Beyond the Diet Mentality: Helping Clients Through Attuned Eating

This month’s article is written by Judith Matz, LCSW, co-author of The Diet Survivor’s Handbook: 60 Lessons in Eating, Acceptance and Self-Care and Beyond a Shadow of a Diet: The Therapist’s Guide to Treating Compulsive Eating.  I came across this article in the latest issue of Psychotherapy Networker, a magazine geared toward what’s new in the world of psychotherapy.  Aside from my obvious professional interest in the article, I was impressed with how clearly Judith outlines what it is exactly we do as therapists working with people who struggle with yo-yo dieting and emotional eating.  Although this article is written by a professional for professionals, I think it comes across as quite accessible and will demystify the whole process of how therapy and coaching can help you overcome your struggle with food.  Judith’s website can be found at www.dietsurvivors.com. 

Q: Many of my clients struggle with food and weight problems. I’ve helped them look at the emotional issues behind their overeating, but it doesn’t always help. What else can you recommend?

A: When I began treating clients with eating problems, I believed that once they understood the emotional triggers behind their overeating, their compulsion to reach for food would decrease--which in turn would lead to weight loss. Instead, I discovered that, although they could resolve issues around depression, anxiety, relationships, work, and self-esteem, conflicts with food and weight usually remained. In the early 1990s, after witnessing the failure of most diet programs, I learned a nondiet approach to treating compulsive eating, one that has enabled me to intervene directly in the diet-and-binge cycle and help my clients make peace with food, their bodies, and themselves.

In our culture, dieting is seen as the primary way to control eating and feel better about one’s body. It’s often viewed as a means of self-care--the route to happiness, success, and greater self-esteem. Statistics, however, tell us that diets don’t work in the long run. Virtually every diet leads to short-term weight loss, but research shows that 95 to 98 percent of dieters will gain back the lost pounds, and about 66 percent of those people will end up heavier than they were before they started dieting. People who diet are eight times as likely to develop an eating disorder, are at higher risk for disease as the result of weight cycling, and have higher rates of depression and lower self-esteem. Thus, while dieting may seem like good self-care, it’s actually hazardous to our clients’ physical and mental well-being.

The Root Causes of Overeating

According to the nondiet philosophy, the major causes of overeating are deprivation caused by diets and the use of food to manage feelings. When a new client comes to me, she’ll often be aware that there’s an emotional aspect to her overeating. Most of my clients express deep concern over the weight gain that accompanies their overeating. Most are eager to figure out how to control their food intake. I start by helping them understand how they’re translating the language of feelings to the language of food and fat. I explain that, even though it may seem that they’re eating because they feel sad, angry, lonely, bored, or even happy, it isn’t actually the feeling itself that leads to the desire to eat. Rather, it’s the inability to sit with a feeling that triggers the need to reach for food.

Take the case of Julia (ed. note: not me!), who’s had a difficult day at work. Her boss just gave her a new assignment, which requires a large commitment of time. She already feels overwhelmed by the work that several other people in the office have asked her to do. However, she doesn’t want to undermine her chances for promotion, so she agrees to take the project on.

When Julia arrives home, she heads straight for the kitchen. She eats a bag of potato chips, followed by half a box of cookies. As she eats, she begins to reprimand herself. “You slob! Your stomach is getting so big, and here you are out of control again. No wonder your pants are too tight! No wonder everyone treats you so badly! Look how you treat yourself. You’re too fat, and you have to do something about it now! You’d better go back on your diet and get this under control.”

Julia has just made a translation from the language of feelings to the language of food and fat. When her boss gave her a new assignment, she felt angry. She believed she was being treated unfairly, but she was unable to speak up for herself. However, it wasn’t her anger that led to her overeating: it was her inability to tolerate the anger. Reaching for food at that moment was an attempt to calm herself, because her anger was unacceptable to her. She may have had a clue that she was upset, but she couldn’t handle her emotions. Or like other compulsive eaters, she may have found herself eating, but had no idea what was bothering her, or even that something was bothering her.

As I discuss with my clients the process of avoiding feelings through food, I urge them to become compassionate with themselves. When they reach for food to manage feelings, they’re trying to help themselves in a time of distress--which is a positive action. Nevertheless, it’s the wrong solution to their difficulties, just as rubbing ice cream on a cut knee would be. As they stop castigating themselves, they find that the bingeing decreases. They learn to say to themselves instead, “I’m reaching for food, and I’m not hungry. Something must be bothering me right now, and this is the best way I have to deal with it. I look forward to the day when I no longer need to do that.”

Learning Attuned Eating

The next step is for clients to learn how to normalize their eating--a step that must take place for them to be able to end their emotional reliance on food. First, they must stop dieting, since the deprivation caused by eliminating or restricting foods only increases overeating. I’ll ask my clients to consider the following question: if you were told that, starting tomorrow, you could no longer eat ice cream, what would you do today? Clients typically say that they’d eat a lot of ice cream today, whether they were hungry for it or not. I encourage them to get rid of the notions of “good” and “bad” foods--a daunting task in our culture!--and learn instead to become attuned eaters.

Attuned eating (also called intuitive, mindful, and normal eating) teaches clients to listen to their internal cues for hunger and satiation. By honoring their hunger, clients become able to “match” what food would feel just right in their bodies at a particular moment. They notice that they’re just as off base if they eat a salad when they crave a cookie as they are when they eat a cookie when they’re actually hungry for a salad. In this way, they realize that their bodies need a wide variety of foods. They discover that when they eat exactly what they’re hungry for when they’re hungry, they feel satisfied. This feeling of satisfaction ultimately allows them to stop when they’re full.

In using this approach, I make sure that clients understand that this is a process that will take time. The goal isn’t to control their eating by deciding that they can now eat only when physically hungry; I explain to them that if they could do that just by hearing these ideas, they wouldn’t be compulsive eaters. Rather, their objective is to pay attention to the difference between physical (stomach) hunger and psychological (mouth) hunger.

As clients begin to collect stomach-hunger experiences--eating when hungry, eating exactly what they’re hungry for, and stopping when full--they find that this way of eating is much more satisfying, both physically and psychologically, than eating what they “should” eat in response to external rules and then breaking out of all the restraints. They develop a consistent framework for eating what strengthens their internal selves and places them in a strong position to experience feelings that make them uncomfortable. In fact, it’s only when clients find that most of their eating is now out of physiological hunger, that they no longer have “forbidden” foods to reprimand themselves about, and that much of their negative dialog about food has been replaced by compassion that they’re in a strong position to end their reliance on food to manage emotions.

I help my clients identify what’s really bothering them by encouraging them to ask the following question when they notice mouth hunger: “I’m reaching for food, and I’m not physically hungry. I wonder what I might think about or feel if I didn’t eat right now.” Clients will eventually find that when they try to turn to food for comfort, it no longer works! I refer to this moment as “the good news and the bad news.” While my clients no longer eat compulsively, they must deal directly with their issues instead. But, of course, this is really a wonderful step, since clients now feel they’re in charge of their eating and can face their real problems. I emphasize that when weight loss occurs, it’s a side effect of their new relationship with food and not the main event. I spend time teaching my clients about positive body image and size diversity: that people naturally come in different shapes and sizes. I find it helpful to remind them that even if we all ate the same things and maintained the same exercise program, we wouldn’t weigh the same amount.

As clients discover how to cure compulsive eating, rather than control it, they take the first steps along the way to physical, emotional, and spiritual well-being. Energy freed up from a preoccupation with food and weight can be channeled into more productive endeavors, including relationships, work, hobbies, and good self-care. Learning to tune in to needs related to physical hunger leads to an ability to recognize and respond to other kinds of psychological hungers. Taking pleasure in food and one’s body leads to a fuller, more satisfying life. These benefits will empower your clients, and they may empower you.

Judith Matz, L.C.S.W., the director of The Chicago Center for Overcoming Overeating, has treated eating and weight issues for more than 25 years. She’s the coauthor of Beyond a Shadow of a Diet: The Therapist’s Guide to Treating Compulsive Eating and The Diet Survivor’s Handbook.

Listening to Our Bodies: They Know More Than We Do

The body holds much of the information we need to function at our best, but too often we ignore its messages and plow ahead with what our minds tell us. Perhaps because we’re not taught from early on to pay attention to internal messages as well as external demands, we frequently ignore our body’s communications.

So we take another extra-strength aspirin rather than investigating what’s causing our head to ache. We use more caffeine or sugar to give us a lift when we feel tired, rather than hearing our bodys message about needing rest or recognizing our fatigue as an early symptom of burnout we’d do well to heed. Or perhaps we’re so disconnected from the wisdom of our bodies that we have no idea what we really want to eat, reacting instead to the temptations that abound in our imagination and in the ads we see.

We fail to take into account the thousand little messages communicated to us by how we’re holding ourselves: the mouth that’s pinched and tight rather than relaxed. The fact that our shoulders are up around our ears, the knot of tension in our stomach as we promise to do something when closer consideration might tell us we are already over-extended.

These days it’s not uncommon for us to put deadlines ahead of the protests of aching bones or inadequately nourished bellies. (Is there hidden wisdom in calling a due date a deadline in the first place?) Instead of asking our body what it wants, we go for the quick fill-up or the comfort food that may be the last thing we really need.

So what to do to give your body an equal say in how you use it?

* Start with the breath. Breathing consciously is a major part of body awareness. Turn off your thoughts and just let yourself experience the inflow and outflow of breath. Label them, “In. Out. In. Out.” Note how and where you are breathing or failing to, a clear sign something important is going on.

* Allow yourself quiet time. Sit for ten minutes just observing yourself, even (especially!) in the middle of a busy day. Meditate. Take a walk or a nap. Allow time to do nothing. Soak in a hot tub rather than taking a quick shower.

* Get a massage. It’s not self-indulgence to be massaged; it wakes up the whole nervous system and helps you tune in to your body, its tensions as well as its sensations of pleasure.

* Use your journal to dialogue with your body. Ask your body how it’s feeling, what it wants, what’s going on. Give that sore wrist or stiff lower back a voice and let it tell you what its message is.

* Eat when hungry, sleep when tired. Take a week and really pay attention to your body’s most basic needs. Do your real rhythms for eating and sleeping conform to the habits you’ve established? If they don’t, change them!

* Do a body inventory to relax. Start with your toes and work upwards. Scan your body from the inside. Or try tensing each part slightly, then relaxing it to release residual tension.

* Practice mindfulness. Get used to tuning in to your physical self, wherever you are, whatever you’re doing.

And if your body suggests rolling down a grassy hillside, taking flight on a playground swing, or skipping down a winding path, why resist? Its impulses hold the key to our well-being!

Enjoy discovering the hidden messages your body holds, and learning to develop a two-way stream of communication.  Your mind and body will thank you for it!

New!  Online appointment scheduler

I’m happy to announce that I have added a new online appointment scheduler to my website.  I love gadgets and software like this that help keep my life simple and organized.  I think you’ll find it quite easy to use too, and rest assured that all of your information will remain confidential.  To book an appointment, just click http://healthehunger.clickbook.net/ and follow the instructions.  Easy as pie!  You’ll also find a button on my Contact page that says “Book Now” for future use.

You can, of course, continue to schedule appointments with me the usual way.  Just give me a call or email me to set up a time, or to reschedule your appointments if you’re a current client.  See the Contact page for my contact information.

New!  Additional office location in Westmount

I am pleased to announce that I have officially joined a brand-new wellness clinic called inspira crea located steps away from Westmount Park.  It’s a gorgeous, large, and spacious clinic housed in a Victorian-era home, and is dedicated to helping people thrive, in mind, body and spirit.  I’m looking forward to growing my practice in the area, and working with a team of dedicated wellness professionals. If you live or work in the city, and are ready to make a lasting, positive change in your life, now is the time to set up a consultation! 

The new office is located at:
4455 Sherbrooke St. O
Westmount, QC H3Z 1E7
Directions: Google Maps

Intuitive Eating: The Anti-Diet Approach to Eating and Losing Weight

In my last article, I explained why diets don’t work, and how they can actually do more harm than good (from causing weight gain to contributing to the development of eating disorders).  But if diets don’t work, and you really want to lose a few pounds, what will?

The answer is lies in looking at the ingredient missing in most diets: your relationship with food. In order for your weight to change, so do your thoughts, feelings and actions around food.  Intuitive eating, an approach developed by Eveyln Tribole and Elyse Resch, helps you do just that.

What is Intuitive Eating?

Intuitive eating is an approach that teaches people how to become more attuned to their bodies’ hunger signals, rather than keeping track of calories.  The process focuses on developing a healthy relationship with food, mind and body.

The basic premise is that we all contain an inner wisdom that knows exactly what we want to eat, and how much to eat at any given moment.  Skeptical?  Think of how a baby or small toddler eats: when they’re hungry, they know it (and so do you!), and no amount of pushing and prodding can get them to eat when they aren’t.  However, somewhere along the way many of us lose touch with our body’s hunger and fullness signals. Food rules learned at home or at school ("finish your plate!"), or being given food as a treat or a comfort, can eventually distort our natural relationship with food.

Intuitive eating is a non-diet approach that can help reverse this distortion.  It is also sometimes referred to as conscious or mindful eating.  However, it is also much more than that.

The 10 Principles of Intuitive Eating

In order to embrace this way of thinking and eating, there are 10 principles you can follow.  While it can be helpful to work through each one by one, remember that Intuitive Eating is a process, and it takes time to fully transition and heal your relationship with food.  (For a full description of these principles, buy the book or go to the official Intuitive Eating website.)

1. Reject the diet mentality: by letting go of the hope that there is a diet out there somewhere that will “save” you, you can find new hope in this approach.
2. Honour your hunger: eat when you’re hungry, so you don’t go into starvation mode and trigger “primal hunger.”
3. Make peace with food: give yourself unconditional permission to eat - food is always more attractive when it’s forbidden.
4. Challenge the food police: stop listening to that critical voice that judges you for every little thing you put in your mouth.
5. Respect your fullness: learn to know how much is enough, and stop overeating for good.
6. Discover the satisfaction factor: enjoying your food means less is more!
7. Honour your feelings without using food: by learning how to cope with the ups and downs of life (whether through therapy or on your own) you won’t need food to fix your feelings.
8. Respect your body: it’s hard to reject the diet mentality if you are overly critical about your body.
9. Exercise - Feel the difference: who knew focusing on the feeling of movement could be so gratifying?
10. Honour your health - Gentle nutrition: choose foods that please both your health and your tastebuds.

The Benefits of Intuitive Eating

There are many reasons you should embrace Intuitive Eating:

* It can help you lose weight slowly but permanently while eating the foods that you love
* It stops the destructive cycle of restriction, overeating and guilt that results from dieting
* It can help restore your self-esteem and self-confidence
* It teaches you to trust your body
* It helps you discover your love of movement
* It improves your health, including cholesterol and triglyceride levels

If this approach sounds like an appealing alternative to traditional weight loss methods (dieting, excessive exercise, or more invasive strategies like “magic” pills or surgery), then I encourage you to learn more about it.  It will truly revolutionize the way you think, eat and feel!

Dieting: The Worst Way to Lose Weight

It’s a familiar scenario.  You wake up on a Monday morning after a weekend of overeating feeling sick, bloated and disgusted with yourself.  The first thought that crosses your mind is, “That’s it, I can’t do this anymore.  Time to change my ways!  Today I’m going on a diet, and I swear I’ll stick to it this time!”

With renewed hope and optimism, you start your day off with a tiny bowl of fruit and pack a lunch with some raw veggies and lean protein. But by 3 or 4 o’clock you’re famished, and the battle begins. “Should I or shouldn’t I?” The vending machine calls to you, and after struggling with the impulse to resist for what seems like an age, you make a mad dash for a bag of chips.  On your way home, you stop for a burger and fries - because who cares, you blew it anyway.

Before going to sleep, you tell yourself that tomorrow is another day, and you’ll start fresh again...

Let Go of the Struggle

If you’ve tried every diet out there, from faddish to more sensible, you know this routine all too well. And you know that it never lasts.  Sometimes you’re “good” for a week, sometimes you don’t make it past breakfast.  And if you actually manage to stick it out long enough to lose a decent amount of weight, somehow it eventually seems to creep back on.

And here’s the sad truth: 95-98% of all diets fail. If your doctor recommended a treatment with that kind of failure rate, would you eagerly rush in?  Somehow, I don’t think so.

It’s so easy to blame yourself for this neverending yo-yo cycle. After all, it’s YOU who didn’t stick to the plan, it’s YOU who gave in to your cravings, and it’s YOU who’s to blame.  But what if that wasn’t true?  What if you didn’t fail your diet, but your DIET failed you?

Diets Don’t Work

A novel idea, isn’t it?  But here are a few reasons why diets don’t work:

* The reason diets are so appealing is that they make you feel like you’re being proactive.  They give you a bunch of rules to follow with the promise that if you just stick to them, you’ll lose the weight.  But just like any other plan based on optimism and hope alone, the excitement eventually wears off, and so does your motivation.

* The diet mentality is a temporary state of mind, not a way of life.  When you say, “I’m going on a diet,” you’re not trying to make incremental changes.  You’re entering “diet mode,” which is not a sustainable way of living.

* Diets don’t address the causes of weight gain, just the symptoms (the weight itself, and the calories in/calories out balance).  But there are a lot of reasons people overeat that have nothing to do with eating a “sensible diet.” Emotional eating, stress eating, mindless grazing are just a few of the causes of excess weight.

Diets Can Be Harmful to Your Health

If the only problem with diets was that they didn’t work, it might not be so bad.  But research has consistently shown that diets can in fact be hazardous to your health, both physical and mental.

* They turn on “primal hunger.” Diets are essentially a set of rules about what you can and cannot eat, and whenever we feel restricted, our inner “deprivation meter” goes on high alert.  Whether the deprivation is real (in the form of too few calories to sustain you) or perceived (that feeling you get when you aren’t allowed something), it sets off that ravenous feeling of primal hunger that screams, “FEED ME!” This usually results in backlash eating, binging, or otherwise “cheating.” Over the long term, this creates a vicious cycle of guilt, self-loathing and obsessive thinking about food.

* Diets can actually cause you to GAIN weight. One study actually showed that 2/3 of all dieters eventually gained back more weight than they originally lost.  In the author’s words, “dieting is a significant predictor of weight gain.”

* They contribute to the development of eating disorders. Another study showed that preteens who had been on a diet were 12 times more likely than their non-dieting counterparts to develop binge eating problems by the time they were in their late teens.

If I Don’t Diet, How Will I Lose Weight?

With all this evidence against dieting, it would make sense to stop the insanity and find a better way.  And of course it’s important to eat sensibly and exercise.  But an excessive focus on counting calories and restricting yourself is not going to work. So what WILL work?

Looking at the missing ingredient: your relationship with food. In order for your weight to change, so do your thoughts, feelings and actions around food.  And the best way to do that is to develop an intuitive, or mindful approch to eating.  Stay tuned for next month’s article to learn more about this approach and how it can help transform your eating for good.

Shedding Layers: The Key to Bringing Out Your Best Self

With spring in full swing, many people are ready to shake off the heaviness of winter. Yes, it means you can now go outside and play, but it also means you can’t do it while hiding behind your winter clothes.  Shame, self-loathing, and a sense of panic to lose weight NOW are only further fuelled by those ads urging you to “get ready for bikini season.” Well, what if you didn’t have succumb to those pleas to “melt away layers of fat” - what if there was a better way?

Now is the perfect time to start thinking about shedding more than just your winter coat and that extra weight. Instead of focusing just on losing weight, think about the internal layers that need to be shed so that your inner “happy and healthy” self can break free!

The Layers that Keep Us Stuck

Here are some of the different levels of layers that make us who we are (from the outside in):

Physical layers:

* Stuff: a lot of household clutter is a sure sign that you’re hanging on to a lot of “stuff.” The things we keep are often tied to the past and future, not the present.  We either can’t get rid of an item because it reminds us of something from our past, or hold onto it because it might be useful in the future ("I’ll get around to it some day!").  Either way, you end up feeling buried and trapped by it.

* Clothing: our personal sense of style (or lack thereof!) makes a statement about how we want people to see us.  We can either let our beauty shine through, or stay hidden behind drab, lifeless or baggy clothes.

* Weight: although we can’t change our bodies the way we can change our clothes, the amount of weight we carry can act as both as a statement (stick-thin ideals be d*mned!) and as a self-protective barrier.  While almost no one chooses to be overweight, it can sometimes, paradoxically, be a comforting place to hide.

Psychological layers:

* Habits: these are ways of doing things that provide a sense of structure and routine (and of course, safety).  The foods you consistently choose and the activities that fill your days are what create your reality.

* Limiting beliefs and attitudes: most of us are the prisoners of our own minds.  All that self-talk about what you can and cannot do, what you deserve, and what you are capable of, again, create your reality.

* Fear and doubt: these are the powerful allies of our limiting beliefs.  They say, “Stop!  This is unsafe!  Don’t you dare change a thing.” But if you don’t push through those feelings, you’ll never experience the exhilaration of expanding your world.

* Social layers: we all have different masks we wear in different social situations.  Some of these are appropriate and necessary, but sometimes you might find yourself rigidly attached to those social masks and unable to be yourself.

* Spiritual layers: these include the deepest layers of who we truly are and what we believe our place in the world is.  When we are disconnected from the flow and beauty that life has to offer, it’s time to examine the barriers we’ve put up around us.

How to Shed Those Layers

There are a few steps you can choose from to start peeling back the layers.  See which ones resonate most with you.

* Start on the outside.  Are there some changes you can make to your personal sense of style to reflect who you’d like to be?  Adding more colour, using accessories and dressing your best can go a long way in boosting your self-confidence.
* Examine your habits.  Remember that the flipside to safety is stuckness.  Are there things you do repetitively because they feel comfortable and safe?  Trying something new or different can help you stretch out of your comfort zone.
* Pay attention to your self-talk.  Are there things you are saying to yourself that are keeping you stuck, unhappy or overweight?  Try challenging those statements or developing new ones to replace them.
* Experiment with being yourself and speaking your truth more often. While scary, you might find yourself feeling more liberated than ever!

As you shed each layer, you uncover the truth of who you are.  And as that happens, you’ll find yourself feeling the joy of living your best life, and wanting to take care of the body that houses that person.  The focus will shift from trying to lose weight to letting it simply drop away as the inner layers keeping you trapped fall away themselves.

In my work, my greatest joy is seeing my clients have a breakthrough moment. Some old habit or limiting belief gets discovered and let go, like an article of clothing that no longer fits.  As they take a moment to process how profoundly their lives have changed in that one instant, I know that we have accomplished something great: the unique and beautiful person I could see beneath all the layers has finally come to life.