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The Diet Survivor’s Handbook: 60 Lessons in Eating Acceptance and Self-Care

Fall 2014 – Diet Survivors Group Newsletter

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Greetings:

Welcome to the Fall 2014 e-mail!

(Based on The Diet Survivor's Handbook: 60 Lessons in Eating, Acceptance and Self-Care)

As the leaves of this autumn season begin to change color we're reminded that we, too, are constantly changing. And as the temperatures begin to cool, we may find ourselves slowing down and turning inward. For many people struggling with overeating, turning to food is a way to navigate the uncomfortable feelings that can arise for all sorts of reasons. On the one hand, the practice of self-compassion is important to cultivate so you can be kind to yourself as you acknowledge that when you reach for food, you're doing the best you can in the moment to take care of your emotional needs. At the same time, however, it's also important to become curious, reminding yourself that, like the leaves in fall, change is ongoing, and that slowing down and turning inward are part of the journey.

You may find that there are times when you feel like you're "spinning" with thoughts or worries, and food is a way to calm, distract, or numb the discomfort. Another option to consider is learning mindfulness practices that help you stay grounded so that you can notice your feelings without them taking over. Just like building a muscle, if you develop a mindfulness or mediation practice on a regular basis, the ability to stay present will become stronger and more accessible to you during times of distress. [We sent out an email last month about a special webinar series, The Foundations of Well-Being from Rick Hanson that teaches what he considers to be the 12 Pillars of Well-Being: Self-Caring, Mindfulness, Learning, Vitality, Gratitude, Confidence, Calm, Motivation, Intimacy, Courage, Aspiration, and Service. If you're interested you can learn more here.]

Our lesson this month focuses on the benefits of a meditation practice and begins like this: Meditation increases your physical and mental well-being. Consider whether you would like to incorporate meditation into your life. Click here for more.

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STAY ATTUNED!

Do you find that you're better at identifying you're hungry than your fullness? If so you're not alone! We often hear from diet survivors that once they start eating, they have a harder time deciding when to stop; two common reasons are that it's hard to identify fullness or that the food tastes so good.

As an attuned eater, you're in charge of deciding when, what and how much to eat. You also get to choose how you want to feel when you're done eating. Here are some strategies to help you become more intentional about your level of fullness:

  • Before you begin eating, check in with your body and ask yourself how you want to feel when you're finished.

  • Visualize what you're about to eat. Ask yourself: How will I feel when I'm done? Is that okay with me?

  • Make sure that you're eating foods that satisfy you.

  • Let go of distractions that get in the way of noticing your fullness such as the TV or Internet.

  • Remind yourself that if you stop when you're full, you can eat again when you experience hunger (and keep the food that tastes so good available whenever possible, such as by taking home the leftovers from a delicious restaurant meal).

  • Notice that food tastes better when you're hungry.

  • Check in often with your stomach/body to assess your fullness. By paying attention, over time you'll have a better sense of how you'll feel after the meal, as well as 10 – 20 minutes later.

WEIGHTY MATTERS

Does going to the doctor create anxiety for you as anticipate a conversation about your weight?

An excellent article by Tracy Tylka et al. was published recently in the Journal of Obesity, examining ethical issues that result from traditional weight management approaches—including the increase of weight stigma, which is actually linked to poorer health. Instead, data supports an approach such as the Health At Every Size® framework for improving both physical (e.g. blood pressure), behavioral issues (e.g. binge eating) and psychological (e.g. depression.) This is an academic article – if you're interested, it's well worth the time to read. It's also a great resource to pass along to your healthcare provider(s).

The article begins and ends with a patient/doctor scenario. We're going to share those parts of the article with you because it captures the difficult experiences of many diet survivors, and then ends with a wonderful depiction of what is possible. We hope you enjoy it!

Weight-Normative Approach (emphasis on weight and weight loss when defining health and well-being):

Jasmine is waiting in the exam room and her chart shows that her weight today is up five pounds from her last visit two years ago, putting her BMI at 32. Her blood pressure was borderline high in contrast to the normal readings in previous visits. Although Jasmine's labs were normal in past visits, they are out of date. When Dr. Johnson greets her today, Jasmine seems anxious and tells Dr. Johnson, "I almost did not come in today knowing my weight is up from the last time I was here and you suggested a diet. I feel like such a failure. However, I need help for my migraines, so here I am." Dr. Johnson and Jasmine look at each other, there is a beat of silence, and they both sigh. Dr. Johnson thinks about all the moments like this one. Usually patients are coming in reluctantly, with medical issues that cannot wait any longer. There is a palpable sense of frustration about yet another problem related to high weight. There is a predictably tense discussion about what needs to happen. Promises are made, referrals are given, and patients drop out of sight until the next medical crisis that absolutely cannot be ignored. Dr. Johnson cannot help but think, "Could there be a better way?"

Weight-Inclusive Approach (emphasis on viewing health and well-being as multifaceted while directing efforts toward improving health access and reducing weight stigma):

Jasmine is waiting in the exam room and her chart shows that her weight today is up five pounds from her last visit two years ago, putting her BMI at 32. Her blood pressure was borderline high in contrast to the normal readings in previous visits. Although Jasmine's labs were normal in past visits, they are out of date. When Dr. Johnson greets her today, Jasmine seems anxious and tells Dr. Johnson, "I almost did not come in today knowing my weight is up from the last time I was here and you suggested a diet. I feel like such a failure. However, I need help for my migraines, so here I am." Dr. Johnson and Jasmine look at each other, there is a beat of silence, and they both sigh.

Dr. Johnson says, "You know, Jasmine, I have been reading the research on weight loss interventions and weight-cycling and I'm realizing that if the same thing happens to almost everyone, it probably is not the fault of the person, it is probably more about the process itself. So, instead of focusing on weight loss, I'm encouraging my patients to think about what makes them feel better in their everyday lives; emotionally and physically. For example, do you feel better when you eat more fruits and vegetables, drink more water, take a walk with a friend, meditate to relieve stress, and get enough sleep? There's good evidence that those behaviors are going to make you healthier and feel better even if your weight does not change."

Jasmine is a bit surprised by Dr. Johnson's shift and says, "Well, typically, when my weight loss slows down or stops completely, I stop doing any of those things you mentioned that would help me feel better and be healthier." Dr. Johnson says, "I understand, but we're going to turn the focus from your weight to your health. Because those behaviors are linked to health, why not do them anyway?"

Jasmine smiles at Dr. Johnson and says, "It sure would be easier to come back and see you the next time I'm supposed to if I did not have to lose weight first."

Dr. Johnson replies, "I do not want anything to stand in the way of you getting your medical care, including worrying that I might scold you. Now that we have a better plan, I am going to have the nurse retake your blood pressure." Jasmine and Dr. Johnson then discuss treatment options for Jasmine's migraines.

Right before Dr. Johnson leaves the room, Jasmine shares one more quick concern, "I like the shift from weight to health, but there is this Weight Focusers group at work. If I do not go, I'll get charged a higher premium for my health insurance."

Dr. Johnson says, "Let me know if I can help with that. The Affordable Care Act is supposed to allow you to follow your doctor's recommendation, and I have no evidence that Weight Focusers is going to make you healthier and lots of evidence that says that weight cycling is linked to poorer health."

Jasmine leaves the doctor's office feeling hopeful and understood.

As Dr. Johnson finishes the chart note, she realizes that her own body is relaxed, her jaw unclenched. She feels like she has made a better connection with Jasmine and developed a sustainable treatment plan she can follow. Dr. Johnson is curious and maybe even a little eager to see what happens next. However, she does wonder what will happen if the reviewers do not see weight loss in this patient, or a goal of weight loss in the treatment plan.

[From: Tracy L. Tylka, Rachel A. Annunziato, Deb Burgard, et al., "The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss," Journal of Obesity, vol. 2014, Article ID 983495, 18 pages, 2014. doi:10.1155/2014/983495

UPDATES

  • Fostering a Healthy Body Image: Changing the Conversation about Dieting, Food, and Weight is the name of Judith's talk for the Deerfield Parent Network on Monday, November 17th at 7:30 pm at the Deerfield Public Library – free to the public.

  • You can still receive a 20% discount (and free shipping!) on the 2nd edition of Beyond a Shadow of a Diet: The Comprehensive Guide to Treating Binge Eating Disorder, Compulsive Eating, and Emotional Overeating through our publisher by entering code IRK71 at checkout. Also available through Amazon.

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  • Join Judith at the Psychotherapy Networker Symposium from March 26th – 29th. She will present a full-day workshop on Creativity Day (Thursday) and a clinical workshop as part of the conference. Watch for more details!

  • Two books of interest! Our colleagues Linda Bacon and Lucy Aphramor just published Body Respect, an excellent book that explores the connections between weight, health, and social justice issues. Sigrun Danielsdottir released a wonderful picture book for children (and adults!) entitled Your Body Is Awesome.

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  • Amanda's Big Dream is in its final stages – our website is almost complete so check back soon! We're in the midst of collecting reviews, tweaking the illustrations, and developing our marketing plan. If you're a blogger who is interested in learning more, please contact Judith ( This email address is being protected from spambots. You need JavaScript enabled to view it. ).

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  • Please "like" Diet Survivors Group on Facebook.

NANCY'S NON-DIET DIET

After years of dieting, Nancy decided she was ready for a new approach. She understood that while her past attempts at dieting worked in the short-run, inevitably she ended up bingeing out of the restrictions and gaining back the weight… plus more. Nancy was tired of this cycle and seeking a way to find peace in her relationship with food.

Nancy embraced the concepts of attuned eating. She was able to identify her physical hunger as a gnawing feeling in her stomach. She was receptive to giving herself permission to eat forbidden foods, including pizza and ice cream, and she felt excited to begin this process.

Nancy reported that she found it easy to eat when she was hungry and stop when she was full. With support from her family, she stocked her refrigerator and pantry with all types of foods that had been "forbidden" to her on her past diets. And she collected many experiences that felt satisfying. Nancy was thrilled with the non-diet approach!

Several weeks later, however, Nancy reported that her binge eating resurfaced. She was surprised to find this happening as she had found attuned eating to "work" so well. She expressed that she now felt like a failure, and was concerned about whether anything would ever help to end her overeating.

Why did Nancy return to overeating after experiencing the physical and emotional benefits of attuned eating? Like many diet survivors in the initial phase of breaking the diet/binge cycle, Nancy had turned the non-diet approach into a new diet! This time the rules were that she could only eat what she was hungry, and she must stop when she was full. While honoring signals for hunger and fullness are certainly the goals of attuned eating, we like to gently remind people that if they could "just do it" they wouldn't need to read The Diet Survivor's Handbook or seek counseling to end their overeating.

Instead, as Nancy came to learn, ending overeating is a process that takes place over time. Rather than turning the non-diet approach into a new diet, as you reconnect with your signals for hunger and fullness remind yourself there will be other times that you turn to food that have nothing to do with physical hunger. This is a normal part of the journey, not a sign of failure. Stay compassionate with yourself as you learn how to have this new and satisfying relationship with food; if you need support, reach out to a professional who understands what it truly means to help people let go of dieting behavior.

Wishing you a season of abundance!

All the best,
Judith and Ellen

Judith Matz, LCSW
This email address is being protected from spambots. You need JavaScript enabled to view it.
www.judithmatz.com
Ellen Frankel, LCSW
This email address is being protected from spambots. You need JavaScript enabled to view it.
www.authorellenfrankel.com

www.dietsurvivors.com

Diet Survivors

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