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Newsletter Articles • Gentle Discipline: The Feeding Ourselves Paradox Gentle Discipline: The Feeding Ourselves Paradox Earlier this month I had the opportunity to lead one of my favorite Feeding Ourselves workshops, "Breaking Through the Impasse," which we offer periodically for program participants who wish to renew their conscious eating skills and push past some of the roadblocks they are encountering on the way to a peaceful relationship with food and their bodies. I particularly like offering this workshop as spring approaches; it is so clear to me that people come back to the program because during the course of their initial experience they planted a seed of hope and insight, a vision of finally being freed from the exhausting battle with dieting and food deprivation. And it is precisely because that seed was planted that they are able to come back to the principles of the program despite wintry periods of forgetting or discouragement. As I listened to the women who had assembled for our day together--some recent graduates of the program, others participants from quite a few years ago--I heard many of the problems encountered as they worked at integrating what they had learned in their groups. In some cases there was frustration at finding the time in hectic and demanding lives to "tune in" to bodily hunger, to identify what food was humming, and to go the extra distance to actually acquire it. In other cases there was the fear of finally letting go of using food as anesthesia or emotional "band-aid" for life's tough times. What would it be like, they wondered, to face the pain of a loss or rejection, or the boredom of a dreary day at home without their good old reliable box of chocolate chip cookies? And then there was the nagging anxiety about fully trusting oneself with previously "forbidden foods"--vestiges of the diet mentality that can persist before complete liberation from years of dwelling in the prison of calorie restriction and weight loss deadlines. My antidote to the perils of despair and discouragement during this process of change is best expressed through what I call the four "Ps":
Staying connected to the work of other Feeding Ourselves members who are traveling the same road is a wonderful source of support and renewed commitment. It can also be inspiring. Take a look at the stories of Feeding Ourselves alumni in our Participants Speak column. [Back to top]Teaching Kids to Eat and Love their Bodies, Too! Excerpted from, On the Move, a newsletter published by the Melpomene Institute for Women's Health Research Teaching Kids to Eat and Love Their Bodies, Too! was developed
with the goal of preventing the primary risk factors known to contribute
to the onset of disordered eating. The paradigm shift this curriculum
proposes is as follows: Developmental changes, body size, shape,
weight or hunger are not within our control. Choices can be made
about what will be eaten and about a sedentary versus active lifestyle.
These choices may or may not influence weight. Children who are
taught early that an individual's "best" weight may be
fatter, slimmer, or in between will grow up with more realistic
body image expectations for themselves and others.
Breaking the Exercise Barrier:Using positive thoughts to get to
positive behaviors Joan B., a Feeding Ourselves alumna from the 1980s, started running exercise classes over 10 years ago after realizing that what was available for larger persons in the world of health clubs and the like was less than satisfactory. When she sought out places to exercise, trying both aerobics and jazzersize, she found herself facing what she describes as a problem for many large women, that the barriers to exercise are both physical and psychological. Her large size required adaptations to the traditional exercises and the health clubs made her feel like a pariah. She very much wanted a place where she could feel safe, both physically and emotionally, while she worked to improve her overall fitness. Joan credits the work she did at Feeding Ourselves with waking her up to the possibility that she could be free from the "diet mentality", which she experienced as that voice which says you really can't do anything until you lose weight, a voice which had the potential to sabotage any efforts to effect positive changes in her life. Once freed from that message she was able to start her own fitness program that met her requirements and those of other large individuals. She has been running classes in Newton and Lexington ever since. Other Feeding Ourselves alumni have told me how changes in how they think and believe have led to positive behavioral changes. WLW participated in the Feeding Ourselves program in 1995. She shared with me the eye-opening experience of sitting in a room with four very large women and four small. "It was the universality of our experience which amazed me. Each of us woke up each day saying yuck I don't like the way I look. I'm too fat!" Wendy spoke of the sadness she felt at the shame each of these women carried and its effect on their lives. Once Wendy began to pay attention to her own internal dialogue about her body she was appalled--"I wouldn't talk to a dog the way I talked to myself on a daily basis… 'you're fat, you're ugly, don't try that, don't even think about wearing that,' and on and on." It was this awareness, coupled with a growing realization that her life was slipping away while she waited to get thin enough to start living, that prompted a number of behavioral changes. Wendy told me, "I was able to turn down the volume on the 'you are a fat person station', and turn up the volume on the other stations. These gentler stations talked about me as a large woman who is also many other things,--intellectual, political, socially concerned…." Once she was free from the "waiting to get thin" conundrum and the negative self-talk, she began to make significant changes in her life. Like Joan, Wendy sought a place to exercise, and found a gym for women only in Natick. "Gyms filled with buffed men and gorgeous women" had intimidated me in the past" she said. "I felt uncomfortable and out of place." At the all women's gym she still has to deal with trainers wanting to know her weight loss goals. Her goals now are not concerning weight loss, but rather to feel better internally and to become stronger. She has been able to find exercise clothes in the Junonia Catalogue, a fitness wear catalogue for large women, which fit well and make exercising comfortable. Over time Wendy has maintained a fitness program that is right for her. In her exercise classes Joan B. also stresses that the exercises are being done to feel better, as opposed to being a means to weight loss. Exercise, from Joan's point of view can be a chief contributor to the development of self-respect. She believes that exercise is a way to "..feel powerful, comfortable, and safe in (your) body" and that " "fitness is the ability to do the work our bodies were meant to do. Joan describes fitness as "having enough stamina, energy, and strength to performs life's activities, such as walking upstairs, carrying packages, holding babies, catching a bus, dancing, working, making love, and cooking lasagna….." She also emphasizes that any exercise is a step toward increased fitness. Any movement is an advance. Along with Joan and Wendy, Tracy I. learned that she did not need to put her life on hold until she got "thin." She remarked that "at one time weight loss was the be all and end all in my life." Exercise had always been part of the consuming campaign to lose weight, now she does it because it makes her feel better. Responding to this internal motivation means she can exercise as much or as little as she wishes, no longer bound by external rules about how much she needs to do to make it really count.. Becoming free from the rules and regulations that dictated her life in the past has enabled Tracey to attempt The New York Aids ride this year. On September 12 she will join 3,200 riders for a three day journey to New York City. "In the past I would have said, I'm too large to do this, this year I said 'why not'." [Back to top]American Baby or American Babe? Deep rose, pouted lips, head cocked, chin up, cheeks blushing, hair moussed with a careful curl adorning her forehead. She glances wistfully over her shoulder, clad in a wine-colored sweater with gold edging along its scalloped neckline. A Vogue model? Calvin Klein's heroine chic? Try American Baby's December cover girl, aged 12 months. Yes, before a child can walk or talk in this culture, she can be objectified by the advertising industry. Fortunately, even through the blur of new-parent sleep deprivation, the readers of American Baby magazine woke long enough to fire off letters to the editor in angry response to this adultified image. The magazine responded that it would never dream of applying make-up to their infant models. Their cover baby was a natural beauty, whose only enhancement was a bit of styling to her hair. Nonetheless, what is the message behind choosing to portray an infant posed and outfitted provocatively enough to appear decades beyond her first birthday? If the cover headline alongside this image, promising post-partum moms ways to "Get Your Body Back!" fails, are these mothers meant to dress their baby daughters up to reflect the lean sophistication they don't feel in themselves? In doing so, would these mothers not risk pushing their babies to grow into teenagers before they've even made it to pre-school? What foundation for healthy self-esteem would be built upon the expectation that a child look "model perfect" on the playground? Doesn't this expectation interfere with the basic "job" of toddlers, which is to dig, taste, tumble and otherwise explore their world with physical and emotional abandon? An even greater risk of this type of objectification may be the implied message that self-worth is based on external appearance rather than internal qualities, perhaps leading children to preoccupation with weight, eating and body image issues later in life. As we work to reclaim a healthier relationship to our bodies and eating behaviors, it is important that we also encourage our children to appreciate themselves from the inside out, rather than as mirror images of the culture's ever-changing ideal of beauty. [Back to top]More on "American Baby or American Babe?" I just read the Spring 1998 Newsletter and wanted to add something to your column, "American Baby or American Babe?" There has been a commercial on television recently for some sort of Kraft fat-free dressing, which shows a new mother sitting at a table, eating salad with fat-free dressing, while her, say, six-month-old baby sits gurgling across from her. Earlier shots, in the same ad show the mother's struggle to lose her pregnancy weight. To her baby she says, "Sure, those chubby thighs are cute now, but just wait!" I found this the most offensive ad I have ever seen (and I've seen plenty of ads and taken plenty of offense in my life). So much so that to contemplate expressing the full range of how it makes me feel, and think, is heartbreaking. As a once-chubby child, as a once-postpartum mom, whose self-image was so confused that it left me with little realistic sense of who I was or what-so much so that I valued my worth as a mother right behind my size as a female body-I think this ad is one of the most blatantly anti-woman, fat-hating commercials ever created in a sea of anti-baby and anti-child. I have written to Kraft. I have refused to buy any of their products (beyond my usual refusal to buy special "low-fat," "diet," "lite," "fat-free" versions of anything). I hope others will do the same. P.S. Newsletters from Feeding Ourselves, like the program itself (which I did a year ago), are what let me know I am sane, and not as alone as I sometimes feel. Thank you. [Back to top]The Binge Underworld Fairy tales, myths, and dreams carry the symbolic meanings of universal hopes, fears, beliefs, and aspirations down through the ages. In our attempts to understand complicated relationships with food, we often turn to these forms to help unravel the mysteries of our feelings and behaviors. Our interpretations of dreams and ancient tales can provide clues to such questions as what triggers compulsive eating bouts; what are we truly "hungry" for with our emotional appetite; or how we use food and weight obsessions to keep us from achieving what we really want and need in our lives. A powerful example of how we can learn about our unconscious fears and needs through ancient tales can be found in the Sumerian myth about Inanna, Goddess of Heaven and Earth. Realizing that her great strength is ebbing, she decides it is time to take the perilous journey to the underworld in hopes of reviving her power. In this dark and dangerous realm, she encounters many life-threatening obstacles, culminating in the confrontation with her destructive sister Ereshkigal, Queen of the Great Underworld. Despite these terrible risks, Inanna eventually emerges with her powers renewed, and returns to rule over her kingdom with new wisdom and strength. What can we possibly have in common with such a mythic tale? Actually, quite a bit. After a binge, driven by its wild out-of-control impulses to devour endless cookies or doughnuts, we feel demoralized, exhausted, defeated-like Inanna with her waning powers. During and after the binge we are in a stupor, overwhelmed with self-disgust and shame; we may hide not just our bodies from the world, but also our personal power and presence. At that point, just like the Sumerian Goddess, we, too, must take the fearful journey down to our own psychological "underworld" in order to discover buried feelings and fears-the dark "sister" of the self we want to avoid. We use food to bury those aspects of ourselves deep under our consciousness, and we use weight and body preoccupation, and self-recrimination about overeating, to push them still further underground. In fact, the more determined we are to disconnect from the "darker" or seemingly shameful parts of our nature, the more likely they are to emerge in the form of compulsive or addictive behavior. To undo this painful pattern, and to recover our balance and energy, like Inanna, we all must be courageous enough to explore our personal underworlds, and take the risk of confronting our own shadow sister. By allowing those negative aspects of ourselves-whether it is a long-buried secret about abuse or rejection, or unspoken anger from our past-to come into our conscious awareness, and eventually into acceptance and even compassion, we will no longer need to use food and compulsive eating to keep them submerged. And like the Goddess in the myth, we-not the food compulsions-will gain strength, and thus the power to re-direct our own lives. For those Feeding Ourselves participants interested in learning more about exploring the unconscious as a way to understand and change behavior and eating patterns, Dr. Kales will be leading an evening workshop Friday, November 20, from 7 to 9:30 p.m., as well as continuing dreams workshops in 1999. [Back to top]Raising Diet-Free Children in the Baby Boom Generation's Diet Culture A woman in her forties recently called Feeding Ourselves, seeking information about how she could help her teenage daughter, who is struggling with anorexia. By the end of the call, she confided that she, too, battled her own diet and weight demons in the form of compulsive overeating. Yet another woman called "on behalf of my daughter and myself." This fifties-something mom and her thirties-something daughter both signed up for a Phase 1 Feeding Ourselves group, and in doing chose to support one another, in a non-diet approach to their life-long struggles with overeating. Another woman in her late-thirties just had a baby girl. She sought help for her own food and body image issues, so she wouldn't "pass them on" to her little girl. Each of these calls reflects the paradoxical culture of the baby boom generation: we've grown up on diets and weigh more than ever. A well known study of Playboy magazine "centerfold" models and Miss America winners found that they got progressively thinner over a 20-year period, while in actuality the national average for woman has increased by seven pounds! At the same time, the products of this diet and fitness culture, our children, exhibit more and more "sub-clinical" or abnormal eating behaviors, paving the way toward full-fledged eating disorders in later adolescence or adulthood. For twenty-three years now, Feeding Ourselves workshops have helped individuals make the connection between their own eating and weight issues and what family eating scenes were like for them as children. Now, it seems, more and more individuals are also connecting the way their struggles with food have impacted how they've fed their children. This, in turn, has affected how their children regard food and their bodies. The $10-billion per year diet industry of 1970 had become a $33-billion industry by 1994, and is estimated to grow to $77 billion by the year 2000. How has this trend helped us? On any given day, 48 million Americans are dieting. At the same time, millions of us have become "food obsessed. We dwell on how many calories, carbohydrates and fat grams we've consumed by lunch time, only to blot out these guilty thoughts with a four o'clock trip to the vending machine. This may even trigger an all-out binge as soon as we leave work. Our children-who don't miss a beat as we pick at the meals we've prepared for them and nibble on leftovers as we clean up-are also growing more and more preoccupied with extreme dieting, at increasingly younger ages. Recent studies have found that as many as 50 percent of fourth grade girls try to diet because they are afraid of being too fat. In another study of female students between 12 and 18, 40 percent perceived themselves as "overweight"-while a mere four percent actually weighed more than the weight-for-height-standardized measures. Yet another study of 15-year-old girls found seven percent abusing laxatives and 11 percent inducing vomiting to prevent weight gain. One out of 200 girls aged 12 to 18 is anorexic. Despite our children's drastic weight-loss measures, many of them are growing more obese. There's been a dramatic rise in childhood obesity-54 percent since the 1960s-and 27 percent of these obese children are aged six to 11. This is not to say that women of the "Boomer" generation are responsible for the "X"-generation-and-under's eating disorders. There are many complex factors at play in the development of an eating disorder that extend beyond the values of an individual family. In American society, body image is central to self image. As children enter puberty, they experience the looming cultural pressure to conform to standards of beauty that equate attractiveness with thinness. At the same time, it is normal for developing females to add 20 percent of their body weight in fat, sometimes as much as 20 pounds or more in a single year, between the ages of 10 and 14. This split between the physical reality of their bodies and our culture's "model" body-the average fashion model weighs 110 and stands 5'10"-has a devastating effect on girls. Preoccupation, anxiety, and denial of hunger begin to consume girls' attention and interfere with concentration on social, emotional and intellectual growth. As Kathy J. Kater, LICSW, commented, "A growing child's inability to feel comfortable in his or her own skin can be extremely destructive on many, often hidden levels. Too many pubescent children, particularly girls, quickly feel forced to choose between their authentic selves and fitting in. For many girls this begins with objectifying their bodies." Ms. Kater points out that it is the norm not just for girls, but for their mothers, aunts, and grandmothers, "to feel disgusted with their bodies and fear eating will make them unattractive (i.e., fat)." To these women and girls, healthy eating and physical exercise are only valid as means to weight loss or slimness. Motivation for exercise does not arise out of an inherent feeling of self-worth or desire for well-being, let alone simply because it can feel good to move. If dieting and fitness fervor aren't the solution to our eating and body image issues, and if we don't want to "pass on" our food struggles to our children, what can we do? Just as the safety guidelines on any airline flight point out that we need to put on our own oxygen masks before assisting our children with theirs, we need to take care of our own hunger and satiety, in order to be of support to our children in trusting and caring for their bodies. In this case, putting on the oxygen mask may be learning to trust that we can eat on demand-when we are hungry, exactly what our bodies crave, stopping when we have satisfied physiological hunger. Helping our children with their oxygen masks means supplying them with assurance that they, too, can trust and respect their bodies as we have learned to do. We can offer a whole range of food choices to ourselves and our children, while practicing the tools of conscious eating and living. Our children will glean far more from our eating attitudes and behaviors than from our lectures about "healthy" vs. junk" food. We can teach them about the changes their bodies wil naturally undergo in adolescence and support them in appreciating them better. We can show them that we appreciate our own bodies by wearing comfortable clothes that fit well, versus ones that cinch our middles or are designed to hide who we are. We can borrow from some of the guidelines that Ms. Kater has developed in her curriculum, "Teaching kids to eat and love their bodies, too!" [Back to top]Reviving Ophelia: Saving Our Daughters From a 'Girl-Poisoning' Culture A cell is defined as the smallest structural unit of an organism that is capable of independent functioning, consisting of nuclei, cytoplasm, various organelles, and inanimate matter, all surrounded by a membrane. That membrane, vital to the health of the cell, is designed to be permeable to life-giving nutrients necessary for the cell's survival. However, that same membrane, weakened by constant attack from outside pathogens, and the like, can disintegrate, spilling its contents into an abyss of the demands of the outside world. A metaphor perhaps, but its message can be found in an insightful book by Mary Pipher, Ph.D., entitled Reviving Ophelia. Dr. Pipher looks at the problem of keeping our adolescent daughters safe from an ever-increasing danger-the "outside" world. "They are coming of age in a more dangerous, sexualized and media-saturated culture. They face incredible pressures to be beautiful and sophisticated…as they navigate a more dangerous world, girls are less protected." Where do we begin then? Do we shore up the membrane, or try to change the world? Dr. Pipher suggests awareness as a first step. By coming to know the world our girls must navigate, we move in the direction of protecting them. "As I looked at the culture that girls enter as they come of age, I was struck by what a girl-poisoning culture it was. The more I looked around, the more I listened to today's music, watched television and movies, and looked at the sexist advertising, the more convinced I became that we are on the wrong path with our daughters." After advising awareness, Dr. Pipher goes on to define a plan of actions. "Adolescent girls today [also] face a problem with no name. They know that something is very wrong, but they tend to look for the source within themselves or their families rather than in broader cultural problems. I want to help them see their lives in the context of larger cultural forces." She also advised that we encourage "emotional toughness and self-protection." She goes on to tell us to support and guide our girls. [For more on the subject of support and guidance, see "Raising Diet-Free Children in the Baby Boom's Diet Culture," and "Teaching Kids to Eat and Love their Bodies,Too!"-on the following pages of this newsletter.] And finally, she admonishes all of us to change the society we live in: "…we can work together to build a culture that is less complicated and more nurturing, less violent and sexualized and more growth producing." The book is illustrated with case histories in the context of individuals, families, and community. The accounts of real lives is both unsettling and encouraging. While reading this book three years ago, I remember sitting on the subway and thinking that I wished I had read it sooner. As I continue to parent two wonderful girls and a wonderful boy, I feel light years ahead because of this book. But getting back to wishing I had read it sooner…perhaps what I was really feeling is, I wish it had been around for our own Mothers. [Back to top]WWLW…More Music…Greater Variety I have had an addiction to National Public Radio on and off over the years. At times, it has seemed as though there were no other frequencies on my radio dial. The latest news, analysis and commentary had been of supreme interest. I was always tuned in, no matter where I was…in my car, waking up to my clock radio and as background to household tasks. After a couple of years of this pattern, I began to notice that when others mentioned new music or artists, I would be lost. This began to concern me….In my twenties and early thirties, I had been known among my friends as the one with the most current information regarding music…the disc jockey for the parties. As a child, I listened to a variety of music with my family, from big band music of the forties to Broadway musicals to Peter, Paul and Mary to the Steve Miller Band. My interests had begun to shrink, until I was only listening to the news. I hadn't realized that my right-brain, my creative, artistic self was starving until there was no recall of the current music scene. I then became aware how small my world had become. I wanted this to change. I began to listen to music again, all kinds of music, I could now converse more intelligently with others about the new music scene. I found myself turned off to all that information that had been my mainstay. My daily diet of information and left-brain food was changing to accommodate my rediscovered appetite for the poetic, musical side of life. After a few months of bingeing on music, both live and recorded, I began to feel the need to know what was going on in the world. I felt the need to speak more intelligently about issues. However, I had learned my lesson. No longer would I only feed one part of myself to the exclusion of others. It seemed that balance was the key. I've not veered from that path since I made that decision. Now, I tell you all this because it dawned on me that tuning in to only one frequency did not only happen during my radio listening moments. During my whole life, I've found that I had been tuning in to only one frequency regarding my self image. The one, insistent, consistent message was: "You, Wendy, are too fat to ever think of seriously flirting or having anyone interested in you. When you slim down, and stay slim for a long time, you may then flirt and entertain the possibility of the love of a man. But until then, know that you are a turn-off to all men, no matter how well you dress, and how witty and smart you are." Through my work in Feeding Ourselves groups and one-on-one therapy with Dr. Emily Fox Kales, I now have a clearer understanding of the limits I placed on myself by only dialing in to that one station, and tuning in with the volume at full blast, as well. The incessant noise of that one station had been blocking out many other messages that were also available to me. I've turned down the volume to a quieter level, and turned up the volume in other areas of life. For instance, the message that not all men have the same ideas about what is attractive. Another message I was blocking was that I was capable of loving and being loved despite my body size. I had not been tuning in to the message that I had just as much a right to go to women's gyms as the next person, to get exercise and get strong, despite what others may think of seeing me in exercise clothes. Truthfully, my worst enemy in this department has been myself….I'm still working on tuning the volume way down to a whisper with the message of, "Oh, Wendy, you look so awful at this size don't wear this in public…." Meeting and marrying Jeff has provided me with lots of terrific stations to tune in to. One of my favorites is, "Wendy, you are so beautiful. Thank you for marrying me." [Back to top]Conscious eating - Simple but not easy "STOP OVEREATING - LEARN HOW IN 4 MINUTES!" - This statement was seen on the September 1996 cover of Prevention . The article describes the value of what Feeding Ourselves calls "conscious eating." Dr. Dean Ornish, director of the Preventive Medicine Research Institute in Sausalito, Ca. and a leading exponent of low-fat eating describes how he enjoys chocolate, in much the same terms as participants in the basic Feeding Ourselves program would describe the Chocolate Kiss exercise. "I'm not talking to anyone, and I'm not on the phone or reading. First, I look at it. Then I close my eyes and smell it. I bite in slowly. I notice all the different flavors; the textures; the way it feels going down my throat. I notice the flavors occur at different times, almost like a symphony, in different parts of my mouth and throat. ...The whole encounter takes several minutes. I do it two or three times a week and usually, I find that one piece is all I want. It's enough. The experience lingers."...Dr. Ornish was interviewed for this article along with several other experts from a wide variety of fields who also believe that "paying close attention to what you are eating can help prevent overeating..." Dr. Elizabeth Wheeler a clinic psychologist at the University of Massachusetts Medical Center's Stress Reduction Clinic notes that ,"Many people who have food problems eat on automatic pilot,. a lot of times the only way they know they have eaten is because the food on their plates is gone.'' Like Feeding Ourselves (see page 1) their follow-up studies "suggest that a program built around mindfulness works. "Our patient's significantly reduce symptoms of compulsive eating," says Dr. Wheeler. "They're less likely to eat when they're not hungry and less likely to eat beyond the point of fullness. " Throughout the Feeding Ourselves twelve week Basic program, and again in the Phase 2 and Phase 3 programs, our group leaders stress the principles of conscious eating. Participants first encounters with the ice-water and the chocolate kiss exercise are often very powerful experiences and for some very difficult ones. In our advanced groups participants often express frustration that conscious eating has not become a daily automatic and permanent fixture in their lives. Being asked to slow down and be mindful with food sounds like a simple thing to do. It certainly sounds easier than religiously counting calories, or chastising oneself for eating a "bad food'. Prevention's cover offers the promise of a four minute cure for overeating, and yet anyone who has tried conscious eating know that it is not such a "quick fix." Dr. Fox Kales, the founder and director of Feeding Ourselves says, "Because it is simple does not mean that it is easy" Over the years of working with Feeding Ourselves participants we have learned that it requires a commitment of time and a kind of mindful attention to an individuals relationship to food that is vastly different from "diet will power." The requirement that you give gentle but constant attention to what you are doing while eating shifts the focus dramatically from the distraction of obsessing about calories and what one is eating. The focus is on the body rather than external guides. This constant gentle awareness is an art, and must not only be learned but practiced as well. This practice can be thought about in terms of what Dr. Fox Kales has called, the three P'S -- patience, permission and persistence. Patience is the acknowledgment that owning this skill takes time, and that there are no diet "deadlines" to strive for. Permission is the acceptance of the fact that you will not do this without making some mistakes. It means giving yourself permission to get off track and to get back on, without the self- loathing that so often accompanies broken diets. Persistence means knowing that if you overate in the morning you can eat consciously the very next time you get hungry without waiting for an artificial start date for your "new diet". What makes all of this such a challenge is that we are not used to responding to our bodies' internal messages. To unlearn old habits requires a great deal of support. Support is also required to practice the art of bringing our attention back to our hungers both physiological and emotional, to recognize fullness and to live life with awareness. The first introduction to conscious eating often brings with it a silent "wow -- this is so simple!" As simple as it appears, a concept which could be learned in four minutes according to Prevention , it is clearly not easy. [Back to top]Health Risks of Obesity: The On-going Debate The New England Journal of Medicine recently reported the results of one of the largest studies ever conducted on the health risks of obesity. In the study, researchers analyzed the fates of 324,135 white adults who were followed for 12 years. They found that the excess risk of dying associated with obesity was modest and declined as people age. By age 65, the effect was virtually absent. It disappeared altogether by the time people reached 74. Yet another "scientific finding…" But, as the New York Times reported, the study's results were met with apathy on one end of the spectrum and outrage on the other. Many Americans remain skeptical in the face of yet another "scientific finding." "Here we go again….Another example of scientists saying one thing one day and another thing the next. Why should anyone believe them?" commented Gina Kolata of the Times. Proponents of the diet industry resoundingly do not. Others, such as former Attorney General C. Everett Koop, who now heads a public health campaign called "Shape Up America," were also quick to respond to the New England Journal's article. He, along with JoAnn Manson of Harvard Medical School and Dr. Theodore VanIttallie of Columbia University, claimed that obesity causes 318,000 excess deaths a year. Is it risky to be fat? So, amidst all the controversy, the question remains, is it risky to be fat? Apparently it depends on how you pose the question. Does being fat make it more likely that a person will develop chronic disorders like diabetes, high blood pressure and high levels of blood cholesterol? The answer among experts seems to be a unanimous, "Yes." But when the question is posed another way, "Does obesity lead to an early death?" the answer according to the new study is "No". According to the authors of the study, Dr. Marcia Angell and Dr. Jerome P. Kassirer, the evidence that losing weight reduces the risk of premature death is "limited, fragmentary and often ambiguous." Why, they wonder, has an entire industry been built around combating obesity as the "second-leading cause of preventable death after smoking in the United States"? Is it possible, they question, that the "medical campaign against obesity" comes from the tendency to "medicalize behavior we do not approve of….In this age of political correctness, it seems that obese people can be criticized with impunity, because the critics are merely trying to help them." If science can say that obesity is a major cause of premature death, it follows that it must be treated, with drugs if necessary, even if "every drug to date has been only minimally and temporarily effective." And some pose serious dangers. Recall the popular fen-phen combination which was recently pulled off the market after being associated with serious heart valve defects. While the authors of the study do not advocate extreme obesity as healthy for the individual, Kassirer maintains, "The whole area is a slippery one. I don't think we have enough data yet to be confident that being slightly overweight is terribly bad for you." Finding one's "own voice" In the mean time, one essential question has been left out of the debate: How does one find one's "own voice" amidst the din of such conflicting advice? Such inquiry resides at the heart of the Feeding Ourselves program. For any treatment to have a lasting positive effect, it must be used in conjunction with a program that offers the cognitive and behavioral tools needed to aid the individual in managing vulnerability to over-eating. It is not enough to be "intellectually aware" of the health risks of overweight, however controversial they may be. Such knowledge is not enough to inspire long-term change in one's eating behaviors and attitudes. The problematic eating behaviors will return unless attention has been paid to the beliefs, attitudes and emotions that drive overeating. Feeding Ourselves helps individuals to develop the skills which will enable them to respond to internal urges in a more balanced way and to tolerate intense feelings without turning to food. As Dr. Fox Kales has said, such life skills "should be personal, portable and available without a prescription." [Back to top]The Heartbreaking news about Weight loss I returned home from vacation to find a pile of newspapers awaiting my attention. As I lay out the front pages on the breakfast bar I was immediately struck by the tragic irony of two stories run on July 9 and July 10. The first headline announced: "Blend of Diet Drugs tied to heart disease", the next day the death of a ballet dancer gave rise to the following headline: "A dancers death raises questions-Boston Ballet had told woman to lose weight" While the front page often carries news that is heartbreaking, these back to back items spoke of another kind of heartbreak, both literal and figurative. On one front page we are told that a young woman's heart appears to have stopped as the result of the punishment inflicted on her body by an eating disorder. We then read about five women who had used the diet drug combination of fenfluramine /phentermine and subsequently required surgery to replace damaged heart valves. In both of these stories hearts were broken in the attempt to lose weight. Weight loss is not meant to result in death or illness. Weight loss is meant to assist the individual in becoming a healthier person, able to live a fruitful and productive life, and as Joan Belson tells her exercise classes, to be able to move the body in the ways it is meant to. Extreme measures to achieve dramatic weight loss should be prescribed only when excess weight interferes with the achievement of one's life goals. The desire to meet a cultural expectation of slenderness occasionally results in the tragic consequences which have made recent headlines, however there is the less dramatic heartbreak that occurs in the lives of thousands of men, women and children who struggle with eating disorders and obesity. There are the thousands of lost opportunities and dreams not pursued by people waiting to get "thin enough." Developing a healthy relationship with food and with your body
cannot be accomplished through diets or medication. A positive relationship
is achieved through the process of changing behaviors and addressing
the cognitive and emotional issues that impact on that relationship. |
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