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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Why It Can Be Hard to Lose Weight

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...
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Diet-think versus Health-think

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...
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Weight-loss Surgery

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...
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Exercise and Weight Gain Prevention

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...
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Worries and Weight

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...
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The Role of Bacteria in Weight

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...
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Chemicals and Overweight

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...
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Thoughts on Fat

I’m always thrilled when the media catches up to enlightened thinking. Sadly, it’s a rare occurrence, which makes it worth mentioning because, to greater or lesser degree, what we read, hear and see often shapes our thinking. A NYTimes article by Roni Caryn Rabin, “Fat Wasn’t Always a Bad Thing,” jumped off the page at me. It’s one of the few I’ve read for public consumption that views fat from a logical, realistic perspective. The article explains the purpose of fat in evolutionary terms: folks who had the most meat on them survived times of food scarcity and famine (which was most of human history), while those who were lean died. Fat was a good thing! In fact, fat was just about the best thing you could be if you wanted to live long and prosper. The heavy people who survived, of course, passed on their genes to subsequent generations who...
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Weight and Relationships

If you’re a plus-size woman, this blog could be a downer—but only if you let it be one. An article in ScienceDaily (6/23/09), “Heavy Women Have Lower Quality Relationships, But Same Is Not True for Men, Study Finds,” is far from heartening, but, remember, research is about statistics and doesn’t dictate your romantic choices or situation. The research, coming out of the University of Hawaii at Manoa, focused on body image, weight, romantic relationships, and the perceptions between males and females in 57 New Zealand couples who were studied to see if there was an association among their body mass index (BMI), the quality of their relationships, and perceptions about their partners. The finding was that “heavier women had lower quality relationships, which they predicted were more likely to end. They partnered with less desirable men and thought their partners would rate them as less warm/trustworthy.” Not surprisingly, “male partners of...
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Fat Girls Guide to Living

I want to tell you about a fabulous new website I discovered for overweight women—The Fat Girl’s Guide to Living at http://www.fatgirlsguidetoliving.com/. Here’s what the women who run the site say about it: “The Fat Girl’s Guide to Living is a lifestyle blog for and by overweight women who are tired of missing out on really living because of internal and external pressures and perceptions of themselves.“ They also describe the site as “a life hacker for the full-figured set.” Good stuff, huh? What I love about this site is that it makes no apologies for fat women. It proudly proclaims that you can be fat and still have a life, which many of you—fat or thin—don’t believe. Too many of you insist that being fat prevents you from being lovable, dating, going on vacation, saying what’s in your heart or mind, asking for what you need, being attractive or successful,...
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Thwarting Fat Phobia

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...
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Are We How We Look?

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).”...
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Confirmed, Diets Don’t Work Long Term

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...
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Weight and Genetics

Generally whenever I mention the statistic from Gina Kolata’s Rethinking Thin that 50-70% of our body weight is inherited, I receive such dirty looks that I often add that there have been challenges a plenty to this conclusion. Now, however, The New England Journal of Medicine has weighed in on the subject by publishing the conclusions of a twin-study on eating and weight, and it looks as if Kolata was right on the mark. The NEJM study had male identical twins consuming 1,000 extra calories per day for 84 out of 100 days. Theoretically, each volunteer should have put on 24 pounds but, lo and behold, although each twin in a set gained about the same amount as his brother, there was a striking difference in weight gained between twin sets, within a range of 9.5 and 29 pounds. The researchers’ explanation was that “40% of our weight may be determined...
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Thinness and Lovability

If you believe you must be thin to be lovable, I’m sorry to burst your bubble. Two interesting things happened during a recent afternoon which prove my point. First, there I was on the supermarket checkout line gawking at trashy magazine headlines and photos of unhappy looking, but thinner than thin, celebrities. Some of these sad souls were being ditched because their spouses or partners had found someone new, while others were being abandoned because their lovers had had enough of their nasty dispositions, bizarre behavior, or running around. Second, later that day, I was thumbing through a Sarasota magazine and saw this positively glowing overweight couple on the wedding announcement page. Although the groom was bit pudgy in his suit and the bride was definitely chunky in her white wedding dress, what stood out was that they were beaming and obviously gaga in love. I was so thrilled to have...
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Fat Cells and Weight

There is so much amazing scientific information out in the world about weight these days. As an evidence-based person, I’m a big fan of science and love to understand the workings of the mind/body. Another scientific bonus is that it helps keep our heads on straight by disproving myths about fat and thin, and gives us a fact-based reality from which to set our goals. So, heads out of the clouds and feet on the ground. A May 24, 2008 Science News article entitled “Fat Cells Gain Weight” is a case in point. It’s short, so I’ll share it here: “Even when people lose weight, they don’t lose fat cells. The cells just shrink. Kirsty Spalding of the Karo-Linkska Institute in Stockholm and her colleagues figured out the birth dates of fat cells in adults. The team reported online May 4 in Nature that, in adults, as fat cells die, the...
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Counting Calories and Fat

A while ago a question came up on my Food and Feelings Workbook message board about whether counting calories and fat grams makes a person a dieter. Do “normal” eaters never count calories? Do they ever think about the amount of fat contained in food in making choices? Merely because a person considers caloric or fat content, does that automatically make them a dieter rather than a “normal” eater? Does eating intuitively preclude eating intelligently? This subject is complex and requires letting go of black-and-white thinking. Attending to nutritional information is not a question of always focusing on calories and fat or never noting them. The difference between dieters and “normal” eaters is how the information is used to make satisfying, healthy eating decisions. In a nutshell, dieters and restrictive eaters base food decisions exclusively on whether a food is high or low in calories or fat. If it’s high, they...
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Willpower Gene

For years overweight people have been scolded for lack of will power. If they had more, thinking went, they’d eat less and not grow fat. The term has always made me think of a product, as if out we could go and buy a box of Will Power somewhere (you know, sitting there on the shelf next to the Elbow Grease). At the least, it seemed as if we should be able to scrounge up more of it if we tried hard enough. Now a study at the State University of New York at Buffalo (Allure, May 2008, “Body News”) has discovered where will power comes from and the reason some of us have it and others don’t. Big surprise—it’s in our genes! What researchers discovered is actually an anti-will power gene variant, rather than a gene for it. They found that overeating was linked to a gene involved in chemical...
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Weight and Mating

According to Amy Alkon, Sarasota Herald-Tribune “Advice Goddess,” men are hard-wired to assess women’s looks. From an evolutionary standpoint, they’ve used body weight to select mates to ensure survival of the species, hoping that someone who looked healthy was healthy. Alkon adds that “…research suggests that the body size men look for in a woman is inverse to the availability of food. Where eats are scarce, like in the Sahara, Lane Bryant ladies are in. Where there’s food-a-plenty, men go for slimmer women.” (When I emailed her, Alkon quoted the source as Shackleforth and Buss and I will try to track down their work and get more information on the theory). An interesting and unsettling observation. What the quote is saying is that at least one explanation for the fat phobia epidemic in the U.S. (and elsewhere) and males rejecting females for being overweight is due to a lethal combo of...
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Weighing Weight

A client of mine lost about 30 pounds by stopping dieting and bingeing and learning to eat more “normally.” Like many of the people I treat, she’d previously been hyper-focused on her weight rather than on her eating. This mindset must shift for intuitive eating to start taking hold: losing weight needs to take a back seat to gaining skills in eating and emotional management. I knew the shift had occurred for this client when she said she wasn’t sure if she could lose more weight or if she even wanted to, but that she’d decided, for now, to continue trying to eat “normally” and see where her weight stabilized. How many of you agonize over losing under 10 pounds: or 7 or 3 or 1? In your head the amount is huge—the difference between night and day. But in reality, what would change if you lost it? Go through every...
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