

An article on weight gain during and after menopause in Environmental Nutrition (April 2011, vol. 34, no. 4) caught my attention because it contains important—and surprising—information for all women, whether they’ve reached menopause or not. The article states that “The transition through menopause is typically burdened with significant weight gain—about 1.5 pounds per year during the middle years, regardless of initial age, initial body size, or ethnicity, according to data from the Study of Women’s Health Across the Nation (SWAN), a multi-ethnic, community-based, longitudinal study of more than 3,000 women. However, there is broad debate among scientists over why and how this weight gain occurs.” According to one researcher, fat cells are protective because they produce estrogen. As it declines in a woman’s body, fat cells take over the process of helping her get through what may be a difficult transition. Another researcher challenges this conclusion by saying that the estrogen...

As someone who suffers from occasional, mild irritable bowel syndrome (IBS) and takes the probiotic Align to keep me virtually symptom free, I was surprised to learn that imbalanced gut bacteria may also affect how much you weigh. Here’s what Mehmet Oz and Michael Roizen, MDs, have to say on the subject (Sarasota Herald-Tribune, Health and Fitness, 8/9/11). Answering a question about gut bacteria generating weight gain and if medication prescribed for it can produce weight loss, the docs maintain that there’s “some lab evidence” that gut bacteria can impact the number on the scale, citing research that “mice who lack a certain protein are about 15% heavier than other mice and have more of an intestinal bug that causes calories to be stored as fat.” They add that “the mice also have higher body-wide inflammation, which is linked to heart disease, diabetes and cancer. Worse, they have metabolic syndrome, which...

The December 2010 Nutrition Action Healthletter provides some new and enlightening scientific evidence that establishing a healthy weight is even more complicated than previously thought. Forget what so-called experts say about calorie consumption and energy expenditure being the sole or major determinant of weight. Here’s the real deal. These research conclusions are from Eric Ravussin, head of the Division of Health and Performance Enhancement at the Pennington Biomedical Research Center in Baton Rouge, Louisiana:“When people lose weight, their leptin (the hormone produced by fat cells which lets the brain know when your body has stocked up enough fat) goes way down, and the body interprets that as a state of starvation. When the survival of an organism is at stake, the body has redundant systems to avoid starving.”“When people lose 10-20% of their body weight, their metabolic rate drops and becomes thrifty. So they need fewer calories to stay at their...

When I blog about topics related to weight or weight loss, I’m not trying to get you to focus on losing weight. However, sometimes weight is necessary to talk about, such as when disregulated eaters become frustrated that they’re eating more “normally” yet aren’t losing weight. The answer, as you might expect, is complicated. We’ve been told repeatedly that there are 3,500 calories in a pound, so we think that if we cut back by that many, we should lose a pound, right? An article, “Still not getting it?” (Nutrition Action Healthletter, 6/12), explains why we’re wrong. When we decrease calorie consumption, our resting metabolism slows down to conserve and burn fewer calories. It’s vital to take this information into account if you’re concerned with weight loss. Of course, it’s smarter to not to think about it and work solely on eating “normally.” Most of us have heard this metabolic explanation...

You know how it is after you’ve been dieting and even have lost some weight. You’re feeling so good about yourself—til you’re feeling bad because you’re back into abusing food. It’s time to stop blaming yourself and to recognize that biology may be at work stoking your hunger. That’s why eating disorder experts keep insisting that diets don’t work long-term. So, if you must assign blame, try your hormones. “Blame hormones for wrecked diets?,” an article by Malcolm Ritter (Sarasota Herald-Tribune, 10/27/11) explains what’s going on. It says that the findings of a recent study “suggest that dieters who have regained weight are not just slipping back into old habits, but are struggling against a persistent biological urge.” Joseph Prioietto of the University of Melbourne in Australia, one author in this New England Journal of Medicine study, offers some excellent advice: “People who regain weight should not be harsh on themselves,...

If you wish to reach your goals (who doesn’t?), don’t get seduced into making New Year’s resolutions. Why? Because research says resolutions don’t work. Paradoxically, by not making them, you may be more likely to achieve and maintain your goals. According to The New Year’s Resolutions That Won’t Fail You by Oliver Burkeman (NEWSWEEK, 12/24/12), “psychological research increasingly suggests that ‘repeating affirmations’ makes people with low self-esteem feel worse; that visualizing your ambitions can make you less motivated to achieve them, [and] that goal setting can backfire.” Positive messages deliver only a “short-lived boost, and when that fades, the most obvious way to revive it is to go back for more.” Kinda like dieting, huh? Burkeman goes on to talk about why change is difficult, giving a similar explanation to the advice in my book, THE RULES OF “NORMAL” EATING. Even making one change, say, around food, is hard because it...

I’m giving you fair warning that I’m on a bit of a rant here about body image. How is it that so many of you bright, capable, clever, terrific folks won’t stop obsessing about your weight and keep choosing to make it the arbiter of your worth and lovability? If you must focus on weight, studies show that folks who shed pounds that stay shed do so through having fitness and health, not weight, as their goals. I spend much of my professional life trying to convince clients, mostly women, not to devalue their bodies because of their weight/shape/size. I confess that I get frustrated; worse is how sad it makes me that so many of you insist on joining the mob mentality that you’ll have more fun, approval, romance, love, etc. if you only lose weight. Yes, weight discrimination in professional and social circles is alive and well and living...

I rarely blog on weight loss because obsession with a number on the scale or clothing size is unhealthy, and a goal of shedding pounds is not as effective in changing eating habits as a focus on fitness and health. However, many of you still struggle with whether or not to diet and may need a bit more convincing that diets really don’t work long term. Toward that end, I was delighted to read Jane Brody’s, “Why Even the Most Resolute Dieters Fail” (Sarasota Herald-Tribune, 9/27/11) which explains what goes wrong with diets and how to shed pounds that stay shed. Here’s her summary of research on the highly complex subject of weight loss as published in The Lancet. She observes that "…lasting weight loss takes a long time to achieve“ and “gradual weight loss is nearly always more effective because it allows the new eating and exercise habits to become...

A few months ago, a client and I had a discussion about her changing feelings about the largeness of her body. For years, her reflection in the mirror didn’t even register; then one day she realized that she couldn’t stand to look at herself. She’d gone from one extreme to the other: from denial about her growing size to being disgusted by it. Many people view their larger-than-they-wish bodies either by exclusively denying or exclusively hating themselves for their size, or yo-yoing between denial and contempt. Makes sense, as disregulated eaters often possess an all-or-nothing mentality about food and weight—and most things in life. If they’re not thin, they must be fat; if they’re not dieting, they have no use for rules about eating. If they’re not perfect, they’re horrid. Moreover, our culture reinforces engaging in both sets of unhealthy attitudes and lifestyles, as well as obsessing about thinness and living...

Did you know that May 6 was International No Diet Day? This day, dedicated to promoting a healthy lifestyle and raising awareness about the mental and emotional destructiveness of diets, marks an annual celebration of body acceptance and body shape diversity. If you didn’t get a chance to celebrate this year, start getting yourself ready for when it rolls around in 2013. International No Diet Day (INDD) was created by feminist Mary Evans Young, director of the British “Diet Breakers” in 1992. No, it’s not a rock band, but a group formed to combat the craziness of dieting and disregulated eating and encourage a sane approach to food consumption. The goals of INDD are simple: Doubt the idea of one "right" body shape; Raise awareness of weight discrimination, size bias and fat phobia; Declare a day free from diets and obsessions about body weight; Present the facts about the diet industry,...

Science writer Sharon Begley is one of my favorite columnists. In Fat canaries in a coal mine (Newsweek, 12/20/10), she tackles the fascinating topic of rising obesity in animals, offering some surprising research on the cause of their weight gain. Begley starts by critiquing societal lifestyle changes as the accepted cause of Americans’ escalating weights: a decrease in physical activity due to less walking to places such as work/stores/school coupled with an increase in caloric intake due to irresponsible food industry packaging and preparation. Then she goes on to seek answers in the research of scientists working with animals. She cites the conclusion of University of Alabama at Birmingham obesity researcher David Allison who has studied marmosets for 15 years: without changes in any other variables, their weight has soared. She cites the conclusion of his collaboration with colleagues who, after reviewing the weights of other animals, including alley rats, mice,...

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...

Many disregulated eaters who are heavy have had difficulty talking with medical professionals due to their treatment of “overweight” patients. We know from anecdotal experience that this is true, and now a study in the journal Obesity gives us proof. But don’t despair, you can learn to get the most out of medical visits. Says Dr. Kimberly A. Gudzune of John Hopkins School of Medicine where the study was done (Sarasota Herald-Tribune (5/7/13), “The bedside manner may improve with slimmer patients. Doctors seemed just a bit nicer to their normal-weight patients, showing more empathy and warmth in their conversations. It’s not like the physicians were being overtly negative or harsh. They were just not engaging patients in that rapport-building or making that emotional connection with the patient.” No surprise to many of you, I’m sure. While this is disappointing news, it may feel good to be validated. It can be hard...

Sometimes I think I have more discussions with clients about weight than about eating. They tell me what happens when they weigh themselves, ask how often they should hop on the scale, explain that they want to stop but can’t help themselves, and just plain can’t seem to get weight off their minds. Does this sound like you? Truth is, a focus on weight may actively prevent you from becoming a “normal” eater. Remember this: Weight loss comes at the end of the eating process. Many of you act as if it’s a determinant of what you “should” or “shouldn’t” eat. It is not. You know what happens when you weigh yourself. Either you’ve lost weight or haven’t gained any and are thrilled. Or you haven’t dropped pounds or as many as you’d hoped you would and you’re disappointed. If you’re happy about your weight loss, you may feel it’s okay...

Let’s move on, shall we, from believing that weight is based solely on what and how much we eat. Learning about other factors influencing weight can help take pressure off yourself for doing something “wrong” or for not doing enough of what’s “right.” “Could bacteria be influencing your weight?” by Gina Kolata (Sarasota Herald Tribune, 9/6/13) tells us that gut bacteria “may help determine if a person is fat or thin.” The study involved mice and humans, in this case twins, one obese and one lean. Dr. Michael Fischbach of the University of California, though not involved in this twin study, called the findings “the clearest evidence to date that gut bacteria can help cause obesity.” Does this mean that if you have fat-generating bacteria, you’re destined to be fat? Interestingly, the answer is no. It seems that “the part of the study that most surprised other experts [ie, those not...

One of my favorite sayings is, “You can’t see the picture when you’re inside the frame.” It means that sometimes you need distance and objectivity to see yourself clearly and realistically. Nowhere is this more true than in an obsession with losing weight. Take “The Tongue Patch Diet,” which I learned about in a segment of 20/20. Silly-sounding, it’s truly horrifying. The segment followed two young women who had a doctor sew a rough plastic patch atop their tongues to make it painful and impossible to eat. Body mutilation, anyone? The back-story was that one woman wanted to fit into her skinny jeans and the other wanted to wear her bikini on vacation, but both loved eating high-sugar and –fat food which they swore they lacked the “will power” to give up. Hence this $2000 surgery! Long story short is that they each lost about 20 pounds and were over the...

Although many disregulated eaters know that diets don’t work long-term, when they get frustrated that “normal” eating isn’t producing the weight loss they desire, they consider—and sometimes return to—dieting. So for those of you teeter-tottering on the brink, here’s more proof that restricting calories will hurt, not help, you. In “Why crash diets call for some caution” (Sarasota Herald-Tribune, 3/26/14) Gabriella Boston gives prime time to several experts on the subject. Nutritionist Rebecca Mohning advises that “If you go on, say a 900-calorie-a-day diet, you will have a hard time getting the nutrients you need. Without the daily requirement of protein, you will break down your lean muscle mass.” The problem: Lean muscle mass burns calories, so the more we have of it, the more calories we burn. Mohning also reminds us that, as night follows day, lost weight after dieting will return—likely as fat, not muscle—decreasing, not increasing, calorie-burning efficiency....

I try to keep up with new research about eating and weight, and occasionally run into surprising or contradictory information. Although it can be unsettling to learn that what I thought was true is not now (or maybe never was), I endeavor to keep an open mind and not get too attached to ideas which may be proven wrong. For examples, read on. Here are some conclusions from an NIH study (Obesity Facts and Fiction, 4/13, DukeMedicine Healthletter) as well as some challenges to them from Franca B. Alphin, MPH, RD, CSSD, LDN of Duke University:Conclusion: “Small changes in calorie intake or calorie-burning do not build up over a long period of time to effect large changes. In fact, individual body mass changes alter the body’s calorie requirements”; Challenge: “Small changes do lead to some gains, but you have to keep adding new changes to see further gains.”Conclusion: Compared to realistic...

Being comfortable with your body at any size comes from practicing wisdom. And what’s that? Wisdom is a combination of discernment, valuing self, and utilizing cognitive skills—not your emotions—for problem-solving. Anyone can be wise. Based on studies, experts tell us repeatedly that good health, not weight loss, is the most effective goal for achieving and maintaining healthy eating practices for life. Every single moment you think about shedding pounds takes you farther away from wisdom—and reaching eating goals. Though it’s true that when we eat well, we can't see our bodies growing healthier, we still can rejoice in how fine they feel when well nourished and bathe in the glow of pride that comes from taking good care of ourselves. Growing healthier—how can that not happen when you’re eating more nutritious foods than you did before?—and feeling better about yourself are major achievements. Why not focus on them, on what you’re...

The controversy over whether higher weight leads to increased disease and mortality is as confusing as the one over whether sugar is addictive or not. First we hear that obesity leads to poor health and premature death, then we hear that it doesn’t. All we can do is stay informed and pay attention to the results of reputable research studies. I offer the following information not to take sides in the debate, but in the hopes that you’ll take it in with self-compassion and use it to motivate yourself to become healthier. According to an article in the 3/13 Nutrition Action Health Letter, “Weighing the options: do extra pounds mean extra years,” a recent “fatter-people-live-longer” meta-analysis reported on in the Journal of the American Medical Association was so flawed as to make its results false—its numbers were skewed by including former smokers and people who were sick and it failed to...

As if there aren’t enough differences between men and women, science is now telling us that we’re farther apart than we might think in terms of eating and weight. According to “Uneven struggle: from food cravings to moral support, men and women diet differently” (Sarasota Herald-Tribune, Health & Fitness, 8/26/14, 5-7E), there are major dissimilarities between the sexes. Fortunately, recognizing these differences can help each gender become more like the other in positive ways. Because men have more muscle than women and muscle burns more calories than fat, guess who has the faster metabolism? Why men, of course. Which enables them to go on to lift heavier weights than women do and build even more muscles which burn more calories. Then there’s the matter of women’s brains lighting up when they smell, taste and observe sweets and treats in a way that men’s brains don’t. If you think it’s harder for...

It’s crazy when we’re attached to a particular weight and achieving or not achieving it colors our mood. I know there are people who weigh themselves and who don’t think much about the number on the scale, but for those of you who’ve spent much of your life dieting and obsessing about weight, it’s a different story. Here’s how I know. If you’ve read my books, you’re aware that I had eating and weight problems galore during the first half of my life, then became a “normal” eater and ditched my scale. The only times I’ve known my weight since then have been weighing in at the doctors’ office. But that changed a while back due to some intestinal problems I’d been having, which included—said the doctors’ scale—losing about five-pounds in a short period of time. Concerned because I hadn’t changed my eating or exercise, I started to monitor my weight....

Every once in a while I come across enlightening and useful scientific studies which speak directly to actions that disregulated eaters can take to become healthier. Smart people use scientific conclusions (as opposed to irrational thinking or profit-driven marketing) to guide their actions to change behavior. Here are summaries of two studies and their take-away messages which I hope will help you move toward your health goals.“Nighttime Light Exposure as a Risk Factor for Obesity Through Disruption of Circadian and Circannual Rhythms” (McFadden et al., Am J Epidemiol. 2014; 000(00):000–000) Abstract: “Nighttime Light Exposure as a Risk Factor for Obesity Through Disruption of Circadian and Circannual Rhythms” reports findings on the relationship between light exposure at night and obesity from a cross-sectional study of United Kingdom women. Their research extends findings from a previous study with elderly participants by including a larger sample size of over 100,000 women and a broader...

Let’s talk about clothes. I can hear a lot of you out there groaning. Yuck, clothes. Oy, clothes. I get how you feel, but maybe by the end of this blog you’ll feel a bit better. You know, this subject really doesn’t have to make you unhappy. Many people who’ve struggled with their weight also struggle with their attitude toward clothes. It’s not uncommon for them to have several sizes of clothing in their closets, from larger and smaller times. It’s not uncommon for them to hold onto these items because they tell themselves they can’t stand to part with them. What do these clothes that no longer fit mean to you that you believe you can’t let them go of them? Some clients say that certain items are associated with happy memories of feeling popular, loved, and unashamed of their bodies. Others insist that giving up smaller-sized pieces is like...

Although I’ve never been a great fan of Body Mass Index (BMI) to assess quality of life, I find it interesting that something so many people have relied on for evaluation of health and longevity is now being questioned. Perhaps BMI will go the way of the scale and we’ll be left determining how we’re doing taking care of our bodies by more valid health measurements. But don’t hold your breath for that to happen. BMI is the measurement of a person’s weight in relation to their height. According to “Body mass index flawed as a measure of obesity” by Jane Brody (Sarasota Herald-Tribune, 4/22/14, 41E), the index, developed between 1830-1850, was later adopted by insurers as a way to assess weight in large populations. Brody points out that BMI was not developed for doing individual assessments of health and longevity, but it became the gold standard anyway. Gotta wonder how...

The thing that diet promoters don’t tell you is why you get so hooked on diets. But this is just the information you need to get yourself unhooked. The answer is found both in physiology and psychology. First, when you begin dieting you lose weight which is precisely what you want to happen. You think, “Hey, fab, this works!” which, of course, it does for a while, until it doesn’t. So, then you think that if it worked for a while, you must be doing something wrong that you’ve stopped dropping pounds and, therefore, redouble your efforts. If you then resume shedding pounds, you think it was you who caused the failure and success. This dynamic of on-and-off rewards is called intermittent reinforcement which means sometimes getting what you want and sometimes not, and it works as well, if not better, at strengthening goal-seeking behavior as positive reinforcement does. Second, if...

If you came from a home or a childhood in which food was regularly restricted or off limits, studies now tell us that this may be a major cause of your food problems today. In “Restricting food makes it all the more desirable” (Sarasota Herald-Tribune, 4/29/14, page 32E), Tara Parker-Pope looks at why some kids eat more than others. These children are called “reactive eaters” and, in studies, eat way more than “non-reactive eaters.” Pope notes that “Genetics and biology play a role in foods we like and the amounts we eat. At the same time, studies show that children who grow up in homes with restrictive food rules where a parent is constantly dieting or desirable foods are forbidden or placed out of reach (my childhood home), often develop stronger reactions to food and want more of it when the opportunity presents itself (I did!).” Summarizing Penn State experiments on...

Oddly, many of you are more disturbed by how you look than about the questionable or poor state of your health due to excessive unhealthy eating. While over-focusing on what you and others think of your size, you under-focus on how large quantities of non-nutritious food affects your body, which is the opposite way to think to eat better. I know this because I have a whole caseload of troubled eaters who think like this and because I run a Food and Feelings message board whose members talk a lot about hating their fat or overweight bodies, but not so much about how their eating is ruining their health and shortening their lives. I have clients who could spend hours telling me how horrid they feel going to a party because they’re not the size they wish to be, but are taken aback when I suggest that this might be the...

Reading an article about why people are attracted to rigid ideologies, I got to thinking about dieting as a telling example. What follows are my musings on the subject which may help you understand and change your way of thinking about food. I have no science to back up my ideas, but ask you to consider them as food for thought. In a fascinating article, “Why they join” by Mark Potok (Intelligence Report, Southern Poverty Law Center, Spring 2014, issue 153, p.65), about the attraction of extremist groups, Pete Simi, an associate professor of criminology and criminal justice at the University of Nebraska at Omaha, identified personality traits which make people more likely to join these groups. He says, “In terms of personality, I wouldn’t say there is one type of personality, but I would say there are certain characteristics of thinking that make a person more prone or susceptible. For...

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...

One of the most frequent laments I hear from clients is that, although they are finally starting to eat “normally,” they’re not losing weight. They understandably would like to shed pounds along with becoming healthier, yet recognize that focusing on weight loss per se might derail their improved eating. This is tricky business for troubled eaters. There’s nothing wrong with wanting to lose weight as long as it’s part of an entire regime toward health and fitness. The best approach is to follow the Health At Every Size protocol. Its health and fitness—rather than weight loss—goals, keep you focused on caring for your body. Using their protocol and continuing to eat “normally” should help you shed pounds. If you want to lose weight because a lower weight feels better and because you’ll be able to do more activities, that’s fine. Be careful, however, about putting your attention on the scale. Avoid...

Here’s your pop quiz for today: 1) Is there a correlation between how frequently you think about losing weight and the shedding of pounds? 2) Is there a correlation between how desperately you want to lose weight and losing it? 3) Does focusing, or worse, obsessing about losing weight actually help you lose it? I confess, I don’t know if there’s been research done on these questions, so you’re stuck with my take on this subject based on 30-plus years of experience working with people who are unhappy with their eating and their weight. To a person, I would say that one of the major impediments to “normal” eating, getting (and staying) healthy and fit, and becoming mentally healthy is over-focusing on weight. Losing weight is the end of a process, but if you’re not focusing on the process itself, you will never reach that end. Think about weight loss as...

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...

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...

“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....

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...

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,...