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Incidence rates of obesity have doubled (from 14.4% to 30.5%) over the past 25 years, suggesting that genetic factors aren't even close to telling the whole story. Unlike alcohol and substance abuse treatment, when you abuse food, you can't abstain. You have to eat. Consequently, this book teaches you how to determine if you are eating because you need to and how to stop non-essential eating. Learning about your mind and your body are the first steps toward long-term weight maintenance and finding a peaceful balance in your life. Introduction There are thousands of diet books, diet aids, and programs to follow in order to help someone lose weight. And for the most part, they work. According to recent research, however, the stark reality is that these programs are effective only for the short term. Within three years of successful weight loss, most people (95%) regain at least all the weight they originally lost or are heavier than when they began (Grodstein, 1996). This type of weight change is referred to as weight cycling or "yo-yo" dieting. People typically move from diet to diet, sometimes with minimal progress. I have heard people say over and over again, "I know how to lose it, I just can't keep it off" or "I know what to do, I just can't do it." Some people say things like, "I lose ten and gain back twenty" or "I've lost over a hundred pounds over the course of my lifetime, but I'm still a size sixteen." These people are struggling with a real problem that is missing in most commercial diet programs: the ability to keep weight off for the long term and manage their "diet" along with a high-paced and stressful life. Under varying degrees of worry and anxiety, a well-planned day of dieting can quickly turn into a tug-of-war with a bag of Oreos. Commercial diet programs are behaviorally oriented; they tell you what to eat and how much of it. They don't help people understand the impulse to overeat. Behavioral programs fall apart when a person overrides what they know is right, and overeat anyway. This impulse can make a person feel discouraged to the point that they can't recover and get back on "the program." The purpose of this book is to help people understand the mind-body connection and the reasons that people stop following their program. There are many excellent weight loss programs available but this is not a diet book. This is a book to be used along with your diet program. The main focus of this book is not on what to eat. I will not tell the reader to avoid any foods. This book teaches the reader how to be prepared for the impulse to override their program and overeat. My hope is that this book will help people have more long-term success with these diet programs by teaching them how to manage life stress and strike a healthy balance within themselves. All of the chapters have pen and pencil exercises taken directly from a group that I run at my practice. Each chapter ends with a behavioral checklist to help you translate the information (presented within the chapter) into changes you can make in your everyday life. Unlike alcohol and substance abuse treatment, when abusing food, abstinence is not an option. It is necessary to learn how to eat. Consequently, the first part of this book teaches the reader how to determine if they are eating because they need to. The reader will be encouraged to make a distinction between essential and non-essential eating. The physiology of weight loss will be outlined and the hormone cortisol is introduced and described as undermining many attempts at fad dieting. The reader will be taught how to pay attention to internal hunger and fullness cues so that eating is driven by a feeling and stopped at a certain level of discomfort. Hunger and fullness cues will be strengthened so as to reduce the impulse to overeat. Skills taken from the treatment of phobias will be outlined as they relate to feared foods. The pitfalls of expecting abstinence from food and the power of psychological deprivation will be discussed in Part One of this book. Case examples from treating people with eating disturbances will illuminate the concepts presented. The second part of this book introduces the concept of eating as an addiction which worsens under stress. The stress hormone, cortisol, is again discussed. While learning about the cortisol connection, the reader can begin to build a bridge between life stress, skill deficits, and weight management. Various stressors and the life skills necessary to maintain a balanced emotional and hormonal state are outlined. Personality traits, relationships, life pace, and negative mood states will be outlined and the reader will be provided with skills specifically designed to alleviate stress. The positive effect of reducing stress and its effect on establishing a regular exercise program are outlined. Part Three of this book contains personal testimony from two people who are in the midst of completing their journey. You will get a first-hand glimpse of their experience as a stigmatized overweight person and travel with them as they find a healthier relationship with food and figure out who their true friends really are. The socio-political aspects of obesity are discussed in the final chapter. |
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