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Dear Reader,
Open up your local paper and read about the Harvard Nurses' Study, Olestra, dexfenfluramine, the "ob" gene, yo-yo dieting, etc. What are we to make of all this news? We decided that our column should be devoted to an understanding of the latest information which besieges us. To this end, we've asked Miriam Berg, friend, activist and director of the Council on Size and Weight Discrimination, to take over our column and give us a view from another window. Thank you, Miriam. -- Jane and Carol
For those who are larger than average, the world is full of land mines. We are constantly bombarded with ads for diet products, pictures of slim, happy women who "owe it all" to some pill or packaged pseudo-food. Fashion magazines tell us in no uncertain terms that we don't belong in their world. Even some catalogs that sell only large size clothing continue to use slender models. Television offers very few role models of healthy, lively, attractive fat women. With each step we take, we are at risk of having society's scorn of our size explode in our faces.
The most dangerous land mines are located in the field of science. One group of researchers recently studied a hundred thousand nurses and concluded that the fat ones were less healthy and died sooner than the thin ones. Another concluded that yo-yo dieting does not in fact cause weight gain, as previously proven by a different study. A third laboratory claimed to have discovered "the gene that causes obesity", and a fourth found that when a lab rat lacks the hormone leptin, the rat gets fat. Losing weight, they concluded, might be simply a matter of adding more leptin to our systems. Meanwhile, drug companies are coming out with a barrage of new appetite suppressants, and our former surgeon general, C. Everett Koop, has declared war on fat.
To negotiate such a mine field, we need to educate ourselves, maintain a healthy skepticism, and have faith in our personal experience. We need to read the reports in reliable sources, and to ask the tough questions. When we do, for instance, we find out that the 100,000 nurses were classified according to current weight. Some might have just had a large weight loss or gain, but that was not considered significant. Some might be chronic dieters, or binge eaters, or anorexics. None of those questions were asked, even though women who smoked were excluded from the study because smoking was considered another risk factor that might skew the results.
Why didn't the researchers consider dieting an independent risk factor? The health risks of dieting have been well documented (Frances Berg, "Health Risks of Weight Loss", Healthy Weight Journal, 1992). The failure to consider dieting history is the fatal flaw in this and other population studies on weight, and this omission is not consistent with sound research practices.
We also find out, when we investigate this study further, that Dr. Joann Manson, the scientist whose name appears as the head researcher, works as a consultant to two pharmaceutical companies, and that one of those companies is about to market a new weight-loss drug. How can a scientist maintain impartiality, objectivity, and professional credibility if some of her funding comes from companies with a vested interest in proving the need for new weight-loss methods?
As for the genetic research being reported in the media, most scientists believe a single gene could not possibly determine body weight, and that many genes and many other factors must work together to establish any one person's size. Several years ago, there was talk of genetically eliminating Tay-Sachs disease, which affects some people of Eastern European Jewish descent. When they studied it further, however, they found that the genetic predisposition to Tay Sachs also protected people from tuberculosis. Any attempt to eliminate the one disorder through genetic manipulation would have interfered with this ethnic group's ability to stave off another deadly disease.
Genetic manipulation is a dangerous prospect until we reach the point where the body's mechanisms are fully understood. Aside from the cultural advantage of living in a world where people come in all shapes and sizes, it may well be that there are physical and medical advantages for some people to carry more weight than average.
To keep our skepticism healthy, we need to look at the big picture and remember history. A few days after the news of the "magic" hormone leptin, a much less publicized report told us that fat people already have more leptin than average. The rat studies, it turns out, are probably not applicable to humans. Over the past few decades, we have seen the recommendations for the "best weight-loss diet" change from low carbohydrate, to low calorie, to high protein, to high fiber, to low fat (with a few bizarre detours along the way). We need to be suspicious when so many researchers say that they and they alone understand the cause and "cure" of obesity, but each of them says something entirely different.
It is also necessary to determine who funds these studies. Weight Watchers™ and Heinz™ (its parent company) each pledged a million dollars to Dr. Koop's "Shape Up America" campaign. As long as the main source of funding for weight-loss research and anti-obesity campaigns is large pharmaceutical corporations and diet product manufacturers, we must be extremely cautious in interpreting the results of such research and the goals of such campaigns.
Finally, we have to believe in ourselves. The readers of this newsletter, I suspect, have some experience with yo-yo dieting. Most of us have lost and regained weight, and most of us have had the experience of regaining more than we lost. Now a new study says that yo-yo dieting does not cause weight gain. The regain, they say, must have been due to our lack of will power and our voracious appetites.
A large number of studies have shown that, in both laboratory animals and in humans, weight loss results in greater "metabolic efficiency." This means that after a diet, the body requires less food to maintain weight, and weight will be gained on a smaller number of calories than the pre-weight loss eating pattern [eg, R. Keesey, "The Body-Weight Set Point" Postgraduate Medicine 83 (1988) and D. Garner and S. Wooley, "Confronting the Failure of Behavioral and Dietary Treatments for Obesity", Clinical Psychological Review 11 (1991): 729-80.] It has also been shown that blood pressure rises as a result of weight cycling ["Dietary Obesity and Weight Cycling: Effects on Blood Pressure and Heart Rate in Rats," American Journal of Physiology 256 (1989): 1209-10, and the article by David Levitsky to be published in the International Journal of Obesity (Jan. 1996).]
Many people have figured out for themselves, after yo-yo dieting their way down and up the scale many times, that they had to stop dieting for the sake of their physical and mental health. And for most people, binge eating behavior ends when they stop dieting. Our internal body wisdom confirms the earlier research on the dangers of weight cycling. Scientific research is not immune to social bias, and must not be considered conclusive until there is a consensus in the scientific community. We are nowhere near that point in the area of weight loss research.
Why are we seeing such fierce attacks on weight, and so much scientific support for dieting at this moment? Perhaps the reason is that the multi-billion dollar diet industry is hurting, and that the funding for scientific research is becoming more competitive. The size acceptance movement has become much more active. Anti-dieting workshops are springing up all over; books encouraging women to feel good about themselves are proliferating; people of all sizes are refusing to take the abuse any more. As a result, those whose livelihood depends on women's dissatisfaction with their bodies are fighting to get us back. In order to keep research money flowing, scientists are overstating the risks of obesity and understating the risks of their particular weight-loss methods.
I see these attacks as a hopeful sign, a sign that the anti-diet, size-acceptance movement is having an effect. Perhaps someday we will see more independent research on weight issues. Perhaps scientists will acknowledge the overwhelming evidence, and reach the consensus that doctors should not be prescribing weight-loss diets. And perhaps our society will come to understand that size diversity, like other forms of diversity, has a positive effect on our culture.
Miriam Berg is a free-lance writer and the president of the Council on Size & Weight Discrimination. For more than two decades, she has worked to improve women's health care and access to services, and has been an activist in the size acceptance movement since 1980.
You may be familiar with the "Food House" fantasy exercise from When Women Stop Hating Their Bodies, workshops or OO tapes. In the fantasy you move from a peaceful, lush field of grass through a quiet, lovely wood, to a house that is there, just for you, with your name above the door, filled with whatever foods you want or need in whatever way you want to imagine them.
In the early part of your work with Overcoming Overeating, the fantasy helps you identify your food desires and tells you something about how ready you are to bring food into your home and life. Some people discover they feel calmed by the presence of all types of foods in very large quantities; others find that the availability of food seems overwhelming; still others discover that a particular "glitter" food has great meaning to them.
However, the Food House fantasy is a useful tool at any stage in the OO process, and therefore worth revisiting periodically. We'd like to show you how we use the Food House fantasy with women who are well into their OO work and discuss a variation of the Food House fantasy that extends its creativity to other aspects of the approach. First, let's take a look at how we use the Food House fantasy to help women who are feeling stuck with some aspect of the OO mechanics.
Tracy worked with the Overcoming Overeating approach for about one year. She had difficulty bringing food into her home because she did not feel entitled to have needs, let alone try to meet them. Stomach hunger frightened her. Throughout this time though, she tried to bring in a variety of the sweets that glittered for her. Gradually, Tracy began to give herself permission to get hungry but had no idea what to match with her body's signals. For several weeks in a row we used the Food House fantasy to help her learn about her desires. In week one, she imagined turkeys, hams, and stuffing. She bought and prepared these foods and felt great. The second week, she imagined a houseful of fresh breads; and the third week she filled her Food House and her real house with pasta and fruit. After several weeks, Tracy had a good feeling for the wide variety of foods she needs and loves. The fantasy showed Tracy how important it is to keep a large stock of a variety of foods, and how stocking made it easier for her to recognize that she does have needs. She will be in a better position to experiment with meeting her needs in general as she begins to respond to her food needs.
Another woman in the group, Claire, wanted warm home-cooked food, but felt she couldn't or wouldn't prepare it for herself. Claire had been working with OO for several years, and we thought that revisiting the Food House might shed some light on her problem. To our surprise, Claire's food house came up empty! On the one hand, this was strange given the fact that Claire had legalized food years ago and has always kept her home well-stocked. Yet in another way, because she has never prepared the cooked food she really wanted, her house is truly empty. What did all this mean to Claire?
Claire talked about her mother who died many years ago, and who cooked all during Claire's childhood, making delicious dinners and homemade breads. Claire feels the loss of her mother and wishes her mom were still around to take care of her. She associates the warm homemade foods with pleasant family time. In addition Claire and her husband are deciding whether or not to have children &endash; a fuller house, so to speak. Not only did Claire's empty food house represent the absence of the real foods she wants, but also the loss of her mother and the uncertainty about creating a family of her own. Our work with the Food House fantasy has allowed Claire to start cooking for herself when she has the energy, and to buy prepared foods (the next best thing) for other times. Having these foods in her life is also helping Claire find pleasure in the memories of her mother.
True to the nature of OO in which concepts evolve and expand over time, the Food House fantasy was bound to expand and change as well. One morning in one of our groups we wondered, "Who says the food house has to be in the woods?" We decided to make the food house a "house without walls" using the following imagery:
"Close your eyes &endash; breathe in and out and try to relax as much as possible...Now imagine yourself anywhere you'd like to be &endash; a place that's special to you somehow...Just picture yourself there, quite comfortable and relaxed...Now imagine that somewhere in this environment is all the food you would ever want or need...Where is it? What does the food-place look like and how is it organized? How does it differ from the way your food environment looks or feels at home or work or on the road? Does your imaginary food environment feel truly complete? If something is missing, try to bring it in. When the food-place feels just right, look around, enjoy it, remind yourself that it is all yours and gently come back from the fantasy to where your are now...Breathe in and out...When you are ready open your eyes."
For many women this fantasy helps clarify problem areas. Generally, what is missing in the fantasy is missing in a particular woman's life. In many of the fantasies, good caretakers such as chefs, hired shoppers and computer delivery services make food more available, and suggest creative possibilities for real life changes.
Given her chance to put her food supply wherever she liked, Charlene found herself in a convenience store with everything she wanted or needed at her fingertips. She had been working with OO for 31/2 years and was feeling successful in many areas, but she was having difficulty carrying a food bag. She had explored her resistance to carrying a food bag in many ways, but none of our work had helped her to actually carry food with her. This variation of the Food House fantasy brought to light a previously forgotten memory from the one time in her life (at age 18) when she had not dieted and instead, had relaxed around food. She ate what she wanted, and discovered that her weight stabilized at a comfortable level. At the time, she had a job in a convenience store! We talked about her food bag as a convenience store she could carry with her &endash; an important thing for a busy woman to have nearby! When she thought in these terms, Charlene could see the food bag possibilities in a new way &endash; not necessarily a bag with prepared foods, but a bag full of supplies, including food and utensils to prepare what she needed. Suddenly the thought of preparing the bag was less burdensome and more enjoyable.
We have found that we can tailor the Food House fantasy to accommodate particular issues. For example, Lisa, a survivor of her father's sexual abuse, has been working consistently and painfully to piece together a story of her childhood that makes sense to her. Often her work around demand feeding has paralleled her recovery from the abuse.
Lisa noticed that she feels overwhelmed when she has a bountiful supply of foods available. Invariably she allows the food to decay in the refrigerator. Through gentle and difficult work in group we began to see that the rotten food in her refrigerator has a lot of meaning for her. We discovered that each time Lisa felt stomach hunger, she was responding with annoyance and anger. Actually, she was re-enacting her mothers response when she, Lisa, was hungry and needed food as a child. To Lisa, it felt like her mother was saying, "Oh, you're hungry? Here &endash; have some of this crap." The rotten food in her refrigerator haunted Lisa, but seemed essential. It repulsed her, yet drew her close &endash; close to the experience of her relationship with her mother.
We used the Food House fantasy to help Lisa in this stuck place. We suggested that in her fantasy, she could stock her food house with rotten and spoiled food. As she did, Lisa said, "It was filled with everything I want and love," she told us, "but it was all spoiled." With painful clarity, the fantasy revealed Lisa's childhood longings for love, attention and the nurturing she deserved, but that "all felt spoiled" by her father's sexual abuse and her mother's denial of any problems.
Lisa's rotten food represented not only her relationship to her mother but also her rage at the spoiled years of her life. Her Food House fantasy opened the door to exploration of the dual nature of Lisa's feelings toward her mother &endash; the painful longings for closeness and the rage and disappointment at her mother's inability to respond to her needs. As Lisa gently experiments with providing good matches for herself, we anticipate that she will ultimately feel comfortable with good food provided by her own hand.
The flexibility and adaptability of the Food House fantasy gives it a special place in the OO process. Try using it &endash; or your own variation of it &endash; when you are feeling stuck in some particular aspect of your work, or you are feeling on track, but still looking for a way to gather more information. The Food House fantasy is adaptable to many situations; your imagination is the key to continual self-discovery on your path to good caretaking.
Dear Overcoming Overeating Newsletter,
My sister read Overcoming Overeating in February 1993, and then urged me to read it. It has totally changed our ideas about eating, dieting and body image. Although I'm still grappling with mouth hunger, I know I will never diet or deprive myself of food again. I could go on forever about this approach and all of the questions I have, but there is one particular problem I'm having that I hope you can help me with.
For the last year-and-a-half I have tried to use this approach to eating with my seven-year- old son and five-year-old daughter. My daughter has become a pretty good demand feeder, but my son has become an increasingly picky eater. He rarely eats fruits and vegetables, and doesn't like much of anything else either. However, he has always had a sweet tooth and still does, despite my attempts to legalize sweets and treat them like any other food. (I have also read Preventing Childhood Eating Problems by Hirschmann and Zaphiropoulos.) My goal is to have him become a demand feeder, and eat a variety of foods. Do you have any suggestions on what I can do to help him? Does your experience working with compulsive eaters explain why some people are more drawn to sweets? Is there some genetic or physiological explanation for this? I also have a sweet tooth, but I am not as drawn to sweets since using the OO approach. I would really appreciate any help your could offer!
Sincerely, Laura
Dear Laura,
How wonderful that you have helped your children to become demand feeders. However, every person will have his or her individual preferences for foods. It sounds like you may be expecting your son to stop wanting sweets in the way that your daughter did. Therefore, you may give him mixed messages about his reach for sweets. In other words, he may pick up on your assumption that he should eat less of the candy or cookies. Make sure that you continue to keep all types of foods available and that you keep out any judgment about what he chooses. For example, questioning his request for cake but happily offering broccoli communicates that one food is better than another.
There does seem to be a genetic preference for sweets related to survival of the species during time of famine. After all, these foods provide more energy for survival. At the same time, however, studies with children show that when left to their own devices, they absolutely will regulate their caloric intake with amazing precision. It is only when parents or caretakers try to control children's eating that they lose this inborn ability.
Given this knowledge, here are a couple of things you can do. First, it is worthwhile to actually put a variety of food on the table. Children, like adults, will sometimes go for the easiest and/or most visible foods. For example, sometimes a child may not request fruit, but when it is cut up and placed on the table sometimes he/she will choose to eat it. Again, the fruit must be offered along with other types of food and without an investment on the part of the parents as to whether the child actually chooses to eat it. Secondly, research indicates that children can have a fear of trying new foods. Therefore, parents may need to help some children learn to try new foods. Encouraging your child to try something different can help him/her discover a new food that she/he really enjoys. Make it clear that your child does not have to eat it if she/he doesn't like it and if your child still refuses, move on. We have seen children discover new foods through this process. Check to make sure that you are not invested in the outcome of your child's preferences.
Finally, remember that being a "good demand feeder" means listening and responding to your body's signals. There is no guarantee about what a particular person's eating will look like. Trusting your child is at the core of demand feeding. So, relax and recognize that children vary greatly in their eating preferences.
Dear OO:
I wrote a letter just recently, but I had to write again because of a letter I received from Sears Shop at Home Service. I received their catalog from size 14 and up called "Women's View". In their catalog, I noticed that none of their models were large sized women so I wrote to say how dissatisfied I was with this. I explained that I would be more comfortable buying clothes that were modeled by women who were my size. This is the reply I received:
"We have run many research tests over the years regarding the models used in our catalogs. Test results tell us overwhelmingly that the majority of our customers prefer the models we currently use over the fuller figure models. Since our company markets merchandise for a variety of fashion conscious shoppers &endash; we cannot truly explain why the majority feels as they do. This is especially true since our fashions look as well &endash; if not better &endash; on our fuller figure customers.
This was the heart of the letter. I want to know who they surveyed, because I can't imagine that they surveyed "full figured women. I know that I don't want to buy clothes that are modeled on a woman who does not even slightly resemble me. I find this infuriating and intend to respond again. If you feel the same way, write to these catalogs. If things look better on full-figured women, then show them on us.
Thanks, I just had to get that off my "full-figured" chest.
Sincerely, Laurie M.
Dear Laurie,
We have heard a number of stories from women who feel angry about the marketing of larger-sized clothes on not-so-large models. One woman took the order form from a catalog and across it she wrote, "Take me off your mailing list until such a time that you use models who are the size of the clothes you sell." Another woman made her way through a large-size department unfolding the clothes that were arranged to look smaller than they actually were! You are not alone!!!
Imagine a wardrobe filled with beautiful clothes that fit your body and feel comfortable! In the past you may have felt that when you were "thin enough" you would finally deserve to buy clothes you love. However, one of the most important activities you can do to promote self acceptance is to clean our your closets and drawers of anything and everything that no longer fits. Next, begin to build a collection of clothing to suit your body at its present size.
Although women of all sizes feel better when they wear attractive clothes that fit their bodies, we hear many objections to closet clearing. Here are some of the obstacles and experiences women report as they work toward clearing out, and filling up, their closets.
"If I get rid of the clothes that used to fit me, I feel like I am giving up the hope of ever losing weight."
A familiar diet rule for many people is that looking at a small pair of jeans will motivate you to eat less and, therefore, lose weight. Yet let's think about what really happens when you see something hanging in your closet that you are no longer able to wear. How do you feel when you open the closet in the morning and can't wear an outfit because it is too tight? Chances are you feel angry, depressed or defeated. Not only is this a terrible way for millions of women to start their day, but there is a strong possibility that these uncomfortable feelings will lead you to the refrigerator to calm yourself. So, rather than providing motivation to eat less, looking at your "thinner" clothes can actually cause overeating.
When you clear out your closet of clothes that don't fit, you grant yourself acceptance at the size you are now. Giving yourself permission to dress in clothing that reflects your current body shape and size says nothing about what size you will ultimately be. Furthermore, recognizing your entitlement to have a great wardrobe now paves the way to experimenting with styles and colors that are just right for you.
"I spent a lot of money on clothes when I lost some weight. I feel like I'm wasting money by giving them away."
It is understandable that you experience feelings such as sadness or regret as you think about putting away the clothes you recently bought. Ask yourself how you are getting your money's worth by having them hang in the closet when you cannot wear them. If you feel strongly that you do not want to give these clothes away, consider putting them in storage or giving them to someone who you know will enjoy them. While buying new clothes can be expensive, remember that you are making an investment in yourself. Of course, clothes of all sizes range in price; you will need to find stores or catalogs to match your budget. As you think about allocating money for clothing, however, think about how you prioritize your available income. Are you an equally important "piece of the pie?" Or do you allocate to yourself whatever is left over after other necessities? Those of you with families may find this a particularly helpful question.
As with all guidelines in the Overcoming Overeating approach, you need to move at the pace that is right for you. Karen, a woman in one of our Overcoming Overeating groups, stated that she couldn't bear to part with some of her favorite clothes. She felt very upset all week because she knew her Overcoming Overeating group would ask about her progress on this front. She said she felt like a failure. Karen was surprised and pleased when the group reassured her that if she didn't feel ready to take this step, she should leave her clothes just where they were. When Karen felt the compassion of group members, she became compassionate with herself as well. Interestingly, as soon as she gave herself permission to keep her clothing, she felt comfortable beginning to shop for new outfits. She realized that she no longer needed the old clothes to hang where she could see them; in fact, Karen now needed the space for her new wardrobe.
"I have cleared out many of the clothes that no longer fit me, but there are some outfits I just can't let go of."
Often, women will keep favorite clothing in case they become that size again someday. In this situation, ask yourself if you would actually wear the outfit again. After all, styles change and clothes can quickly become outdated. One night in group, each woman brought an article of clothing that was difficult for her to give away. When it was her turn to speak Margie began to laugh. "I kept thinking that if I lost weight, I would wear this suit again. I spent quite a bit of money on it and it was very stylish when I bought it. But, when I took it out of my closet to bring tonight, I noticed the lapels! They are so wide, I wouldn't be caught dead in this jacket!" As she took the plastic bag off the suit, the rest of the group joined in her laughter. The outfit was quite fashionable in the 1970s... Margie now felt free of the need to keep the suit.
Another reason people have difficulty giving away certain clothing is because of the memories they attach to a particular item. Perhaps the mini-skirt hanging in your closet brings back fond memories of being single. Or that classy suit reminds you of an exciting job interview you had and the pleasure of getting the position. Perhaps a bathing suit reminds you of a leisurely vacation you once took and which you wish you could re-create at this hectic time in your life. But remember: Even though you associate the clothing with these events, the experiences remain in your memory and are not actually contained in the clothing. Giving away that mini-skirt doesn't mean you no longer recall what it felt like to be single. And, would you ever really wear it again? If it still feels important to keep a specific item because of the memories attached to it, make sure that it remains a relic of an earlier time in your life rather than another way to say that your body is not okay just the way it is.
"I hate shopping."
As diverse as we are in body size, so are we in our feelings about shopping for clothes.
After years of yelling at yourself for not fitting into certain sizes, it is no surprise that clothes shopping may feel uncomfortable. For some of you, bad body thoughts increase noticeably as you enter the store. If you hate the thought of looking for clothes, try to be compassionate with yourself. By doing so, you will be in a better position to ward off and decode any bad body thoughts that occur during the excursion.
As you work toward dressing your body at its current size, you need to make a concerted effort to stop the yelling. As with all bad body thoughts, first apologize to yourself and then try to put the thought aside. Focus on the fact that you are entitled to have clothes that fit well and that you truly enjoy wearing. Here is a sample of some strategies used by women in the Chicago OO groups.
"If certain clothes don't fit my body, it's because these clothes were not designed for my body. My body is not the problem."
"If clothing sizes had no judgment attached, it wouldn't matter what size I was. I would just choose clothes that fit me comfortably and I would allow my sense of style to determine my choices."
"I buy everything I think I want to try on, but take it home with me to try on later. Then at some point when I have some private time, I shower, comb my hair and maybe put on some make-up and jewelry. Only then do I try on the clothing. It's private; I'm not rushed; I'm not in a hot dressing room and no one is asking me 'How is it going?'"
It is important to know which stores in your area carry clothes that are designed for your body. If you know women who are close to your size and wear clothes that you admire, ask them where they shop. Check for ads in local papers or in publications designed for larger women such as Radiance and Big Beautiful Woman. Send for Freda Rosenberg's catalog of large-sized catalogs*. Make sure that the salespeople maintain a non-judgmental attitude. A knowledgeable staff can help you find styles to match your body size and shape. You may also find it useful to bring an understanding friend with you on you shopping trip whose feedback you trust and whose company you enjoy.
At this point in the Overcoming Overeating approach, you may be cleaning out your clothes with this new attitude for the first time. Even if you cleaned out your closet earlier in your work with Overcoming Overeating, it is important to recheck your wardrobe from time to time. Are you still holding on to clothes that no longer fit? Do you have clothing that you really like? Going "back to basics" keeps your OO foundation solid and strong.
and Speak Out! |
M. Delgros © New England Center for Overcoming Overeating |
I began having problems five years ago after my third attempt to have a baby. My body told me that I was not meant to have children. Following this last miscarriage, my kidneys failed and recovered after four plasmapheresis treatments. Since that time I have had a tendency for high blood pressure.
On a routine visit to my doctor, he commented on a high blood pressure reading. He asked me to keep track of my blood pressure at home until my next visit. I reported it had been higher than the normal or average range. He then asked if I had gained weight. I told him I didn't know since I haven't weighed myself in over a year since I started the Overcoming Overeating approach in June, 1994. Up until then I had maintained a lower than "normal" weight with restrictive eating and long distance running.
He marched me out to the scale and asked me to step on it. I replied that I would but I didn't want to know the weight. I stepped on the scale backwards so I couldn't see it. He chuckled and said, "You really mean it." I said, "Yes." He wrote the weight in my file and then looked back. "Oh, yes, you have gained weight. Well, this could be the cause of your problem." I replied that it may well be the cause of the elevated blood pressure, but after 22 years of dieting, I was not going to restrict my eating. He told me I didn't have to go on a crash diet, but just lose one or two pounds a week. He also suggested exercise and I told him that I exercise everyday. He looked skeptical.
I slowly burned inside. I wasn't going to let him turn this into a weight issue. He sat there looking at me as though I was a naughty child for gaining weight. I was faced with the "you are a bad girl for not being thin" syndrome so prevalent in our society. I was furious.
I looked at him and said, "If it's so easy to lose weight, why don't you do it?" He had no reply. He clearly did not meet the height and weight chart standards. Although I am sensitive to the issue of weight and won't make comments about other people's weight, in this case, I felt justified. He blushed and mumbled something about how hard it was to lose weight. No kidding!
We then went on to discuss the alternatives, but I was just a little bit happier inside for standing up to him. I won't ever let someone make me feel bad for not being thin, including myself. I've fought to hard too accept myself to let anyone else tell me I'm not okay the way I am.
As dietitians working with OO, we have seen examples of just how well this approach works for people with medical concerns. We'd like to share some of these experiences with those of you dealing with similar concerns. The most common health issue we address with our clients is diabetes. Here are two examples:
One diabetic client, Ann, had been working with the OO approach for almost two years. She was no longer binge eating but had never paid close attention to identifying and stopping at the first signs of fullness. She was trying to maintain normal blood sugar levels without medication. Therefore, it was important to eat just what her body physically needed; no more and no less. We discussed how stuffed felt vs. full. Ann experimented with stopping after different amounts of food to see what felt most comfortable.
Ann also began checking her blood sugar three to four times a day especially if she felt different in any way. She kept a running tally of what and when she ate. She started to identify a particular kind of tired feeling when her sugar was elevated. She noticed another kind of higher energy feeling when her blood sugar was in the normal range. We tried to identify any particular foods or combinations of foods that contributed to high or low blood sugar levels. For example, we noticed that richer foods eaten late in the evening correlated with high morning blood sugars.
The blood sugar readings began to feel like numbers on a scale, so it was important for her to learn to look at this information objectively. Neither the food nor Ann were good or bad; it simply did or didn't leave her feeling well. We discussed how stress and physical problems like fever or pain can increase blood sugar, and how activities like walking can lower it. Again, it was not a matter of being good or bad, but understanding how the body works, and striving to find the calm caretaker within who would be attuned to her needs. By tuning in to what she wants to eat and how much is satisfying, Ann is successfully managing her diabetes.
Another client needed insulin to maintain normal blood sugar levels. It is important to recognize that if the body's insulin is significantly ineffective or inadequate, diet alone simply is not going to work and some kind of medication is necessary.
Paula, a 40 year old who has had diabetes for five years, began seeing the dietitian at a time when her physician advised her of the need for insulin to maintain more normal blood sugar levels. Now with a support team of a dietician, a therapist (leading an OO group) and a psychiatrist, she began to put to rest the doubt she had about integrating OO and diabetes. The messages she received from all three reinforced one another.
With encouragement, Paula began more frequent testing of blood sugar. Her views of diabetes changed as she learned that sugar is not a forbidden food. As with all food, it is a matter of the quantity her body can handle. From the records she kept on her blood sugar, she could now say she knew steak and pasta were foods that elevated her blood sugar. She could observe that eating smaller amounts of food at night (which might include a sweet) gave her a more restful night's sleep and a lower blood sugar in the morning. Fearful that insulin would mean great restrictions on her life, Paula interviewed diabetics who were on insulin as to how they coped day to day with their self care. She was relieved to learn that she could monitor her blood sugar and give herself insulin injections any time, any where and therefore have her freedom. When dining out she could carry premeasured insulin, check her blood sugar in the car and give herself the injection in the privacy of a bathroom stall, before eating, so she could continue to eat at restaurants with her friends; an important activity for her.
Over a six month period, Paula became more assertive and confident in her dialogues with her physician. She would prepare for a potentially emotionally charged visit by focusing on what she needed to get out of the visit and by making a list of questions she wanted to ask. As Paula felt more support from health professionals and more secure with her new views on diabetes, she was able to make a relatively smooth and successful transition to insulin medication. In many ways, she is far calmer about her diabetes and notices that she is stopping when full more frequently than in the past.
We have seen that when you listen carefully to your body you can trust it. Working with a dietitian may help you to recognize more clearly how food works in your body, but there is no need for or benefit to rigid rules around food. Even traditional organizations like the American Diabetes Association have recognized the need to legalize all foods, including sugar, to help normalize symptoms as you strive to feed yourself in a nourishing and satisfying way.
Elisa D'Urso Fischer and Marianne Evans-Ramsay are registered dietitians practicing in the Chicagoland area.
Cheers to the Sunday, November 12 WOMANEWS section of the Chicago Tribune for running this "News In Brief" (p. 10):
Brain drain: Worrying about what you eat can be a drag on your mental potential according to a study by the Institute of Food Research in Reading, England. Volunteers were given psychological tests to measure vigilance, speed of reaction, mental processing capacity and memory. Those who scored lowest had just begun a diet or had dieted and failed to lose weight. The study, published in New Scientist magazine, indicates that poor scores among dieters were due to psychological reasons such as anxiety, and not from poor nutrition or lack of energy. "It is a preoccupation with food and body shape," said Mike Green, a research psychologist at the Institute.
© Copyright 1995, The National Center for Overcoming Overeating
Contributors retain all rights to their work. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, without written permission from the National Center for Overcoming Overeating, P.O. Box 1257, Old Chelsea Station, New York, NY 10113-0920.
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