Sunday, November 29, 2009

Step Five: Junk Food Addiction - Part 2

In my previous post, I talked about a study that demonstrated how quickly rats became addicted to junk food. What was most alarming was that once they were addicted it took more and more junk food for the pleasure centers in their brains to light up. When the researchers denied the rats their junk food, the rats preferred to starve rather than eat ordinary, healthy rat chow. Of course, human beings are not rats. However, we can and do become addicted to junk food. And, like anyone who finds pleasure, solace, comfort or relief from anxiety in a bag of chips or ice cream or fast food, we all know how difficult it is to break the grip of this powerful addiction.

When I was creating my own weight-loss program several decades ago, I asked myself many questions about my own behavior. I was loathe to call it an addiction. After all, I didn’t smoke or drink. I was a good student, a loving daughter, a caretaker and so much more. So, I wondered, how could an intelligent young woman who prided herself on her ability to think and reason seemingly go brain dead when it came to her next food fix? What had to change to break this endless cycle of momentary pleasure followed by disgust, sadness and despair?

The first thing I did was to note when I began to have cravings. What drove the cravings? I realized that stress and anxiety were the main culprits in my life. But, fatigue, family celebrations, loneliness, boredom and many other things drove them, too. In fact, any powerful emotion would drive me to eat. Well, I could not go through life feeling nothing, could I? I was always a very empathic person, very caring, but it seemed that the more I felt, the more I ate. I was literally at war with myself. I wrote all of this down in my journal. At the time, I felt both confused and overwhelmed.

If feelings of any kind drove me to seek out junk food, what could I do about it? I decided that each time I had a powerful emotion, I had to be prepared to do something else besides eat. I had to go for a walk, clean, dance by myself in my room, read a book, call a friend, be helpful to someone else. I had to force myself to choose another coping mechanism other than food. I had to keep at that activity or switch to another engaging activity until the craving wore off. Yes, eventually, the craving would pass. But, it was very hard to do this. At times, it was excruciating. I’d be dancing around in my room, but my heart was pounding not only from exertion, but from the desperation I felt. I wanted to eat so badly. But, I told myself, no. I’d say, “Dorothy, you are a prisoner in this room. You will keep dancing until you can’t stand up anymore. If necessary, lie down on the floor and feel the beat of the music. Stay focused. Concentrate on your breathing. Think of something else. The craving will pass.”

Does what I just wrote remind you of a withdrawal scene on reality TV or in a movie? Haven’t we all watched the horrible physical and emotional withdrawal of an addict who goes cold turkey and completely stops his or her drug of choice? I realized that my brain made a beeline for food in so many situations that it was clearly overpowering and overwhelming. No wonder I couldn’t sustain weight loss. The angel on one shoulder had the best of intentions. But, the devil on my other shoulder was whispering in my ear that I needed to “Eat. Eat. Eat!”

At first, I admit, this challenge was agonizing. But, I had strategies in place, and I kept to my strategies. Like Little Nell in the Dicken’s novel, I sometimes trudged through the snow and ice just to get outside and keep myself away from the cozy warmth of food. I even ironed sheets one night. The ironing board was in the basement and, therefore, away from the fridge. I tutored people for free, which made them happy and kept my mind focused on something else. I memorized poems. I even wrote a bad play, well, two of them. It didn’t matter as long as I was forcing my brain and my body to focus elsewhere.

I realized that mind and body must work together for success. In recent years, there has been much written and discussed about integrative medicine, the mind-body connection. However, this was something I discovered on my own. My mind was craving junk food. My body was craving junk food. I, as a whole human being, was craving junk food. My revelation was that the mind and the body were connected. I could, if I worked hard enough, make that connection. If I succeeded, I would make myself whole again without overeating and without stuffing down junk food to feel better.

What gives you pleasure other than eating? Your brain is going to crave pleasure. Just like the rats in the experiment, you need to find a way to withdraw from your cravings. The rats had their researchers to keep them from the junk food until they completed their withdrawal. You don’t have someone to control your eating habits. And, even if you did, you’d only be setting yourself up for failure. My goal, as a weight-loss coach, is to train each client to create strategies that work for him or her. My goal as a coach is to train people to make the right choices on their own. I am not building dependence, although initially a client is dependent on me. Initially, the client needs my knowledge, my guidance, my demands for structure, my nurturing. However, over time, I am training a client to be able to live in the real world and be independent of me. Yes, they can always come back for a “booster shot” when they start slipping, but for the most part, I believe anyone who works with me learns how to care for themselves. They are armed with skills, with knowledge and insight.

So, if you are determined to stop being a junk food junkie, here are my 12-Steps to Break Your Junk Food Addiction:

1. Write down what drives you to eat junk food. What is happening around you when you get the urge to eat junk food? What are you feeling? What are you doing? A food journal is a necessity. Refer to it often.

2. Identify you bad food habits. Write down your bad food habits in your journal. For example, do you always stop off at a fast food place after work because you drive past it on your way home? Is this your daily routine? Or, do you stop at the local donut shop before work or school because it’s a habit? Are you on automatic pilot? The good news is that bad habits can be replaced with good habits.

Once you have compiled a list of your bad food habits, you can begin to make changes. Tackle one bad habit at a time. Replace that bad habit with a good habit. For example, if you eat at night, find something else to do with your time after dinner. Take a walk. Call a friend. Read a book. Play with your kids. Spend time with your spouse. Take up a new hobby. Do volunteer work. Once you have substituted your new and productive good habit for your old bad habit, move on to the next bad habit until you have completed your list. This takes time, effort, trial-and-error, and patience with yourself. Always forgive yourself when something doesn’t work. Always praise yourself for your focus and determination to succeed.

3. a. Write down your emotional triggers. An emotional trigger is any powerful emotion, such as sadness, happiness, anxiety, boredom, fear, excitement, etc., that leads you to reach for food as a coping mechanism. When you feel the emotion, you reach out for food. Write down your feelings in your journal and note the link between your emotions and food. Then, analyze your journal. Get a clear focus on what triggers are driving your addiction.

Once you identify your emotional triggers, you can begin to change them. For example, in many families, food equals love. The more you love people, the more you want them to eat. Therefore, if all family celebrations center around food, what strategies can you put into place to resist the temptation or family pressures to eat? Can you explain that you need your family’s support to succeed in your weight-loss program? Can you explain that you don’t want to die of a heart attack at an early age? Can you share your concerns about your health and wanting to be around to see your children grow up? Can you ask your family to understand that sharing time with them is what counts? If you are consistent, people will eventually accept the new you. But, do expect your family to try to pressure you to conform and return to the old you. Have the courage of your convictions. Stand your ground because you need to nurture and love yourself first before you can truly nurture and love others.

b. Write down your food triggers. A food trigger is usually high fat, high sugar, high salt or some combination. A food trigger leads to a binge of overeating. For example, if you eat ice cream, can you only eat one serving? Do you keep going back for more? Do you eat a whole bag of chips even if you start with a few? Are you unable to resist fast food if you see it, or smell it, or drive by your restaurant of choice? Do you reach for these trigger foods when you feel strong emotions?

List all of your food triggers in your journal. Initially, you will have to keep these foods out of your house. You need to keep yourself safe and avoid the temptation.

When you are in supermarket, for example, avoid any aisle, if possible, where these foods are displayed. For example, in my local market, all of the chips are in one aisle. I never go down that aisle unless I’m looking for a jar of popcorn once a year. If you can’t avoid going down one of those aisles, keep focused on your reason for being there. If I have to go down the cookie aisle to get to the herbal teas, I keep my eyes focused straight ahead. I know it takes me 10 seconds to get to the right spot.

Create your own strategies for keeping yourself safe from your trigger foods while at home, at the supermarket, at work, etc. There may be circumstances, such as parties or get togethers where you’ll be confronted by your trigger foods. Have a strategy in place whereby you remove yourself from the temptation. If you work with someone who brings donuts in daily, try to come in 10 minutes early to get your coffee and move on before those tempting treats arrive.

4. List strategies that you can realistically employ to start changing your brain. For example, can you take a different route to work to avoid the fast food place or the donut shop? If not, can you take other healthy foods with you and wave good-bye to your former “junk food connection”? I had a client who had to drive past her favorite fast food place every day, so she’d wave and say, “Glad to see ya, but I don’t need ya!” It was empowering.

5. Enlist the support of family members, coworkers and friends. The more support you have, the better. This is why people in Alcoholics Anonymous have a sponsor, who is a person who has worked the 12-Steps of Addiction. That person is there for support, understanding and advice. They are living the program, and they want to help the recovering alcoholic to do the same. They know all of the games and the pitfalls.

Your supporters may not be experts on weight loss. They may not have lived your challenges. But, their support, understanding and encouragement can help you to make it through the rough spots and achieve your goals. They can comfort you when you’re struggling and cheer you on when things are going well. Their energy will lift you up and help you to work toward successful weight loss.

6. Accept that breaking the cycle of addiction takes time and effort. You may not succeed the first time, just like the smoker who is trying to quit. You need to keep focused. Do not give up on yourself. It’s hard, but you can do it. Keep the faith. Each time something goes wrong, write it down. Think about it, but do not punish yourself by overeating. Instead, praise yourself for attempting to change. Praise everything you’ve done right. Keep making good choices for yourself. Every positive change is a victory. Be patient with yourself. Again, enlist the support of family, coworkers and friends.

7. Make your house a food fortress. Keep your trigger foods out of the house. If you are addicted to chips, no chips in the house. If your kids clamor for chips, you can explain to them that you need their support. As a family, go shopping for substitutes. Remember, your kids may also be addicted. Break the family addiction together. You are not nurturing your kids by feeding them high fat, high salt or high sugar foods. Give your children fruit and vegetable choices. The more colorful, the better. If there is no junk food in the house, the kids will become part of the team.

8. Keep physically active on a regular basis. Exercise produces endorphins. These are the “feel good” chemicals in our brains. Endorphins are a substitute for junk food. Exercise, as you know from reading my blog, is an essential component of weight loss and weight maintenance. Be consistent about exercise. Get your children involved in regular physical activities as well. Can you take a walk? Go for a jog? Put on music and dance? Do a fitness video together? Set a good example, and your children will follow.

9. Be a true believer. Talk about your program to anyone who will listen. Talking about your positive choices serves to reinforce them. Sharing with others will often inspire them. Being positive keeps the brain active and keeps you motivated. It staves off the depression that comes from junk food withdrawal.

10. Break old patterns of thoughts as well as actions. Write down at least 3-5 positive thoughts about yourself each day. Sometimes the very things you take for granted about yourself are really the best things. Do you hug your kids and tell them you love them? Do you make time to share with your spouse? Do you call a sick friend? Praise yourself for everything you do right. Forgive yourself for your mistakes. Remember, you are human. You cannot be perfect. If you are too strict with yourself, you will eventually break down and make poor choices again and again. Accept the fact that you are involved in an ongoing, lifelong process of weight loss and weight maintenance. You are working on your program to improve your health, your overall well-being and the well-being of your family. Believe in yourself. As your thoughts and food choices become healthier, you will see the positive results. In time, this will all become routine. Exercise coupled with healthy thinking and healthy food choices will be your way of life.

11. Accept that there is no cure for addiction. There can be a lessening of addiction over time. The brain can be retrained, by force of habit, to make healthier, more life-enhancing choices. However, the cravings can, will and do return, especially during times of stress. That is why people who haven’t smoked sometimes start again when they are going through a divorce, a job loss or an illness. Know that this may happen. Have strategies in place for dealing with possible stressors. Keep focused on how you broke the junk food addiction in the first place. Those strategies worked. They will work again. Always ask for support if it is available.

12. Accept that you are human. Eventually, there comes a point when you realize that your healthy exercise habits, healthy thoughts and healthy food choices have become second-nature. You don’t have to keep writing down what you’ve eaten in your food journal. You don’t have to keep track of your exercise routine because it’s exactly that, routine. You don’t have to worry about heading down the chip aisle in the supermarket. You shop according to your list, look for sales and weekly specials, and then you leave for home.

Once you are certain that you are living your program on a daily basis and have truly withdrawn from junk food, you can indulge cravings on an occasional basis. There are times when you will find yourself having a food craving. If you keep having a craving, satisfy it once and move on. If you absolutely must have that ice cream, buy one container with the understanding that you can eat it, enjoy it, but then, you have to stop. You can’t live forever without some treats. Ice cream, a bag of chips, a box of cookies won’t hurt you unless it begins a downward slide toward your addiction. Trust yourself that, yes, some cravings will surface again, but you will go right back to your program of healthy eating and healthy exercise. That is why it is essential to be certain you truly have withdrawn first. Then, you can indulge once in a while, but that’s it. Otherwise, keep these foods out of your home and ask those who love you to respect your wishes.

You are worth this journey. It is difficult, but I am living proof that it can be done.

If you are someone who has broken the junk food addiction cycle, please feel free to share your own thoughts, strategies and ideas. If you are struggling, please ask for help. I’d be happy to respond to your questions.

Tuesday, November 3, 2009

Step Five: Junk Food Addiction - Part 1

On October 20, 2009, Paul Johnson, a researcher from the Scripps Research Institute in Jupiter, Florida, spoke to the Society of Neurosciences at a symposium in Chicago. He told the audience how, in a recent experiment, he and his co-researcher divided rats into two groups. One group was fed normal rat chow, which is a nutritious, low-fat food. The other group of rats were fed high-fat, high-sugar, high-salt food. In other words, the rats were pigging out on junk food. After a mere 5 days, the rats in the junk food group were completely addicted. They loved it. How did scientists know this for a fact? Because they checked the pleasure centers in the brain. Gulp down the junk food, and the pleasure centers in the brain light up like a Christmas display. What was even more alarming to the scientists was the fact that after that brief 5 day feast, the rats didn’t get quite as excited by the same amount of junk food. No, they needed more and more and more for those pleasure centers to light up.

This addiction pattern in the brain is very similar to what happens to human heroin addicts. That is the reason people quickly become addicted, often after their first encounter with the drug. Sadly, it takes more and more heroin to have those pleasure centers in the brain light up. The need for more of the drug quickly escalates. These are the hallmarks of any addiction.

The scientists then took the first group of rats, the chow-rats, and gave them a shock when they went over to eat their food. The rats rapidly realized that if they wanted to eat their chow, they’d get a shock. What happened? They stayed away from their chow. However, with the junk food-addicted rats, the shock simply could not stop them. They did not care about the shock. Yes, it hurt them, but the craving to satisfy their addiction was much greater than the pain of the shock. No matter how much of a shock they received, they could not stay away. Just as a junkie will do anything, whether it’s legal or illegal to get to that next high, the rats followed the same pattern of addiction and cravings. They would not be stopped!

Finally, the scientists decided to see what would happen when they returned the addicted rats to their normal rat-chow diet. The rats shunned the food. For up to 2 weeks, even though the rats were literally starving, they would not eat the rat chow because that nutritious chow would not satisfy their cravings for junk food. The pleasure centers in their brains would not light up when they ate it. They experienced a painful and slow withdrawal.

OK, human beings are not rats. That is true. But, just like any addict, those of us who are addicted to food will struggle, mightily, to break our addiction only to fail time after time after time. In the drug world, they call it relapsing. And, isn’t that what most of us do? We try, really we do. We work so hard, but then, we slip back into our old habits, our old patterns. And, faster than the blink of an eye, we’re hooked all over again. Hand us the junk food, and go away, please. We want to enjoy our next food fix without your nagging!

Clearly, this is not about will power. This is about food addiction. So, what happens to people who have been eating junk food for decades? Their addictions have become literally hard-wired into their brains. They crave high salt, or high sugar or high fat, or some combination of all three. They need to get their daily fix. If they somehow resist temptation, they can become moody, angry, depressed, fretful, even disoriented. Family, friends, coworkers just wish they’d eat the donuts or the chips and calm down.

People who are trying to resist their cravings can really be a pain in the rear. Everyone knows the smoker, for example, who is trying to quit and keeps having meltdowns. Nicotine withdrawal is supposed to be worse than heroin withdrawal. Yes, people do quit, but it usually takes many attempts until they achieve successful withdrawal. Now, smokers have many aids for quitting. There are medications, patches, nicotine gums, smoking cessation seminars and a great deal of public support. However, ex-smokers sometimes say they miss smoking and the good, calm feelings, and pleasure they enjoyed. Are they glad they quit? Yes, of course they are. But, they also understand why they smoked for so long.

If food is used as a drug, just like nicotine or heroin or alcohol, how can people deal with this addiction? After all, we can make our homes smoke free, or alcohol free or drug free. But, we have to eat. We must go out and shop for food, which is our substance of choice. We must bring that food into our homes and consume it on a daily basis. So, is there really any hope?

The answer is yes. You absolutely can break the addictive cycle. Is it easy? No, it is not. That is why people fail to lose the weight and keep it off. While it is a lot of work, and it takes time and effort, it is possible to break the cycle.

What I tell people who are junk-food junkies is that their brains need to change. That is, of course, easier said than done because those hard-wired pathways are just that. If junk-food addicts even so much as think about their favorites, they will start to crave them. Why? Because those pleasure pathways light up in the brain just at the mere thought of them. They know if they seek out their foods of choice, they will have a feeling of inner well-being that is impossible to describe. It is as though, for a brief moment, all is right with the world. Therefore, once the cravings crank up, the hunt for the junk food begins in earnest. Once the chips or ice cream or pie are located, the food junkie needs to eat and keep eating until those pleasure centers in the brain light up. Over time, this process requires more and more and more food to satisfy the craving, unfortunately.

I had a client tell me about eating until she fell into a food coma. She said she would eat to the point where she was in a stupor and could not move or think or feel much of anything anymore. This is very similar to what happens to a heroin addict after they shoot up. They feel the same momentary peacefulness and calm followed by exhaustion. They fall into a drug-induced stupor. How many of us have seen someone passed out drunk? They’ve taken in so much alcohol that they can’t speak or walk properly or even move much. Their minds and their bodies are quite literally overwhelmed by their drug of choice.

Once a heroin addict or an alcoholic comes around again, they feel sick. What calms the sickness? More drugs, of course. So, the alcoholic will pour another drink or pop open another can of beer or uncork a new bottle of wine. The heroin addict will rob or steal or lie or cheat to get the cash for that next fix. It is the only thing that will calm the pain and the sickness.

Most people who crave junk food do not see themselves as addicts. In fact, they might pride themselves on never drinking or doing drugs. They are clean living. The problem is that in many ways they are no different from the drug addict on the corner or the alcoholic staggering down the street just after the local bar closes. Only there are no social sanctions that prohibit the junk-food junkie from seeking ways to satisfy their addiction. They can stop at the supermarket or the all-night convenience store. No one is going to say anything to the overweight man or woman who buys two bags of chips and a quart of ice cream. No one is going to deny a double cheeseburger and large fries to a customer at a fast food restaurant. Why should they? It’s a free country, right? It’s all about choice, right?

Well, no. The person who is addicted to junk food is a slave to his or her addiction. They are about as unfree as they can get. Yet, the shackles of their slavery are unseen by others. Those shackles are in their brains. If rats are willing to starve themselves because they crave junk food after a very short period of time, how can any food junkie change his or her self-destructive brain patterns? Aren’t they set for life? Isn’t it hopeless? Isn’t this why people lose weight only to fall off the wagon and regain it time after time after time?

The answer is an emphatic no! It is not hopeless. Is it easy? Again, that would be an emphatic no! When I was working to develop my own system for weight loss, I noticed that I had terrible cravings. I was a high-sugar, high-fat addict. I loved cakes and cookies and sour cream or butter dripping off a baked potato. I had no weight-loss coach to stop me from eating those foods. They were readily accessible. I knew that once I started eating a cake, I’d eat the whole thing. One slice was never enough. I’d eat a slice, and then another and then another. I was like someone on automatic pilot. I’d return to the cake over and over and over until it was all gone. Then, I’d hate myself, berate myself, but I’d do it all over again the next time. Why couldn’t I stop? Why?

That was the question I kept asking myself long before brain MRI’s, long before all of the recent studies about pleasure centers in the brain. When I was growing up, it was all about will power. Alcoholism, for example, was not considered a disease. If people drank too much, they had weak wills, weak characters. The same with people who did drugs or overate. Smoking wasn’t even considered an addiction. In fact, smoking was considered to be sophisticated and chic. Believe it or not, some doctors even encouraged their patients to smoke during pregnancy!

Of course, this was 40 years ago when people simply were not armed with the kind of useful information that is readily available today. So, all I had at my disposal was my own determination to keep trying to observe what I was doing and why. But, on so many levels, I simply didn’t understand myself. How could I be so disciplined about studying, taking care of my sick father, taking care of a house, doing so many thing well, but continue to fail miserably to control my weight? Food was my downfall. When food was involved, my self-control inevitably flew out the window. My resolutions failed time after time.

I’d tried all the diets, but nothing had worked. I had tried the diet pills that did curb my appetite, but left me shaky, nervous and unable to sleep. I’d tried the fads, the diet prescribed by my family doctor, the liquids, the artificial sweeteners, etc. Nothing helped. Each time, I went right back to eating and the sweeter, the higher in fat, the better. Plus, I noticed that with each failure I not only gained more weight, but I needed more of my “foods of choice” to satisfy that emptiness inside of me. I ate until I felt better, calmer, more relaxed, less stressed. I ate to nurture myself, but then, I hated myself until the next time….

In my next post, I am going to continue the discussion of cravings and food addiction. I will be listing and explaining my 12-Step Program to Stop Junk-Food Addiction. Please feel free to add your comments or share your experiences.

Saturday, October 10, 2009

Step Four: Shopping the Supermarket

If someone is trying to stop drinking, the last thing they’d want to do is to take a tour of a winery complete with a wine-tasting. But, for those of us who struggle with emotional eating, heading to the supermarket is a necessity. We must eat to live. So, how do we put strategies in place that empower us to shop for healthy foods rather than falling into the many temptation traps that overpower us? Each time we grab that bags of chips or that half-gallon of ice cream that is on sale, we are giving in to former bad habits. But, what is a person to do? It all looks so good. What’s wrong with one bag of chips or an occasional ice cream treat? Well, nothing is wrong with being human, but for emotional eaters, it’s never a serving of chips. It’s the whole bag. It’s never a portion of ice cream. Once we’ve gotten a taste of something that is high fat/high salt, or high fat/high sugar, our brains are trained to keep those cravings going and going and going until the trigger food is all gone.

In order to help myself safely navigate the grocery store, I slowly tested and developed strategies for change that worked for me. First, I did a lot of reading on nutrition, which I continue to do to this day. Knowing what is healthy gives me the knowledge to shop wisely. Although it took a lot of trial and error to learn how to shop the supermarket, I eventually created a few simple rules that enable me to shop in a healthy manner, eat well and save money. I’d like to share those rules with you now.

The first rule for grocery shopping is well-known. Do not go to the store when you are hungry. Well, that’s easier said than done. Many people are so busy that the only time they have to go grocery shopping is right after work. They rush off to the store. They’ve had a long, hard day. They’re hungry. So, instead of resisting temptation, they give in week after week. Therefore, the first step is to bring a snack that can be eaten right after work and before shopping. It can be a slice or two of cheese with a few whole grain crackers or an apple and a few slices of turkey breast. A snack is exactly that. It’s a tidbit to keep your sugar levels from dropping drastically so that you will not buy on impulse.

Of equal importance, don’t forget to drink fluids such as water, herbal tea, or reduced-fat milk. People often confuse being hungry with being thirsty. As long as you eat and drink before you go to the store, by the time you arrive, you will have something in your stomach. Not only will you have more energy to shop, drive home and do what is required of you, but you will be less tempted by all of the unhealthy goodies in the store.

If you can, try to take your children with you to the store. Educating them about nutrition, involving them in food selections and choices at an early age is a great way to start them off on healthy eating patterns that they can establish for life. But, just as you should not go to the supermarket when you are hungry, the same applies to your children. I would not want a child of mine to touch a germ-infested cart and then shove crackers into his or her mouth. Moreover, if children have already eaten, they will not start begging and whining for snacks while shopping. Also, most stores now provide candy-free checkout aisles. Use them. They avoid family conflicts.

The second rule is to always have a list. If you keep a running list on a pad or a blackboard or on your computer at home, you can take that list with you. For example, if you always buy milk, start your list with that item. If you receive sale circulars from your local supermarket, check the sales and add the items you use to your list. If you clip coupons be realistic. Don’t clip the coupon for the potato chips that says, “Buy one, get one free.” It’s tempting, of course, but is it healthy? It’s all too easy to spend our food dollars on unhealthy processed foods when we can use that money to purchase far healthier choices for ourselves and our families.

The third rule is that knowledge is power. Most people who are overweight know very little about nutrition. It isn’t their fault that they don’t know what to eat, what is healthy, what is unhealthy. That is why diets are so popular, especially those with a very restrictive first phase. People are told exactly what they can and cannot eat. The decision-making powers are removed for awhile. If they adhere to the restrictions, they will not only take in far fewer calories, but they are relieved of the stress of making their own food choices. This especially applies to any diet plan that provides ready-made and expensive meals. But, when those restrictions are removed, or people stop eating their frozen dinners, then what? They are still ignorant about what they should or should not eat in order to regain their health and lose weight. Once freed of the restriction, people return to making poor food choices and regain the weight. However, anyone armed with simple nutritional knowledge can not only eat better, eat fresher, but eat wonderful meals for far less money. This post is designed to help you to learn how to make the most nutritious choices for yourself and your family, save money and save time. It’s far, far easier than you think. See Rule Four below.

The fourth rule is to shop the perimeter of the supermarket. What does that mean? When you enter a supermarket, you will notice that if you walk the perimeter of the store, all around the sides and the back, what foods do you typically find? Usually, most stores start out with a large selection of produce. They have dozens of types of fruits and vegetables lined up and displayed in an array of colors, shapes, varieties and price ranges. Then, if you move on, you’ll usually find some sort of deli counter with a cheese selection. At the back of my supermarket, we have a fish counter, poultry section, meat section, processed meats and cheeses. Then, there is a large selection of dairy products, orange juice, yogurts, butter, etc. Toward the front of the store is a bakery with fresh breads, rolls, cakes, cupcakes and other tempting treats.

Well, you might say that some of the perimeter is healthy and some of it is not. That is true. But, our goal is to break down the supermarket into easy-to-manage components so that it is safe to shop. The following are my simple tips for navigating the perimeter:

Step 1: Remember, our goals are to shop for healthy foods, save money and save time. If a plan is not practical, we will not follow it. The steps have to be clear, simple and logical. So, start at the beginning. If you go straight to the fruit and vegetable section, you will notice something. What do you notice? This is the only section of a supermarket that does not have labels on the food. What does that tell us as savvy shoppers? It tells us that these foods are so healthy, so nutritious, so varied and low-fat that they don’t need labels. Always look for what is in abundance and usually on sale. Try different varieties of apples or buy a big bag of them, especially at this time of the year. The apples are fresh, crisp, delicious and reasonably priced. Sometimes peppers are on sale. They come in many colors, varieties and sizes. Some are hot. Some are not. Look for different fresh herbs that you can try. If possible, bring your children to the store and let them help you to make the selections. This is a great way to keep them busy, teach them about nutrition and give them food choices. If you’ve never eaten bok choi, which looks kind of life a leafy celery, give it a try. It has a unique, wonderful flavor that is great in stir fries. Can your kids look up recipes online, print them out and help with dinner? Most children, if taught early, will enjoy cooking and shopping. They will feel empowered, and you can get the extra assistance you need both in the store and at home.

So, the fruit and vegetable section is always the place to start your shopping. You have no labels to read. Try to compare the price of a bag of apples on sale with a bag of potato chips or corn chips. Can you see how you can get far better value for your money if you shop fresh and with nutrition in mind?

Step 2: Next is the deli counter. Studies have shown that nitrates, which are used to preserve meats, are not healthy if eaten consistently. Ask if your deli counter carries foods without nitrates. As the public has increasingly demanded these products, there are more and more of them. You can certainly find many of these non-nitrate products at both Trader Joe’s and Whole Foods. If your store does not carry these products, do talk to your store manager. Nitrate-free products are a response to consumer demand. Be a good consumer advocate for yourself and your family.

Cheese is healthy, nutritious and comes in many varieties. It is a good protein source. Remember, softer cheeses tend to have a lower fat content. The harder cheeses tend to have the highest fat content. But, if we want to put some grated Parmesan or Romano cheese on pasta, how much cheese do we really use? Not much. If you like the taste of the reduced-fat cheeses, they are an excellent choice. If not, then buy the full fat. Just pay close attention to how much you are eating.

Remember, fat is not your enemy. Low fat diets lead to weight gain for a reason. We need a certain amount of fat in our diets. We just need to place the emphasis on healthy fats. Healthy fats are liquid at room temperature. Olive oil, canola oil, flax seed oil, etc. are all heart-healthy fats. Avoid margarine if at all possible because it contains partially hydrogenated oils. These are not heart smart. If you like butter, and I happen to love it, buy the real thing when it is on sale. Just eat smaller amounts.

Step 3: Fish is a healthy alternative to either meat or poultry. Fatty fish contain healthy fats, so buy the salmon or sword fish when it is on sale. Try different varieties of fish. You can make a fish chowder, which is simple, nutritious and delicious. Cod is a mild fish that most children will eat. Fish can be baked, sautéed, served in combination salads. Again, use the internet or check your cookbooks. There are many varieties of fish and many preparations. If you prefer fried fish, use olive oil or canola oil. Drain the fish on paper towels before serving.

Try to select lean meats and try to limit your red meat intake. Red meat is a great source of protein and iron, but it is also expensive. Can you find cuts that are on sale and make a stew that you can serve your family, but have enough left over to freeze for another dinner? Can you combine a cooked meat with vegetables and make a salad? Please consult your physician about your intake of red meat. Also, think about price here. Are there other sources of protein that are cheaper? Lentils are a great source of protein and much cheaper in price. Look for kidney or black beans to put into soups, salads and hearty stews. Use chickpeas for humus or put them into a casserole. There are so many varieties and all are great protein sources when you’re shopping on a budget. If you’ve never cooked these types of foods before, look up recipes online or go to the library and take out a cookbook that explains how to sort, soak and prepare them for delicious and money-saving meals.

We all know that poultry is an excellent source of lean protein. You can roast it, broil or bake it. There are an infinite number of chicken recipes. Pork is also another great source of protein. Again, shop the sales. Have you ever tried roasted roast Cornish game hens? They are delicious and very similar to chicken. Turkey is another very healthy food. You can freeze the leftovers and serve a salad with turkey, green grapes, a variety of lettuce, tomato wedges and a lime dressing, for example. Just use your imagination. Add fresh or dried herbals for wonderful extra flavor, color and zing.

Above all, remember, if you are shopping on a budget ask yourself what are the healthiest and cheapest forms of protein in your supermarket? Lentils, dried peas and beans all fall under this category. You can easily get enough protein through plant sources rather than animal sources. Obviously, if you are a vegetarian, you already know this.


Step 4: Shopping the dairy section is simple. Look for lower or reduced fat items. For example, will your family drink 1% milk or skim milk? If you have babies or young children, you should consult with your pediatrician, as they generally recommend full fat milk until children turn age 2.

There are so many varieties of low-fat milks, yogurts, Greek yogurts, cottage cheese. Again, shop the sales. If you prefer the full fat products, enjoy them, but try to consume a little less. It’s that simple. I am perfectly happy with 1% milk, or low-fat yogurt. But, I prefer full fat cottage cheese. I eat what I enjoy, what tastes good to me. In so doing, I get the taste satisfaction I crave. Therefore, I tend to eat less. We only keep eating and eating and eating when we can’t satisfy our taste buds. So, eat and enjoy, just don’t keep stuffing it in.

Step 5: Whether you like fresh breads or those on the shelf, look for whole grain breads which provide fiber, good nutrition and a variety of tastes and flavors. Try to avoid breads that are made with processed, white flour where all of the good nutrients have been stripped out. Remember, you want the most nutrition possible for eat bite of food you take. If you’ve never eaten whole grain breads, I think you will be surprised at the delicious, nutty taste. Moreover, because these breads provide more fiber per bite, you can eat less and actually feel more satisfied. It’s a win-win. Again, shop the sales. Often you can find good prices or buy-one, get one free or half off. Put the extra loaf in the freezer. If you’re really ambitious, try baking bread at home. I’ve done it for years. We bake 3 loaves at a time, slice them, freeze them and enjoy them. That way, we can make the bread to our exact tastes. But, since many people do not have the time, shop your local supermarket. You’ll be surprised at the variety.

Step 6: Ok, you now have your staples. You have fruits and vegetables. You have meat, cheese, poultry, dairy products and breads. But, what about the rest of the supermarket? How do you avoid the chips, the cookies, the ice cream or other treats?

First, remember that we are all human. We all need treats once in awhile, just not every single day. Therefore, you now have to face the aisles of the supermarket. And, that is where the greatest challenges lie. What I taught myself was to truly know the store layout. For example, if I needed some frozen vegetables, I also knew they were directly across from the tempting ice cream. So, I developed a strategy which I call “eyes right.” When I entered the aisle, I would keep my eyes to the right because that is where I would find the frozen vegetables. I had my back to the ice cream. Sure, I know it’s there. And, yes, it’s calling my name, but I kept my eyes focused on the veggies, not the ice cream. Always remember that frozen fruits and vegetables are a great source of nutrition. They are usually flash frozen, so they often have more of their original nutrients than items that have been chilled and shipped to be sold as fresh. Moreover, there are often coupons and sales. If your favorite peas are on sale and you have room in your freezer, always purchase more than one package. If you like frozen berries and they are on sale, try to do the same. Snacking on frozen berries is a great substitute for ice cream, for example. Children love them, too. Frozen fruit adds color and nutrition to cereal, salads and low-fat desserts.

In my supermarket, there is one aisle devoted exclusively to chips of every shape and variety. I never go down that aisle. I also avoid the candy aisle. The cookie aisle also contains the crackers. Whole grain crackers are great with some cheese, so again, I try to keep my eyes focused on where I’m headed. I avoid, if at all possible, looking at the tempting cookies on the shelf. If you can’t resist, indulging every once in a while is fine. But, when you check the price of those store bought cookies, do ask yourself what else you could purchase with those food dollars. Are there healthier alternatives?

If your family likes cereal, again, shop for whole grain cereals. Try to find cereals that are on sale. Will your family eat oatmeal or other hot cereals? They are not expensive per serving and don’t take much time or effort to prepare. Add a little honey and fresh or frozen fruit with a dash of cinnamon or other spice, and you have a hearty, inexpensive, nutritious breakfast.

Step 7: Do Read Labels. Food labels are a boon to savvy food shoppers. Take a good look at the labels of the foods you purchase. Some foods can contain over 1000 mg. of sodium. That is way, way too much salt for anyone. Reading food labels does take time, but if you read them, you will know what you are purchasing. Is it really worth your food dollars? For example, if you read some labels you realize that a serving is so tiny that you’re going to eat the whole package or can or container yourself. Some servings are so small that I would think a child would ask for more. Think carefully about the nutrition. Does the food contain a lot of sodium, sugar, additives, partially hydrogenated fats? Try to avoid these foods. Look for healthier alternatives. If you have to spend several minutes reading a label because the list of additives is so long, you probably want to look for a healthier selection. My policy is that if I can’t pronounce it, I won’t eat it!

Step 8: Avoid Processed Foods. Everyone today is so busy that we are looking for short cuts. I have had people tell me that it’s far easier to buy a microwave meal loaded with fat, sodium and all sorts of additives than it is to make a real meal. I disagree. How long does it take to rinse, season and pop freshly cut-up chicken into the oven to bake along with scrubbed and fork-pricked potatoes? It only takes a few minutes to bring some mixed frozen vegetables to a boil. For dessert, you can rinse some fresh fruit and put out a wedge of cheese. I truly believe that if at all possible, it’s faster, easier and far healthier to eat real food, not processed food. Moreover, dollar for dollar, it is cheaper. Why not save money, eat healthier and enjoy your food more?

When we eat too much salt and sugar and fat then that is all we taste. We become addicted to these tastes and develop food cravings. Whereas, if we eat a wide variety of foods, eat fresh, or freshly frozen, then we actually eat less food over time.

Always remember to eat the whole food. For example, if you like a glass of orange juice in the morning, eat a fresh orange instead. If you price orange juice vs. a bag of fresh oranges, you will realize that you can actually save money doing this. If you don’t have time to eat your orange, take it with you and eat it as a snack. A fresh orange has more fiber and less sugar. It takes longer to chew. Therefore, it provides more eating satisfaction. You will feel fuller longer. Add in the cost savings, and again, it’s a win-win for losing weight, eating healthier and saving money. If you have children, teaching them to eat the whole fruit rather than drinking juice not only makes nutritional sense, but your children will have much improved dental health. Again, you will save money, and your children will not have as many cavities.

These are the simple steps that I developed for myself. Over time, supermarkets have offered us more and more food choices. That can be overwhelming. But, if you take your list, shop sales, stock up on non-perishables when good prices are offered, pay attention to nutrition and price, you will learn how to eat healthier, lose weight and save money.

Please feel free to comment on my strategies for shopping the supermarket. I’d love to hear your additional suggestions, questions and ideas on this subject.

Thursday, September 24, 2009

Step Three: Habits - Conquering Night Eating

Because I realized at the age of 20 that there were no easy answers to my own morbid obesity, I had to come up with ways to lose weight on my own. It was my willingness to experiment, to step off the beaten path, that led to my current system of weight loss. Change had to come from within. Each of us eats for different reasons. Therefore, as individuals, we need to start with one bad habit and slowly, consistently substitute a good habit. Moreover, we need to simultaneously ask ourselves why and how we developed this bad habit.

One of the most common bad habits among emotional eaters is night eating. Does that sound familiar? You’re busy all day long. You have a job, school, children or other responsibilities. You’re running here, carpooling there. You’re putting in late nights at the office just to hang on to your job and your health insurance. You’re under too much stress on a daily basis. You are exhausted.

By the time you get home, you need to relax and calm down, or you’ll never be able to sleep. You’re drained physically and emotionally. So, you sit down in your favorite chair or on the couch. You watch TV, or you read, listen to music, or you go over your notes for a meeting the next day. You just want to soothe yourself, reward yourself, nurture yourself after giving so much to everyone else. You deserve a treat. OK, you’ve just had dinner, but so what? Maybe you’d like a little ice cream. After the first few bites your mouth is frozen, and you can’t really taste it, but you eat it all anyway. Then, you sit back and relax. Soon, before you even realize it or think about it, you’ve ripped open a bag of chips. You reach into the bag during a commercial, and you’re shocked that it’s nearly empty. Wasn’t that a full bag when you started?

Or, you take the healthy approach to night eating. You put together a large bowl of various cereals topped with wheat germ and layers of banana and sliced strawberries. You add some low-fat milk and gobble down the whole thing. It’s cereal and fresh fruit with low-fat milk, so isn’t that healthy food? Maybe you cut slice after slice of cheddar cheese and eat it on whole grain crackers. Aren’t those great choices? You’re eating protein and complex carbs, so what could be bad?

Well, maybe the foods are healthy, but it’s late at night. Those calories are not going to get burned off by exercise or daily activities. It isn’t exactly aerobic to brush your teeth, change in your pajamas and go to sleep. Therefore, all of those excess calories turn into stored fat. When this pattern of night eating repeats itself on a near-daily basis, the pounds keep adding up. People do not realize that a mere extra 100 calories per day will eventually translate into about 10 pounds of additional weight over the course of a year. The margin for error is very slim, indeed.

Most people who are night eaters find this a very difficult habit to break. Over the years, our brains become hard-wired to eat away the stresses of the day. Without even giving it a second thought, we start to eat after dinner, and we eat until we go to bed. I spoke to one woman who admitted that she ate so much at night that she often woke up surrounded by a half-empty bag of chips, a stack of crackers and crumbs in her bed. Sometimes, she whispered sadly, she had no idea she’d even taken these foods into her bedroom. She was on automatic pilot. Yes, it frightened her, but she had no idea how to fix the problem.

I asked her if she’d talked to her doctor or a therapist about her night eating. Apparently her doctor had confronted her when she went in for her last physical. He’d lectured her about her weight year after year, which had only caused her to get upset and eat more. His solution? “Just stop doing it!” he’d barked.

Well, that’s easier said than done. If you have an addiction to food, you can’t just stop. It doesn’t work that way. It’s an addiction. For example, the person who reaches for a cigarette with their coffee each morning is addicted to nicotine and habituated to certain daily rituals. There is the cigarette on the drive to work. The cigarette break outside, even when it’s freezing. The first puff after work. Beer and cigarettes with friends on the weekends. People who want to quit smoking not only need help withdrawing from nicotine, but they need to often change their daily habits because those habits trigger the hard-wiring in their brains that commands them to reach for a cigarette.

Although people can learn to live without nicotine, people cannot live without food. We must eat to live. The substance to which we are addicted cannot be kept out of our lives. So, how do we change those bad habits? How do we rewire our brains?

With night eating, I made a decision to start very slowly. What I’d learned was that doing anything cold turkey did not work for me. Quitting night eating cold, which I’d tried to do dozens of times, only led me to get nervous, frustrated and depressed. I’d feel deprived and miserable. My brain would keep telling me to eat. I deserved it. I’d worked hard all day. It was like a little devil whispering in my right ear, “Eat, you know you want to.” The angel who whispered in my left ear pleaded, “Please don’t do it,” would eventually get drowned out. I simply could not control the impulse.

Realizing that my brain needed to be retrained truly helped me to understand why, even though I’m not a weak-willed person, I gave in to the ice cream or toast with jam or the reheated leftovers time after time.

My first step was to ask myself some questions? What foods were trigger foods? By that I mean, what foods will cause me to eat more and more and more until I’m in a food coma. Those foods comprised two elements. High fat foods and high sugar foods were my two worst problems. I know that if I start to eat ice cream, for example, I simply cannot stop until I’ve eaten it all. Ice cream is both high fat and high sugar. Sour cream is another example. I always used to joke, “Give me a pint of sour cream and a long handled spoon and go away, please.” I could easily sit down and eat the whole thing. I realized that these foods soothed me, calmed me, relaxed me. They were like tranquilizers to me. I didn’t need a Valium. I needed a hot fudge sundae!

So, I decided that the first step was to keep the high fat foods out of the house. I named my house my “food fortress.” This is the exact same technique I use today. Only good foods can safely enter my food fortress. The trigger foods must be kept out in order for me to stay safe. If I am secure inside of my food fortress, then I cannot be tempted to eat myself into a food coma.

Yes, I have worked with clients who will throw on a jacket and head to the nearest convenience store to buy their favorite trigger foods at 2 AM, but that involves a whole other set of strategies for change. For now, we’ll stick to how I resolved night eating for myself.

On the first night inside my food fortress, as hard as I tried, I kept obsessing about high fat foods, sugar, cookies, even things I didn’t like or want. My brain was telling me to feed it. I began to shake and sweat. It was like going into a drug withdrawal. I knew that I could not go cold turkey. Doing that would involve deprivation. Deprivation = dieting. That never works. So, I cut up an apple, took a few crackers and cut a small cube of cheese. All of the foods were healthy, and the portions were small. Slowly, ever so slowly, I concentrated on eating, enjoying every taste sensation, every bite. If my attention or thoughts strayed, I brought them back to eating. I wanted to be conscious of my choices, conscious of eating. For far too long, night eating was simply an unconscious habit. That had to change. So, for a while, that is all I did at night. I ate healthy food, smaller portions and kept myself focused on what and why I was eating. Once I had that part of the process down pat, I started on the next phase.

What will soothe me other than food? I asked myself. I ran a bath for myself, climbed in with a book and started to read. I made myself soak and soak until my skin was puckered and beet red. Eventually, the panic and shakes went away. I felt drowsy. After rubbing in some refreshing body lotion, I climbed into bed and fell asleep. I actually went to sleep without eating at night for the first time in over a decade!

The next morning, I woke up really hungry. That was a new and different sensation. Usually, I’d eaten so much food the night before that I was never hungry in the morning. I was both surprised and delighted because I realized this was proof that I had made a change in my eating habits.

Proud of my accomplishment, I was sure it would be easier on night #2. No, it wasn’t. Remember, our brains get hard-wired over a period of years. I kept telling myself that if my brain was wired to eat at night, I could develop strategies that would help me to eventually cut that wire and reroute it. I was determined to keep to my new program. On the second night, I again started to shake and have cravings. Temptation was overwhelming me. I told myself, “This is a bad habit. It need not be a life-long habit.” Instead of giving in, I called a fellow classmate to ask some questions about a reading assignment. Honestly, I didn’t need help with my homework. I needed help with my night eating. My school friend and I discussed the assignment and then we got to gossiping about some of our classmates, especially the one who always arrived late and asked the most questions. We had a lot of fun on the phone and even made a date to get together for coffee after our class. What I realized, when I got off the phone, is that by totally shifting my focus, I had not only lost the urge to eat, but I had started to build a new friendship.

Each night, I worked on this challenge. Some nights, I failed and gave in to eating again. But, when I did, I told myself the following: I am human. I will make mistakes. I will search my heart and forgive myself. I will not punish or reward myself with food. I will nourish my body with food, but I will nourish my heart and mind and spirit with loving kindness toward myself and others. I will move forward. I will remain committed to my plan. Over time, I will succeed.

The process took several years. Yes, several years! It wasn’t easy. There were ups and downs. When my life took a very stressful turn, I reverted to eating to calm myself. I regained some weight I’d lost. But, instead of throwing in the towel, I reminded myself that I could do this. I had done this. I just had to return to my program and use the strategies that I had developed that I knew worked for me. Eventually, I learned to do other things at night. If I watched television, I made sure to get up and walk around the house while commercials were on because any food ads made me want to eat. That was an effective strategy for change. If I read, I used a squeeze ball to help strengthen my arthritic fingers. That kept my other hand busy so I wouldn’t be reaching for food. If I decided that I truly was hungry, I’d make a firm decision about what I could eat and how much, knowing that it was not an invitation to keep eating. I might have a slice of toast with no butter or an apple or a small yogurt. But, by that point, I could recognize true hunger as opposed to just eating to soothe myself or relieve stress or boredom. It was not emotional eating anymore.

All eating must be conscious eating. When we eat, we need to understand why we are doing it until we slowly rewire our brains. Now, when I’m stressed out, I actually can’t eat. That is proof to me that my system works. As I live each day, I have a chance to reinforce my hard-won good habits. It does take time, effort and consistency, but it can be done. I am living proof that you can conquer compulsive eating for life!

I would welcome your comments, your questions, your thoughts about your own bad eating habits. What kind of strategies have worked or failed for you? What eating habits are still challenging for you?

Sunday, September 20, 2009

Step Three: Habits - No Free Lunch

As I wrote in my previous post, the good news is that we can change our eating habits. We can substitute good habits for bad ones. However, that takes time, experimentation and patience. Just as we build bad eating habits over many years, we have to slowly dismantle those habits one baby-step at a time. But, as we’re working toward breaking a bad habit, we have to keep substituting and reinforcing the good one. Consistency is the key. We are literally retraining our brains to think, act and react differently to food. We are simultaneously retraining our brains to find new ways to constructively deal with emotions without reaching for food. Because these changes are so difficult and time-consuming, we have to have patience with ourselves, learn from our mistakes and remain dedicated to the task at hand. Yes, we can do it, but it takes time and effort.

I’d like to share a story with you about what happens when someone who is struggling with emotional eating refuses to work on his bad habits. I used to swim with a man, we’ll call him Bob, who had a serious weight problem. After we got to know each other, I told him about the individual programs that I create for emotional eaters. Each time I explained my plan, he nodded in agreement. Yes, he was an emotional eater. Yes, he ate when he was stressed. Yes, he had terrible eating habits, and he knew it. He listened attentively, agreed with me and asked me a lot of questions. I got really excited about his interest because my passion is to help people to lose weight, especially people who’ve gotten to the point where they believe it’s impossible. They’ve tried the diets, the groups, the pills, but nothing has worked. That was exactly how Bob felt. He’d tried everything, but he’d only wound up fatter and more depressed than ever. He’d come to the conclusion that his situation was hopeless. I believed that I was offering him hope.

Did Bob ever decide to become my weight loss client and work with me? No, he did not. Why? He did not want to do the hard work to truly change how he used food to help him cope with his emotions. Instead of heeding my words of encouragement and my free advice, he continued to eat. His weight continued to climb. It made me sad to see him at the gym because despite his vigorous workouts, he was heavier than ever. For me, as a weight loss coach, it’s like watching someone who is drowning. I’m throwing them a lifeline, but they keep refusing to grab on.

Eventually, he needed knee replacement surgery His doctor told him that his knee had worn out due to his obesity. Then, the cartilage in the other knee wore out. Finally, he required back surgery. His doctors told him that his weight was literally killing him. He had Type 2 Diabetes, high blood pressure and he’d already suffered a minor heart attack.

I did not want to give up on my gym buddy, so I talked to him again. At that point, after so many trips to the operating room, I was certain the last thing Bob would do is to elect to undergo bypass surgery for weight loss. Well, I was wrong. Bob did exactly that. I do realize that for many morbidly obese people, this surgery is a lifesaver. It does seem to cure Type 2 Diabetes almost overnight. For some, it is a medical necessity, but for Bob? Well, he thought it was not only necessary, but his only logical choice.


Prior to having bypass surgery for weight loss, all patients, including Bob, were required to have physicals, blood work and all of the medical tests necessary to prepare them for the surgery. In addition, all patients were required to undergo many months of counseling to learn about nutrition and how to control emotional eating. However, despite all of the counseling and group discussions, Bob continued to eat more and more and more. Why? Because he’d learned, through his counseling, that he’d never be able to eat the same way again. No more pizza nights with his extended family where he ate almost an entire pepperoni pie by himself. No more porterhouse steaks and beers with the guys on a Friday night after work. Everything was going to change. The closer his surgery date came, the more he stuffed himself. By the time he had his bypass surgery, he’d gone from 304 pounds up to 365 pounds. He was so focused on being deprived, that he was determined to eat everything he knew he’d have to give up after his surgery.

Like most bypass patients, that first year was a honeymoon. The weight just melted off. He lost about 85 pounds. He looked like a different person. But, he was still struggling. Some days, he’d subsist on crackers, popcorn and diet Jell-O. Other days, he couldn’t stop his urges to eat whatever he wanted simply because he wanted it, which resulted in severe diarrhea or vomiting. Although he continued to receive nutritional counseling and psychological support, his brain, his hard-wired brain, had not changed. He still saw food as a source of comfort, as a way to relieve boredom, as a way to cope with life’s ups and downs.

Once he returned to the gym, he attacked exercise with a vengeance. He was determined to keep losing weight. But, because he alternated between starving himself and stuffing himself, he got sick, so sick he wound up in the hospital. The doctors questioned him about his eating habits, but a friend of his said Bob lied to the doctors because he’d signed a contract at the clinic that he would stick to his eating plan. After that episode, he decided to simply starve himself. No more bingeing one day and then barely eating the next. He was a combat veteran. He was tough. He could survive on popcorn, diet soda and an apple a day. That would prove to the doctors as well as to himself that he was capable of losing weight once and for all. He was determined to get the weight off and turn himself into the buff guy he’d been in high school decades before.

What happened next was truly frightening. One day, after a hard workout at the gym and very little food, he had a seizure. He was taken, by ambulance, to the hospital. The doctors did not want him to drive, so he stayed at home unless one of his friends brought him along to the gym. The next time I saw Bob, he looked haggard, sick and depressed. Yes, he was much thinner, but not healthy-looking. His skin was pallid, his eyes sunken in.

Instead of facing himself and his emotional issues, Bob continued to focus on the exterior instead of the interior. A few months later, Bob had another seizure. He could not heed my words that, “Change starts from within.”

Eventually, as a result of starving himself, he lost so much weight that he had a lot of excess skin hanging around his midsection. After a trip to Vegas, where a young bikini-clad girl teased him about it, he decided to have a tummy tuck. His bypass doctors tried to discourage him, but Bob insisted that after all of his hard work, he’d earned this. He could not exercise away the loose, flabby skin around his midsection. The first doctor Bob saw refused to do the surgery because of Bob’s seizure history. He told Bob it was better to be alive and flabby rather than dead from what was essentially a cosmetic procedure. Instead of taking the doctor’s advice to heart, Bob continued to search until he found a doctor who would do a tummy tuck on him. After the surgery, Bob developed a severe infection and almost died.

Despite everything Bob had endured, he still felt he was making wise decisions. Wasn’t he down over 100 pounds? Didn’t he look great? Well, no, he looked as though he’d aged 10 years. He seemed exhausted. The sparkle was gone from his eyes.

After not seeing Bob at the gym for a while, I asked a friend of his how he was doing. He told me that Bob had had a stroke and was no longer able to come to the gym. He’d suffered extensive brain damage. I felt terrible and sad. Bob was a man of extremes who’d sought out what he thought was going to be an easy solution to his weight problem. What he found out was that he’d actually chosen the hardest path possible.

Obviously, there are many people who have bypass surgery and do well. Again, this is a very personal decision. But, why would someone choose this surgery when there truly are other, safer, non-surgical options? When it comes to weight loss, there is no free lunch. Either a person is going to acknowledge their problems with food, or they will keep trying to find the quick fix, the easy answer, the instant result.

Thursday, September 3, 2009

Step Three: Habits

We all have habits, both good and bad. But, when it comes to eating, we often don’t give our habits a second thought. If I had asked myself back then how I had gotten so fat and why I could never stick to a diet from the ages of 10 to 20, I would have been stymied by those questions. That might sound strange, but like a lot of overweight people, I had no idea that I ate vastly larger portions than I needed. That extra food turned into stored fat. I didn’t understand anything about nutrition or exercise or how calories really worked. It was all a muddle to me. Honestly, I preferred not to think about it. I was fat. I was miserable. I had tried diet after diet. I had failed to lose weight. In fact, each year, I was fatter and more miserable than ever. It seemed like a hopeless cycle of desperation and defeat.

It was only when I turned 20 and really started asking myself some hard questions that I realized several things about myself. Because I was in a hurry to get to the bus stop to catch the 7:30 AM bus into New York City, I was in the habit of skipping breakfast. I had a 9 AM class and a 1 ½ hour commute each way on a daily basis. I preferred to sleep a little later rather than eat. Of course, by the time I got into Manhattan, I was starving. So, I’d stop at the local eatery near NYU and grab a hot dog and a coffee with extra cream and 3 packs of sugar, then wolf it all down while taking notes in class.

By the time I got home, I had a sick, widower father who needed my care. I had housecleaning, laundry, errands. I also had reading assignments, papers to write, tests and exams. I was on constant overload both physically and emotionally. Each day was so draining that I ate and ate to keep myself going. Each day was about fulfilling the demands and expectations of others.

I had been brought up to be a caretaker and a nurturer. That was all I knew. My life was devoted to meeting the needs of others. I took my pleasure from being helpful and compassionate and kind. I asked nothing in return. I was selfless.

Selfless? Yes, selfless. I had no clue who I was, what I wanted or needed. I was there to serve others, love others, protect others, but what about me? While most children think the world centers around them, I never thought that. The message I got was utterly different. When I was little more than 5 years old, I started to slowly help my dad take care of my sick mother. My Daddy needed me to help while he was at work, and I would not fail him. Although I had an older sister, she was not the helpful sort. My father recognized that, so he placed the burden of our mother’s care on me. No one thanked me. No one praised me. I was expected to be a dutiful child, and so I was. This was normal to me.

When I was 10 years old and my sister was 12, our mother died. Not that long afterward, our father suffered a massive heart attack. My sister and I lived in fear that one day, sooner or later, we’d be orphans. Then what? My sister coped by going into denial and turning herself into the perfect young lady. She was smart, pretty, sociable and above all, thin. I turned myself into the workhorse who ate for comfort, for security, for companionship. I was all alone with my worries, my fears, my insecurities. I could not tell my father. What if I upset him, and he had a heart attack? I did not want to kill my father. I wanted to save him. During the next decade, he wound up in the ICU about every 2-3 years. At that time, the only treatment available to him was prayer. This was before lifesaving surgeries and stents and statins. Our father’s life was in God’s hands.

Food became my only escape from constant anxiety and stress, my one true nurturer, my only comfort in my darkest hours, my only friend in time of need. Food was always there. It was the one constant in my life. Yes, I understand that now, but I didn’t understand it then. If I ate, I felt soothed. If I ate, I felt nurtured. If I ate, I felt less afraid. But, then, inevitably, I’d feel guilty. I’d berate myself and promise to stop eating, but I had to eat to live, didn’t I? It was a vicious cycle.

To add to my confusion, my sister never gained weight. In fact, my parents had always encouraged her to eat because she was a picky eater and didn’t like a lot of foods. As a child, she was skinny, bone-thin. So, if my sister wanted to heat up a frozen pizza at 9 PM, that was a good thing. If she wanted to go to the local place that served super-sized strawberry malteds, off we went. If you were thin, I learned early, you were a good girl, a nice girl, an adored girl. If you were fat, you were undesirable, period. If you were thin, you got positive attention. If you were fat, you got picked on, so better to stay in the shadows and hope no one even noticed you were there.

Like most overweight adults, my bad habits had started in my childhood. What I learned from my mother was that being fat was bad. Denying oneself food was good. Unfortunately, her constant attempts to deny me food only made me crave it all that much more. Despite the risk of punishment, I learned to steal food, hide in a closet in the basement and eat all alone, gobbling bread or slices of cheese or a few crackers I was sure would not be missed. The more my mother deprived me, the more my life focused on getting food. Desperation drove me forward. By the time I entered kindergarten, which was the same year my mother was diagnosed with breast cancer, I was already obsessed with food.

After my mother died, I ate and I ate and I ate. The person who had controlled my eating was not there to say no, to grab my plate, to scream at me and tell me I was fat. While my mother was alive, I really was not fat. But, after she died, I became her worst nightmare. What I wanted was comfort and love. What I wanted, above all else, was someone to protect me. I had no one to protect me. Instead, I became the “little mother” to my family. I had to protect them. So, I turned to food.

My brain became hard-wired to reach for food in any and all situations. My bad eating habits became ingrained. Whenever I felt a powerful emotion, whether it was happy or sad, exhausted or stimulated, anxious or competent, whatever I felt was directly wired to food. It was no longer a conscious decision, a choice, an act of volition. Instead, it was like Pavlov’s dogs. I was trained, over time, to reach for food as the solution to every problem, to every mood, to every hurt. I had no other source of comfort or solace in my life. Did I understand any of this? No. By the time I was only 10 years old, I weighed over 100 pounds. The cycle was fixed. The bad habits were entrenched.

For the next decade of my life, I used food as my salvation. It was all I had. My father was in and out of the hospital. He suffered heart attacks and angina attacks. I lived in fear. Would I come home from school and find him dead at the kitchen table? Since my father was also a compulsive eater, this was our bond. We ate. We talked. We read books. We shared cultural interests. But, food was our strongest link. It was how we showed our love for each other and for family and friends. If we had company, they had to leave with full bellies, or we were disappointed and feared we had been inhospitable. Food was love. If food were truly love, I should have been the most loved teenager on the planet. Instead, I was growing increasingly fatter, more depressed than ever, more hopeless as my clothing size soared into the stratosphere.

When our dad had his last heart attack, I was a 20-year-old junior in college and my sister was long since married. Within a few months of our father’s recovery, he proposed to his long-time lady friend. That marriage set me free for the first time since I was only 5. I actually had someone to help me care for the household and my dad. My stepmother hired a housekeeper. My stepmother and I shared the shopping, the cooking, the chores. I could finally step back and think about myself for the first time in my life.

What I realized was that I had a long list of bad habits. I ate in response to everything in my life. For example, prior to my dad’s remarriage, I was so nervous about having a new stepmother that I gained 10 pounds in 3 months. I could barely find anything to wear to the wedding ceremony. After the marriage, with a lessening of my responsibilities and with my stepmother’s support, I started to take a hard look at my eating habits. Since I didn’t have to stay up until all hours finishing the laundry or dusting or cleaning the bathroom, I had time to get up and eat breakfast before leaving for my commute. That was the first habit I changed. Yet, when I arrived at Washington Square, my initial impulse, despite having had a full breakfast, was to hit the Chock Full O’Nuts for a hot dog and coffee. Why? I wasn’t hungry, but a powerful message in my brain triggered off the need to eat anyway. For several weeks, I walked into the bustling restaurant and ordered my usual. Since I’d paid for it, I ate it. I did not waste food. I did not want to waste my money. But, one day, after buying my meal, I saw a man who looked hungry. I asked him if he wanted something to eat. He nodded. I handed him the bag. He was hungry; I was not. I raced upstairs to a study hall for commuters on the second floor. I found an isolated desk in the back, put my head down and cried silently. I understood in that moment that I was not in control of my life. I was like an automaton, a robot, who had dark forces propelling her toward a complete lack of control over her impulses. Did I want to keep living like this forever? No, I did not. It was too painful.

That was the first time in my life that I truly recognized and understood that I had a pathway in my brain, long-used, that led to unconscious eating. If it truly was a bad habit, then there was hope that I could change it into a good habit. I decided that each day, I would buy something to eat and give it away to someone in need whether it was a person on the street or a fellow student. I would turn my bad habit into something positive, life-affirming and good.

But, despite my daily good deed, I knew that the urge to eat was still there. That puzzled me. I had had a healthy breakfast with an emphasis on high-protein as my stepmother had recommended. So, I started to keep a journal where I could pour out my thoughts on this subject. “Why do I want to eat even though I’m not hungry?” The bottom line was that I always ate without thinking. I simply kept right on eating until I was in a food coma. Then, I would stop, exhausted and dazed, bloated and miserable. I was not loving myself with food. I was punishing myself with food. I was not soothing myself by eating. I was only increasing both my anxiety and my weight. I had no concept of who I was except a “Fat Girl.” Did I want to remain a fat girl, or did I want to change?

I made a list of all of my bad food habits. Each time I thought I’d finished the list, I had something else to add. I was getting overwhelmed. And, what did I want to do when I felt overwhelmed, I wanted to eat, of course. So, I had to add that to the list. I shoved the list in a drawer. That was not working.

After giving it a lot of thought, I decided to step back and think about how I had gotten so fat. I had gained the weight over a long period of years. If I took 100 pounds as my starting weight at the age of 10, I had added an additional 130 pounds over a decade. That was equal to 13 pounds a year. Well, no, that wasn’t accurate. Over those years, I’d gone on quite a few diets. I’d lost at least 60 pounds give or take a few. So, in essence, I’d really gained a whopping 190 pounds! My heart started to race. 190 pounds.

I decided that if I hoped to lose the weight once and for all, I had to start slowly, make one change at a time. I had to keep eating my healthy breakfast each morning. That was my first good habit, the first positive change. However, when I got to school, I had to resist the well-worn pathway in my brain that still urged me to eat again. That meant stopping my “good deed” of buying a meal, but I could do something else for someone. I had to distract myself from food altogether. Therefore, I went straight to class. Since another student was struggling with our course, which was Chinese Politics, I offered to help tutor her for free. By shifting my focus to a strength, my intellect, instead of my weakness, the constant craving for food, I slowly built a new habit. By the end of the semester, once I arrived at school, I was hungry for knowledge, not food. I was proud of my hard work, and I made sure to celebrate, without food, to note my accomplishment. That was something new in my life. Praising myself had never been my strong suit. I was determined to change that.

I’d like you to think about one and only one bad eating habit you have acquired over the years. Write it down in your journal or a piece of paper. Put it away and allow yourself to think of a strategy that will work for you. How can you challenge that well-worn pathway in your brain that triggers overeating? What can you do to turn a negative behavior into a positive one? Don’t worry if you don’t succeed at first. No one does. Just remind yourself that if you believe in yourself and keep to your plan, you will succeed. Remember, you are carving out a new life for yourself. That means taking it one step at a time. It might take a few months to change that bad habit into a good one, but that will be time and effort well spent.

In my next post, I’m going to continue the discussion of eating habits.

If you have any questions or comments, feel free to use the comments link below. I’ll look forward to hearing from you.

Sunday, August 16, 2009

The Best Intentions

The Best Intentions
By Sue Phillips

Tomorrow I shall rise at six
and walk three miles or more
eat bran flakes laced with vitamins
drink orange juice galore
at noon I’ll dine on celery
then touch my toes for hours
deep breathing techniques I’ll perfect
while contemplating flowers
Fresh fish baked without butter sauce
shall be my supper fare
I’ll follow with a journey
on a bike that goes nowhere
Yes, tomorrow I’ll begin my plan
you must make no mistake
For now, I think I’ll celebrate
Please pass the chocolate cake

Every January, if you belong to a gym, you see the “best intentions” people. We, the people who have been going to the same gym for many years, call them the “rank amateurs.” They are the people who have made the sure-to-fail New Year’s resolution that this year is going to be different. This is the year that they are going to commit to a new year, new me! They fill the gym, bursting with gusto and determination. They grab the weight machines, fumble with the panel on the treadmills, whiz along to nowhere on the stationery bikes. They sweat as they listen to their ipods, their faces a mask of beet-red determination to stay the course. There will be no calorie unburned!

As I watch them, I feel nothing but compassion. Yes, OK, it’s a tad annoying, I admit. They’re hogging the machines. They’re grabbing my favorite lane in the pool. They’ve overtaken the only locker I can find without my glasses. But, I know, by the end of February, at the very latest, the “best intentions” folks will be gone. The gym will return to normal. Those of us who always show up day after day, year after year, even if we never truly look like the ads you see on TV, well, the dedicated few will always remain.

In Sue Phillips delicious poem, “The Best Intentions,” she sums up all of our most earnest desires to make the commitment to exercise, to eat right and to finally lose the weight. We all know where the path of good intentions leads us, don’t we?

All diets start with the best intentions. We resolve that this time, despite all of our previous failures, this time it will be different. Only, it isn’t different, is it? Within a matter of months, or weeks or days, we fall off the wagon. It might be that bag of chips that was hidden in the cupboard and just seems so right after a miserable day at work, or too many hassles with naughty children. It could very well be that piece of chocolate cake, well, just one slice to soothe ourselves. If we’re honest, we know we can’t eat just one slice. It turns into two, or more, or eventually the whole cake, but who’s counting? Before we know it, all of our resolve, all of our best intentions fade into oblivion. We’re back to overeating, ignoring our food choices, forgetting that walk before work or the gym membership.

By this point you may be asking yourself why some people can lose the weight and keep it off and other people cannot, despite their best intentions? Ms. Phillips makes it clear in her poem. An intention is only that. It is not follow-through. It is not focused. It is more about that imagined, thinner, healthier, better self. It has nothing whatsoever to do with reality.

Diets are my favorite recipe for disaster. As I tell my clients, “Diet is a 4-letter word.” We never use the D-word because it describes failure, misery, weight gain instead of weight loss, self-denial and an utter lack of reality. Diets only benefit the multi-billion dollar diet industry. Diets make other people’s wallets fat. They will not help you to lose weight and keep it off. If diets actually worked, new diet books would not sell. Diet groups would have no new members to enroll, specially-prepared and expensive portion-controlled meals would not be delivered to your door.

Well, if diets are a recipe for failure, what works? I’ve already given you the first 2 steps in my program. First, you must begin to exercise and stick to that exercise. Your program needs to be realistic. For example, can you park your car farther away from your office? Can you take the stairs instead of the elevator? Can you challenge your children to shoot some hoops, or take a brisk walk with the family dog? Can you incorporate exercise into your daily routine? And, yes, housework counts as exercise.

Step 2 of my program involves some form of weight training to build more muscle mass. The more lean muscle you have, the more efficiently you will burn calories. Yes, muscle weighs more than fat, but it’s the secret weapon of weight loss.

Step 3, which I will discuss in my next post, is all about habits. Yes, habits. The good news is that unhealthy habits can be changed into healthy habits. But, that takes time, and it takes work. Our brains control whether we eat, or not. Our brains control what we choose to eat. Those well-worn pathways in our minds that tell us to grab that chocolate cake because we’re happy or sad, angry or elated, frustrated or bored, these are the powerful and overwhelming emotions that trigger overeating. We get into the habit of comforting ourselves with food. We seek emotional gratification through eating. It’s a short-cut to feeling better, which, in the end, always leads to feeling worse. In my next post, I will be discussing how to break the unhealthy habits that trigger overeating.

Take the time to either think about or write out a journal entry on your “Best Intentions.” Losing weight is about learning new habits and substituting those good habits for the bad habits of the past. Losing weight is about living in the real world of temptation. Losing weight is about self-acceptance and self-nurture. We do not lose weight when we feel deprived, which is the essence of all diets. We lose weight only when we feel self-fulfilled.

Sue Phillips, who resides in Massachusetts, is an award-winning poet, graphic art designer, and budding fly-fisherwoman. Ms. Phillips academic posters will be featured in an upcoming episode of House starring Hugh Laurie. The episode will be shown on September 21, 2009. Check your local time and listings.