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Alternative Group is deeply committed to public education and health promotion. We embrace the principal that the benefits and assumptions underlying any treatment program should be clearly and publicly stated. Accordingly, these newsletters are part of an ongoing effort to promote understanding of our philosophy of treatment and to promote discussion of treatment issues.

IN THIS ISSUE
Providing our clients information on weight management is a special challenge. For many, food and weight concerns are simply a distraction from real issues. It would be a therapeutic mistake to dwell on these matters with anorexics and bulimics. Overweight compulsive eaters, and overweight people who are depressed and anxious, on the other hand, need not only sound weight management advice but also help in addressing emotional issues. For us, the task of dispensing information is a problem of timing, appropriateness, and balance. Accordingly, the following article is intended for overweight people who have some compulsive or emotional eating, and other eating disorder qualities.


UNSTUCK AND UNSTRESSED: PATHWAYS TO SANE AND PERMANENT WEIGHT MANAGEMENT

William C. Shearer, Ph.D., M.P.H., M.B.A.
Robin L. Shearer, M.F.T., M.A., M.P.H., R.N.

“How much can I lose and how long will it take?” The lady on the phone sounds desperate. Cost is not a problem. Urgency is in her voice--and something else. Tentative hope is poised on the edge of an expected let-down. As we begin to explain that our program has no special diet and talk instead of mindful eating and life style changes, there is obvious disappointment. Quickly her mood shifts to boredom and impatience. She wants now only to quickly stop wasting time and resume her quest. Next time she will find real diet doctors with fast and easy solutions.

The caller is like so many others. Conditioned by a lifetime of frustration and failure, food and weight issues act as a trigger for stress and depression. She has been brainwashed by countless schemes promising the most recent magical product or program to fix her life. The good news is that real solutions are available. The bad news is that her programming will not let her change course -- unless there is a major revision of the program.

Over the years, a great many people have sought our help for weight management. As our primary focus is treatment of eating disorders, we are careful not to treat weight issues apart from other issues such as self-esteem, self nurturing, effective limit setting, fear, and identity. We do not focus on weight at all unless weight is clearly a problem in itself. For us, the question is not about calories and pounds. For many of our clients, it's about damage to sense of self, and the misery that comes from a lifetime of seeking external solutions in an effort to make up for inner emptiness and anxiety stemming from not having learned self nurturing skills and effective limits early in life.

Overweight clients, as is the case for anorexics and bulimics, often have frequent dieting as a central theme of their lives. In many cases, their treatment of real or imagined obesity by self-deprivation (dieting) has been a precursor of greater problems. For some overweight clients, the result may be bodies increasingly programmed for obesity and a self-image marred by feelings of failure and low self-esteem.

One answer is a twenty-one point program we have developed over the years to facilitate permanent weight loss through life-style change and psychological reprogramming. Our plan works largely through a focus on increasing self-esteem, learning self nurturing skills, and building the power of one’s identity. All twenty-one points are essential. Eliminating any one of them may very well negate the effects of the others. The points are divided into TWO broad categories, “Readiness for Change” and “Action.”

Part 1: Readiness for Change

There is a lot of “head stuff” to be dealt with if your efforts are to be successful. If you are not clear on where you are going or if you are using a faulty map, your journey will no doubt take you to someplace you do not want to be. So consider the following points.

1. Learn from the Past
If you always do what you have always done, you will always get what you have always had. Of course you lost weight with diets. Whether it was the grapefruit diet or prepackaged diet foods, weight loss followed severe calories restriction. But what happened next? Did you maintain the loss? If you are like most people, your loss was short lived and you gained back more than you lost-- and in record time.

If what you're after is lasting and effective weight management, diets do not work. In fact, chronic dieting turns out to be a major cause of obesity. Confused? Read on.

The more you suppress thoughts of taboo foods, the more you will obsess about those same foods.

When you drastically cut calorie intake, your body experiences a threat. Automatic mechanisms are a bodily defense to what seems like famine. To maintain a balance, three things happen. First, to conserve fuel, metabolic rate is cut by 30% or more. Further, fuel or calorie conservation may take the form of a lack of energy, as dieters resist activity to make the most of a limited fuel supply. Finally, dieters become obsessed with food, particularly all those “forbidden foods” that must be avoided at all costs. The more you suppress thoughts of taboo foods, the more you will obsess about those same foods. It's just human nature. We human beings need to feel free. The moment we start restricting our choices is the moment we start to rebel.

When heroic resolve finally collapses, dieters return to eating with a vengeance. Lost weight is quickly regained, with an extra 5-10% added to protect against the next “famine.” Feelings of failure, guilt, frustration, and self-hatred quickly replace the euphoria of rapid weight loss. Does any of this sound familiar?

But that’s not the end of it. Dieters lose fat--but also an almost equal amount of lean body mass. When weight is quickly regained, it is primarily fat, and since only lean body mass requires energy, there is still less of you to burn calories. Dieters get heavier and fatter--and feel like colossal failures.

And still it gets worse. As dieters return to dieting again and again, their bodies adapt. Their metabolic rate, the rate in which they burn fuel, changes -- and in the wrong direction. As protection against these periods of starvation, it becomes easier and easier to gain weight and progressively harder to lose. Such a yo-yo pattern leads inevitably to greater weight, with diminishing chances for normal weight in the future. In the extreme case are our clients who are morbidly obese, physically disabled, and who actually eat far less then normal weight people.

Weight loss clinics, diet programs, and people who write diet books often do tremendous disservice. Whether through ignorance or greed, they do damage. Those who prey on our seemingly insatiable demand for quick results while providing little or no provision for future problems, victimize millions.

2. Determine Priorities and Shift the Focus
What is it that is really, REALLY important? Perhaps it's the class reunion only months away. Perhaps it's being the thinnest person in your class. Maybe your spouse or significant other seems distant and preoccupied lately and you are thinking that slimming down will grab his or her attention.

Jane has mixed feelings about her tenth high school reunion. It should be great fun to see old friends and catch up on news and gossip. But, as she pauses before her mirror, she is gripped by a growing desperation. What if she can’t shed the extra twenty pounds in time? She can almost hear the comments behind her back--“What happened to Jane?” “How could she let herself go like that?” No, she cannot let that happen. She will avoid food altogether and work out each day like she is preparing for war. But as the reunion approaches, she feels increasingly out of control. Heroic restraint yields to ferocious eating sprees--and her weight actually increases.

Dying as late in life as possible with as young a body as possible
is a great goal--and achievable!

John wants to be more attractive to his wife. He decides to train in earnest this weekend and finally lose the spare tire he’s been carrying. However, Monday comes and his wife seems friendly again. Maybe next weekend I'll give it another shot!

Why is it these goals don’t seem to produce lasting results? In our experience, time-limited goals such as squeezing into a new swimsuit by June produces only short term success. Similarly, a focus on pleasing others is likely to produce temporary or sporadic progress.

The priorities should be one’s own health, fitness, and general well-being. The focus should be on deeply satisfying, ego-enhancing, self-nurturing LIFE STYLE CHANGE. How long do you want to live and how free of ailments and disease do you want to be? Dying as late in life as possible with as young a body as possible is a great goal--and achievable! And, if you go about it the right way you can get hooked on your own health and fitness. As for weight loss, it's simply a by-product of healthy LIFE STYLE changes.

Wouldn’t you like to have more energy, sleep better, require less sleep, feel more rested, have more endurance and stamina, greater flexibility, improved posture, healthier skin, greater strength and muscle tone--and a more positive outlook on life? And nothing is more attractive than basic good health. Furthermore, research shows active involvement in fitness to be more effective in combating depression and anxiety than medication. Imagine all these benefits and weight loss too! In fact, you can stop focusing on your weight loss altogether. Take charge of your life and your health in a positive satisfying way and weight loss will just happen. Weight loss is a byproduct of successful living. If you're doing a great job of taking care of you, you probably won't even have to think about managing your weight.

3. Set Appropriate Goals, Avoid Extremes and Take Small Steps
Is everyone supposed to be the same size? Of course not. Yet millions engage in regular self torture, striving to match an unrealistic ideal, most likely someone they've seen in the media. You may like the way some Hollywood personality looks, but is it right for you? Often heroic and ultimately futile effort is needed to achieve and hold a weight below what is normal for you. Accepting a somewhat higher weight may mean sanity and freedom. The right weight for you is probably the weight that will be easiest to maintain. This is the concept of “set point.” Your body will resist and defeat your obsessional attempts to have an unnaturally low weight.

“Whenever I think about going on a diet, I instantly feel tired and hungry.”

A “one day at a time” philosophy and small daily and weekly goals can keep you from feeling overwhelmed. One of our clients said, “Whenever I think about going on a diet, I instantly feel tired and hungry.” Sound familiar? Many have been similarly stressed and sensitized so that the very mention of food and weight issues evokes feelings of guilt, frustration, and fear of failure.

Rather than brooding over all the weight to be lost by a specific deadline, focus on what is achievable now. Small life style changes, practiced daily, add up to long tem lasting success. Keep your eye on present changes and congratulate yourself on each small step, no matter how small. Skip all self-criticism as though it’s poison—it is! Instead, strengthen your commitment by frequently patting yourself on the back for each small success. Skip the guilt!

4. Guidelines, Not Inflexible Rules
In this paper, we are presenting the best insights we have about weight loss, but doing so raises a dilemma. Most of our target audience have been overly conditioned to be rule bound, perfectionist, and guilty over food transgressions and exercise failures. If you have ever dieted with a plan that felt like starvation or trained in the gym like an Olympic hopeful, you have probably experienced frustration with imperfect efforts. Please hear what we are saying. If you think you have to follow our suggestions rigidly, that message comes from you, not us.

Follow our tips in a general sense, but give yourself some latitude. Expect imperfect compliance. You are human--it is important that you enjoy the process and praise yourself for each small effort. Guidelines work to establish a new and rewarding life style. Inflexible rules set you up for defeat.

5. Patience
Accept the fact it may have taken you years for the problem to become apparent. It is unlikely your body will have been redesigned by the first of next month. The more you can accept and enjoy the concept of life style changes, a constantly evolving, never finished self, the more likely permanent weight management becomes.

Slow it down. There is a lot of good evidence that slow, steady weight loss is most likely to be permanent. About the best you could achieve will be about two pounds a week. Often, less is lost. Sometimes a plateau is encountered with no weight loss for days or weeks. Occasionally, a slight gain is noticed. The overall trend is the important thing, with an average rate of loss between one to two and a half pounds weekly. Persistence is rewarded.

6. Overcome Inertia, Commit to Action, Banish Failure, and Refuse to Quit
Inaction is often the result of past defeats. Few people knowingly seek out punishing experiences. For many, the very thought of food and weight issues is stressful. The thought of beginning a strenuous new diet, of ultimately regaining weight is frightening. How will it look to family and friends? One more failure? Easier to do nothing or to promise yourself to start again next month.

When thinking of life style change, the object is to simply keep going and keep growing.

The solution is to do something quite different. The changes outlined in this article are not heroic and you need never feel like a failure again. Change can be easy, gradual, and enjoyable. There are no deadlines, and success can be yours each day.

Life style changes take the place of frantic short term efforts. An ongoing concern for health and fitness replaces a war waged against one’s own body. The best news of all? These changes can be enjoyable! If it is punishing and feels like deprivation, you are doing it the wrong way. You can learn to like the process and praise yourself for each small positive step, each healthy choice.

Get rid of all thought of failure. In fact, banish the word "failure" from your vocabulary. Substitute the word "deviation." You will deviate from your plan -- it guaranteed! The good news is that a deviation is not of failure. It’s simply a temporary departure from a specific plan. The trick is to quickly get back on the right path and continue on, without beating yourself up. You deviated, nothing more. It was predictable and of little consequence in the grand scheme of things. Don't make a big deal of it, just move on.

So forget guilt and feelings of failure. You may be used to constant self-evaluation, condemning each and every shortcoming. Such self-flagellation is useless and ego destroying. When thinking of life style change, the object is to simply keep going and keep growing. You will never do it perfectly, so don’t worry about it. Instead, pat yourself on the back for moves in the right direction. You may deviate, but you cannot fail as long as you keep going. Deviations are allowed and predictable. They are not failures. Simply keep going and each day is successful. One more time--you WILL deviate, and deviations are not failures.

7. Be For Something--It Makes All the Difference
Most dieters give the diet full credit for weight loss. They praise the program endlessly to family and friends. At last a diet that really works! When they start regaining the weight, do they blame the diet? NO! It’s the wrong body, their metabolism, or simply their lack of willpower. Shame, guilt, embarrassment, and feelings of failure go hand in hand with dieting setbacks. Clearly, one did not suffer as much as required of a good dieter.

Whether it is weight loss or anything else you want to change,
you cannot hate yourself into succeeding.

Jane cannot seem to get beyond self hatred. She is not as thin as she would like, certainly not as thin as her friends. No matter how hard she tries, she inevitably blows her diet and starts eating. Each time she is heavier than before dieting. She is terrified she will gain even more weight unless the next diet succeeds. She fears she does not have what it takes. She knows the fault is within her.

Whether it is weight or anything else you want to change, you cannot hate yourself into succeeding. The only lasting success we have seen is that of people who are very clear on what they are FOR. Do it because you are FOR you and your well-being, not against food and feeding yourself--such a negative attitude towards eating is anti-self and anti-life -- actually it's a form of self hatred.

Being FOR you is not compatible with self-hatred, deprivation, and a punishing attitude toward self. Being FOR you, on the other hand, means gentle encouraging self-talk. It means a concern for health and fitness because you matter. It means others’ expectations or an arbitrary fashion ideal are unimportant compared to the need to take good care of you. Real success can only come by being FOR you to the point of taking real pleasure in doing positive things for your health and fitness--and skipping the guilt.

8. Find Social Support and Deal With Resistance and Sabotage
Why is it so hard to ask for help from others in support of your weight loss program? Perhaps you think you should be able to do it on your own, or perhaps you do not want any witnesses monitoring your progress (or lack of it). Perhaps you are embarrassed to be seen trying once again. Perhaps you don’t want simplistic advice or negative comments. There are lots of reasons for resisting getting help, but one fact remains: social support is very helpful, as are skills in dealing assertively with resistance and sabotage.

There are pitfalls. For example:
Ann, fearful of not having the willpower to stay on track, asked her husband to let her know when she overate or ate the “wrong” foods. By the end of the second day, Ann was filled with resentment toward this “policeman” who seemed to always lurk close by ready to bust her for her latest offense. A ferocious battle ensued, culminating in a monumental binge and the pronouncement that “my food is my business!”

At times, social influences can be disruptive. Sarah’s husband, Ted, made no secret of the fact he preferred her thinner. He watched her every bite and frequently asked for a status report. Sarah was filled with resentment. How could he not accept her as she was? And if she did lose weight and he paid no attention to her, she was filled with rage. “Why couldn’t he accept me before? Wasn’t I the same person?” Consciously or unconsciously, Sarah’s continued yo-yoing and subsequent weight gain seemed to express the angry thought, “Fat! I’ll show him fat!”

Family and friends often resist changes they do not understand
or see as threatening.

Do these examples contradict the earlier statement that social support is valuable? No. They underscore the idea that your social network can be either positive or negative. You need to take charge and plan for a positive support system.

Recognize this mixed reality: Family and friends often resist changes they do not understand or see as threatening. Sometimes, as in the case of Sarah and Ted, pressure from others can bring all efforts to a grinding halt. Take the time to talk it over. Explain what you are doing and why. Discuss others’ perceptions of how your weight management program will affect them. Work out troublesome issues. Reassure important people in your life that your program will not change your commitment to the relationship.

When others persist in resisting or sabotaging your efforts, deal with them assertively. You have a perfect right to make your health and well-being a top priority. You need never apologize for acting out of a commitment to your own wellness. Guiltlessly set aside time for health and fitness and let nothing get in the way. Teach others how you wish to be treated. Teach them to respect your right to health.

9. Self-Acceptance
There used to be a needlepoint in our waiting room that proclaimed, “When we like ourselves, we can do anything.” It is vital you like yourself BEFORE weight loss, not attempting to lose weight out of guilt and self-hatred to find a likeable you. Our anorexic clients are the only people we know who lose weight out of guilt, often at the risk of their lives. For anyone else, the stress from constant self-recrimination results in out of control eating, failed dieting efforts, and new weight gain. Becoming more active and eating more sensibly needs to be an expression of self-love, not self-contempt. The only positive change we have ever seen has grown out of self-acceptance and the ability to be self nurturing, never out of self-hatred.

If your program is driven by guilt, fear, and self-hatred,
you are stuck in old thinking.

10. Free Choice
Free choice is essential. We have seen no success for hose who state they are losing weight for someone else. Job centered weight loss programs that stress a “lose or be fired” philosophy are notoriously ineffective. The resulting resentment and stress often trigger nervous eating and further weight gain. Clients who have been sent by a spouse who demands weight loss are often looking for a scapegoat to blame for their predictable lack of success. They are getting everyone off their backs by embarking on a pathway that seems constructive. Their innermost voice, however, tells them that this pathway will lead nowhere. Weight loss only makes sense if it has real personal relevance and is freely chosen.

11. Take Responsibility, Empower Yourself, and Have Fun
No one, absolutely no one, has as much influence over your health and well-being as you do. No doctor, program, or medication can make the difference you can make when you become committed and empowered.

The major reservation we have for all programs that provide you with medications, shots, or special prepackaged foods is they all involve an external dependency. There can be no substitute for developing a confident self-reliance and clear inner direction. Long after you have stopped paying for your special product, you will maintain your progress only on the basis of a firm conviction that it is your choice, your commitment, a solid expression of your ability to be self nurturing, and your freely chosen life style behavior, in essence-- IT'S OWNING YOUR OWN POWER.

It must be a rewarding and enjoyable process. The test of whether you are fully understanding and accepting these points is simple. If your program is driven by guilt, fear, and self-hatred, you are stuck in old thinking. If your program is punishing and feels like self-deprivation, you are doing it wrong. Life style change means inner satisfaction with your choices. It means patting yourself on the back and enjoying growing health and fitness.

Thus far, the emphasis has been on readiness for change. The remaining points deal with taking action and continuing to get positive results for life.

Part 2: Action

12. Sensible Eating.
Sensible eating is not dieting. We teach our clients sound nutrition and help them make gradual but lasting changes in eating patterns. Eliminating guilt over food is essential. Perfect eating is not a goal. “Musts” and “shoulds” about perfect eating underlie most distorted eating. Our clients are taught to congratulate themselves for healthy eating habits. They learn to forgive imperfections. Regular balanced meals are essential.

Fed by feelings of shame and failure, straight-jacket rules often give way to a “feeding frenzy” amidst promises of resuming control tomorrow.

Often, food is the source of intense guilt, and a paradox occurs. The guiltier you feel, the more resistance to rules and controls. Human beings want to feel free and are bound to oppose loss of freedom and rigid restraints. The more forbidden a food, the more it is desired. The more extreme the diet, the greater the desire to binge. Once control gives way, look out! Fed by feelings of shame and failure, straight-jacket rules often give way to a “feeding frenzy” amidst promises of resuming control tomorrow. Clearly, the problem has less to do with food than with your mindset. When you can liberate yourself to eat without guilt, as all free human beings ought to be able to do, food ceases to be a dangerous, fearful, and oppressive substance and becomes just food.

If you can truly choose any food, without guilt, then you are also free to choose healthy food without feeling confined and resentful. This is even more the case as you give yourself permission to satisfy your needs in a wide variety of non-food ways, thus undercutting the substitution of food for other needs.

Once your mindset changes, the following information ceases to be threatening. You are now freed to consider feeding yourself good food and enjoying a new life style--because YOU matter, and nurturing you is important.

Most Americans need to make dietary changes for the prevention and treatment of chronic disease, such as angina, coronary heart disease, stroke, atherosclerosis, claudicating, hypertension, diabetes, obesity, and certain types of cancer. The following depicts the difference between the way we currently eat and how nutritionists believe we should eat.

Percent of Calories from Different Nutrients

Current Diet Dietary Goals

16% saturated fat 10%

19% monosaturated fat 10%

7% polysaturated fat 10%

22% complex carbohydrates 48% complex
carbohydrates
and “naturally
occurring” sugars

6% “naturally occurring” sugars

18% refined and processed sugars 10%

Some important related conclusiona: A). Overall fat intake should be reduced to 30% or less. Reading labels, making substitutions, and counting fat grams makes a whole lot more sense than counting calories. B). Increase complex carbohydrates (plant foods rich in fiber). People need to eat more fresh fruits, vegetables, and whole grains. C). Refined and processed sugars should be reduced to account for only 10% of total energy intake. D). Avoid premixed, ready-to-eat and refined foods whenever possible, instead choosing fresh foods “as grown.” E). Base food buying decisions not on advertising and packaging, but on nutrition, taste, and price. F). Eat less meat and eat lean meat (chicken, turkey, fish rather than beef and pork), less animal fats and oils, and less sugary foods. G). Cut back on alcoholic beverages and sugar flavored drinks.

Get involved in your nutrition. Several inexpensive paperback books we have found quite useful are by a biochemist named Covert Bailey. These are: Fit or Fat?, Fit or Fat Woman, and Fit or Fat Target Diet.

Following the food exchange system of the American Diabetic Association is far more sensible than counting calories. A handy low cost fun way for using this system to insure balanced nutrition has been marketed by Richard Simmons with his “FoodMover” program using a device where you can move objects representing different food groups.

It is not our intent to provide full nutritional guidance in this paper. We want simply to point you in a healthier direction. And remember, if it is not part of a rewarding life style, you are doing it wrong.

13. Aerobic Exercise and a More Active You
A surprising fact: The average overweight person who is sedentary actually eats less than the average overweight person who is active. What does this mean? It means that millions beat themselves up and relentlessly pursue the wrong solution to the wrong problem. They don’t need to stop eating; they need to be more active. If the goal is weight loss, aerobic activity is a must-- and every little bit counts.

While it is true that the only way of burning stored fat is aerobic exercise, it is vital you come to see yourself as an energetic person who enjoys being active.

Start thinking of yourself as someone who was born to move,
whose body needs to be used. Make active choices.

Many of you have been traumatized by a sixth grade gym teacher who convinced you that you were not a born athlete like Joe Biceps or Suzy Cartwheel. Quite possibly, you have come to think of exercise as uncomfortable and an imposition. Others may have had a sedentary life style for years, perhaps having to stay close to home to care for small children. Perhaps you still have difficulty thinking of ways to fit exercise into your busy lifestyle. Now the thought of becoming more active may seem overwhelming. Where do you begin?

If any of the above apply, a change in perspective is needed. Human beings who are active function better and are generally happier. Studies have shown active involvement in fitness outperforms medication in reducing anxiety and depression.

Start thinking of yourself as someone who was born to move, whose body needs to be used. Make active choices. Park where people park their new cars. Take the stairs. Walk around the block just for the fun of it. Do not worry about how many calories you are burning. Think of it as taking charge of your life. Symbolically, every active choice is a contribution to your self-esteem fund.

We awfulize and catastrophize and often snatch defeat
from the jaws of victory by our distorted thinking.

Regarding aerobic exercise, aerobic means “with oxygen.” Aerobic exercise is sustained exercise that gets you breathing harder as your pulse rate increases. When it is aerobic and lasts long enough, you are burning your stored fat like no other exercise can. And what's more, you wind up burning calories at a much higher rate for several hours after the exercise ends, and as you become more fit, you're burning more calories even while you sleep.

Aerobic exercise includes activities that are rhythmic and continuous. For example, walking, running, skipping rope, cycling, swimming, and cross country skiing are all forms of aerobic exercise. Probably the easiest is walking. All you need is a good pair of shoes and the front door. You have fresh air and ever changing scenery. Injury to yourself is very unlikely.

An aerobic workout should include\ a warm-up, cool down, gentle stretching, and calisthenics for shaping and toning. A formula for making sure your workout is effecivet is quite easy to remember: F-I-T. “F” stands for frequency. If your at a level of fitness or weight you merely want to maintain, three times a week is sufficient. If you want to lose weight or upgrade your level of fitness, 5-7 sessions per week are needed. “I” stands for intensity, measured by exercise heart rate. Use the number 220 for a hypothetical maximal heart rate. Subtract your age from this number for your age adjusted maximal heart rate. Next, multiply .7 and .8 to get two heart rate numbers for a 70% and 80% training range for aerobic exercise. After six weeks, you may calculate a new training heart rate of 75% to 85%. Of course, if you're going from being a non-exerciser to having an active lifestyle, you need to consult your physician.

Practice finding your pulse on you neck or wrist. Count for ten seconds and multiply by six for you heart rate. Your exercise heart rate is obtained immediately following your aerobic workout. Make sure you are within your appropriate training range. Again, remember to consult your physician if you are new to an exercise program or have health concerns.

It’s vital to enjoy your increasing fitness and health. Making it social helps. Walk with a friend. Do not forget to progress gradually. Doing too much too soon is the leading cause of sore muscles, pain, discomfort, injury, and early exercise burnout. Gradual progression is a surefire way to make exercise a lasting and enjoyable part of your new life style.

As was the case with sensible eating, make becoming more active an expression of self-love, of self nurturing. If it is painful, punishing, and resented, you are doing it wrong.

14. Make Each Day Rewarding.

Compulsive eating serves a purpose. Food can be a faithful companion. Food can counter boredom and loneliness. Food can distract from issues that feel overwhelming. Food can be nurturing, even a substitute for mother love. Food can comfort and soothe--an all purpose, readily available painkiller. The problem with eating for emotional reasons is that you are seeking an external solution to an internal deficit. You need to find solutions within.

The problem is not food. The solution is not greater control over food. The basic motive behind compulsive eating is positive and life enhancing. The drive to eat is in reality a drive to nurture, soothe, and protect. The need is to be empowered to give these things to yourself in a wide variety of ways, and without fear or guilt. The most important need is to be self nurturing in the way you think of yourself and talk to yourself.

If our assumption about compulsive eating based on the basic need to nurture self is correct, then it can readily be understood how taking away food would produce panic. If your only way to care for self is food, yet you have been taught you are not entitled to food, you have been placed in an emotional straight-jacket. The result is out of control binge eating, guilt, and feelings of failure and low self-worth. The solution is to give to self and have fun on a daily basis.

Barbara, a young college student, studied nightly until after midnight. She longed for a little fun, envious of other students who seemed to mix academics with a satisfying social life. She did not dare to lighten up on her school work however, fearful of not measuring up. Instead she committed herself to endless toil and tension, sadly refusing all invitations to join in the fun. "Fun -- what's that? Who has time for fun?"

Not surprisingly, Barbara found herself in the refrigerator whenever the tension, isolation, and loneliness seemed over whelming. Not understanding this behavior created additional stress and worry. Was her eating out of control? Was she gaining weight? Soon she was ruminating almost non-stop on these concerns, caught up in fear of fat and oblivious to the real nature of the problem. Thinking she had a food problem, Barbara missed the fact that she really had a self-nurturing problem.

When questioned, Barbara conceded that on those few occasions when she allowed herself to have fun, food was not an issue. Somehow she had missed a conclusion that should be obvious: compulsive eating goes with a lack of balance. In this case, all work and play made Barbara not only bored and lonely, but opened the door to food as a way of dealing with the stress of unmet needs.

Again, the need is for balance, a sense of freedom, self nurturing, and building fun
(without guilt) into each day.

15. Self-Coaching vs. Self-Sabotage

The most important part of any program for self-change is something we might call “honoring approximations.” This means being reasonable with yourself and taking small steps toward your goal. It is important to not be perfectionist, but rather to praise yourself for each positive move. You will find yourself getting closer and closer to your goal, working out with more precision and eating more healthfully as time continues. It is virtually impossible to make all desired changes at once and without a sense of deprivation. As stated before, praise yourself for even the smallest successes, accept gradual progress, and refuse to get down on yourself if your program does nor flow with perfect precision, smoothness, and record results.

The following are ways of sabotaging your efforts and ensuring that your program will be short lived.
 Setting deadlines or having a time limited program
 Believing eating must be perfect to avoid failure. Telling yourself that it is “back to square one” if there is a deviation from the plan.
 Resenting other people’s expectations or being controlled by what others may think.
 Believing all efforts must begin on Monday or the first of the month
 Believing you cannot be seen exercising if out of shape
 Using self-blame and self-criticism to supply motivation
 Comparing self to others and becoming discouraged
 Focusing only on far off goals and feeling overwhelmed by how distant success seems
 Allowing a scale to determine your self-worth
 Applying a perfectionist yardstick to measure results and then giving up when results are disappointing

In short, you need an encouraging and realistic coach -- and that coach can be you. Think back to earlier efforts. Were you encouraging or critical and punishing? Remember that nothing positive or lasting can grow out of a harsh, punitive attitude toward self.

16. Avoid Rapid Reacting--Slow Down!

Be conscious of your physical state when stressed over food and weight issues. If you are like many people who have sensitized to feel anxious and depressed at the mere mention of weight, exercise, or dieting, you probably react in a very physical way. Without realizing it, you probably become tense in your neck, shoulder muscles, and begin breathing shallowly from the upper part of your chest. You literally become "uptight."Your anxiety is experienced throughout your body.

Be aware that when you react physically and emotionally in this manner you have greatly limited your options to either fight or flight. In terms of your food and weight issues, this means either committing yourself to heroic and unrealistic measures or abandoning all effort and collapsing into binge behavior. Neither choice is helpful or constructive.

What’s needed is to slow things down, to not panic. You need to be able to rapidly calm yourself and focus on a more purposeful and reasonable plan. The information contained in this article will greatly aid you in your efforts to regain control of your life and to experience health and fitness in a relaxing and enjoyable manner. None of this information, however, is available to you if you get stressed and frantic at the mere mention of food and weight issues.

It is understandable that you would react this way. After all, you have been sensitized for most of your life to stress out when dealing with these matters. What we am advocating here, however, is that you calm yourself, principally by paying attention to your breathing. A focus on your breathing will in turn help you to be more mindful of what is happening in your mind in your body, and to begin to participate in your responses in a more meaningful way. We call this "Mindful Eating" and incorporate this within our group experience.

Breathing from your upper chest and carrying all of your tension in your upper body is very similar to hyperventilation and a state people are in when they are having a panic attack. We are suggesting that you become aware of this state of tension and purposefully shift to a new center, from your upper chest to your abdomen.

Diaphragmatic breathing is breathing from your abdomen rather than your chest. If you have ever watched a new baby breathe or your cat or dog breathe as they curl up to go to sleep, you would notice that the breathing seems to flow from their lower abdomen. This is diaphragmatic breathing and it has an immediate effect on your level of tension. To get used to diaphragmatic breathing, simply place your hand on your abdomen below your belly button and breathe in such a manner, principally through your nose, so that your hand slowly rises and falls. The other hand, placed on your chest, should not be moving much at all. The easiest way to practice this diaphragmatic breathing is laying down.

Breathe deeply and practice this at intervals throughout the day. Allow yourself to take in a deep breath through your nose and then slowly release that breath and think about releasing all the tension in your body simultaneously. Do ten slow repetitions at a time at intervals throughout the day of perhaps every two hours.

While in this slowed down and relaxed state, you are in a position to expand your options beyond fight or flight. While in this state, you can reflect upon all the points covered in this article and resolve in a calm and purposeful manner to put your life on a different track.

17. Make Friends With Food--Gentle and Mindful Eating

Food is not the enemy. Food is not the real problem. Anxiety and guilt over food and strict food rules, however, create a major problem and damage your sense of self.

Many compulsive eaters eat quickly and rapidly--and often by themselves. It is ironic that people who put so much thought and energy into food actually enjoy food so little. It is gone in a flash after so much anticipation--and guilt and frustration remain.

Decide you are entitled to food, and entitled to enjoy it. Believe fully that your body needs and deserves nourishment. Believe that it is right and proper that you give your body the nourishment it deserves--because you deserve it. Skip the guilt.

Make meal time special. Take the time to sit down and focus fully and enjoyable on the food. Relax! This is a great time to practice your diaphragmatic breathing. Set a place. Turn on some relaxing music. Enjoy the occasion. Make it a way of nurturing and honoring yourself. This attitude of gentle and mindful eating is unbeatable when it comes to undermining compulsive eating.

Its ironic -- if you want to get beyond compulsive eating you need to learn to fully enjoy food.

18. Learn How to Lessen or Avoid a Binge

The following five point self-questioning strategy has been developed to help you avoid or lessen a binge. This results from clarification of your innermost needs and feelings and removal of obstacles to direct and positive action.

* When focusing on food, ask yourself, “Is it my stomach or my head that wants food?”:
Whenever it is your stomach, relax, eat, enjoy, and skip the guilt. Take it a step
further. Now that you are free to choose, ask yourself, “What is it that I really want to
eat?” When food is legal and you can comfortably feed yourself on demand, you may
find that beneath the deprivation and guilt driven cravings for forbidden chocolates
there is a long hidden craving for fresh fruits and vegetables. You can only make that
discovery if food is legal. Only then can you choose healthily and not feel drprived.

What if it is your head . . . ?

* Ask yourself, “How is my balance?” “Are areas of my life being neglected?” “What
do I really want or need that I am not getting?” “What am I for rather than against?”

* Ask yourself, “What are my feelings?” “What would I be feeling if I was not focusing
all my time and energy on food and weight issues?”

* Ask yourself, “How do I block myself from getting what I need or expressing how I
feel?” “What am I avoiding?” “If I was not into food, what would I be focusing on
and doing?” “What would I have to deal with that the food and weight problem now
protects me from?”

* Finally, ask yourself, “What direct action should I take to get what I need or express
how I feel?” “Am I willing to take responsibility for me?”

Struggling to find honest answers to these questions is vital. Once answers have been found and acted upon, the food-emotion connection is broken.

19. Meaningful Yardsticks--Body Fat Percentages

Of all the ways of measuring fitness, perhaps the most misleading and misused is the weight scale. Millions use this simple instrument to precisely measure their worth and predict their future. Many of our clients have weighed themselves a dozen or more times a day, often after exercising, going to the bathroom, eating anything, or even after drinking water. A disappointing reading is often misinterpreted as the harshest indictment of self possible. It means failure. It means being unacceptable. It means hopelessness and an empty, lonely future. Irrational? Of course--but such a very common societal quirk that it can be considered normal.

Following the attack of Pearl Harbor, December 7, 1941, members of the Green Bay Packers became caught up in patriotic zeal and went down to the recruiting office to enlist in the Navy. Imagine their shock when these superb physical specimens were rejected because they were overweight. It seems that according to the Metropolitan Life Insurance tables in use at that time, these athletes exceeded the maximum allowable weight for their respective heights.

Were they fat? Unfit? No, they were in great shape with relatively little body fat. The problem was in the way fitness was measured.

A scale can tell you little about how fat or lean you are. It says nothing clear-cut about fitness. Do you realize that, according to height/weight tables, you can be overweight when actually underfat (reference our 1941 Green Bay Packers)? You can also be underweight and overfat, with very little lean body mass.

A healthy male is approximately 15% body fat, a healthy female, approximately 22%. (Women sometimes need to support another life and provide for two even in hard times, hence a need for more stored fuel.) See the table below.

Percent Body Fat Classifications

Classification Male Female
Lean
Healthy
Plump
Fat
Obese (overfat) Less than 8%
8-15%
16-19%
20-24%
Above 24% Less than 15%
15-22%
23-27%
28-33%
Above 33%


 

Note:
Average college male = 15% Average college female =25%
Average middle-aged American male = 23% Average middle-aged American female = 32%

 

Athletic Norms Male Female
Long Distance Runners (elite)
Wrestlers
Gymnasts
Competitive Body Builders
Swimmers (elite)
Basketball Athletes
Tennis Players 4-9%

4-10%
4-10%
6-10%
5-11%
7-11%
14-17% 6-15%

---
10-17%
10-17%
14-24%
18-27%
19-22%





We routinely do body fat measurements by way of skin fold calipers. It is a rapid and highly accurate measure that gives very meaningful information. Additionally, it is then easy to calculate ideal weight and chart a sane, enjoyable course to fitness and well-being.

An even simpler indicator is the way your clothes feel. If tight, do not panic. Simply follow all other suggestions, be patient, and make fitness a gift to self and an expression of self-love and self nurturing.

Before we forget, what about the scale? Get rid of it. Give it to someone you don’t like. If you have to keep it, resist the urge to weigh yourself more than once a month. If truly scale phobic, do not weigh yourself at all. There is no need for further abuse.

20. Change Your Self-Talk

In the first century A.D., a philosopher named Epictitus said, “It is not the event that upsets us but we tell ourselves about the event.” He meant we often disturb ourselves by our self-talk. We make mountains out of mole hills. We awfulize and catastrophize and often snatch defeat from the jaws of victory by our distorted thinking.

We all deny, distort, and falsify reality. We cannot avoid it. None of us mere human beings function like Mr. Spock aboard the Starship Enterprise. When it comes to weight management, there is often a tendency toward self -sabotage rather than positive self-talk.

The following are examples of negative self-statements that get in the way: “I have never succeeded before, so I know I will not succeed now.” “I have blown it today, so I will start again on Monday.” “There is so much to lose, there is no point in trying.” “I cannot start another failure.” “I am not losing fast enough.” “I cannot succeed without giving up everything I like.” “Exercise is awful, boring, painful, lonely, pointless, etc.” “I just do not have enough will power.” “There must be something wrong with my metabolism.” “I must lose weight to like myself or be liked by others.” “If I am hard enough on myself, I just might succeed.” “If I once begin a program and slip back, it will be awful and I will not be able to stand it.” “If I am not perfectly in control of my food and weight, I am out of control.” “If I do not follow my plan exactly, I have failed.” “Once I begin a program, others will be checking me out and expecting results. I must not disappoint them.” “I come from a fat family. I just don’t have a chance.” “It is not fair--others can eat what they want and still be thin.” “I must lose weight before _____________ or it is awful and I cannot stand it.” “My life will perfect when I have lost weight.”

It may not be obvious, but each of the above self-talk examples are irrational. Becoming aware of such thinking and learning to challenge it on the spot is half the battle.

We recommend dividing a sheet of paper into two columns. In the first column write down the automatic habitual food or weight related thought. This is the belief you have always assumed to be true but have never really questioned. In the second column write down a rational response to the automatic belief. The rational response is based on evidence from your own experience and the experience you know others have had. You are asking, “How do I know if what I believe is true? What is my evidence? What contrary belief would the facts support?”

Here is an exercise that may be helpful. Sit back, relax, breathe deep and slow, and close your eyes. Imagine someone before you who thinks you are absolutely wonderful--who holds you in unconditional, positive regard, someone who can only be positive and encouraging. Now imagine that person encouraging you toward health, well-being, and self-love with absolutely no criticism or blame. Is this difficult? In reality, we are talking about your own inner voice. The goal is to develop and strengthen that voice and make it more gentle and nurturing. When you can easily do this, you are alive and well.

Changing the way you think and talk to yourself is difficult. Additional sources of help are:

A new Guide to Rational Living, Albert Ellis and Robert O. Harp, 1975, Prentice Hall Inc.
Englewood Cliffs, NJ.

Maximize Your Body Potential, Joyce D. Nash, Ph.D., 1986, Publisher’s Group West,
Emeryville, CA.

21. Never Ever Give Up!

We have already touched on this point, but it bears repeating. Much of your difficulty in the past may have come from abandoning yourself by labeling yourself a failure and giving up.

Much research has focused on how some people succeed in losing weight and keeping it off, or quit smoking, or stop drinking, or any other self-change effort. Clearly, these people must be doing something different. Millions of others fail in the same efforts. What is different?

After exhaustive efforts looking at every possible explanation, researchers at last concluded that change was due to a single factor: a stubborn refusal to quit trying.

In spite of setbacks, you refuse to condemn yourself and simply resume your efforts in a calm and self-accepting manner. You will succeed. In fact, as we have said before, failure is not even a possibility if you keep trying and refuse to quit. That stubborn refusal to quit along with being on the right pathway as outlined above is an unbeatable combination.

These twenty-one points have been provided to help you find a clear pathway not only to a lifetime of comfortable and relaxed weight management, but also to a more loving view of self. There is much more to be said than can be said in this space. This is at least a basic statement of direction and purpose.

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