Showing posts with label body image. Show all posts
Showing posts with label body image. Show all posts

Wednesday, January 7, 2015

Dieting is Bad for You

Dieting is Bad for You. But I Don't Diet Anymore - I know Better!

 

Don't be fooled - If you're "only trying to eat healthier," ask yourself these questions:

  1. Does this "new way of eating lifestyle" require that I change my eating habits to omit or considerably limit one of the three major food groups that all humans need to survive: carbohydrates, proteins, or fats?
  2. Does this "fitness fat-burner menu" cause me to wait to eat for long periods while hungry or to stop eating before my physical appetite is satisfied?
  3. Does this "high nutrition program" require that I eat according to externally dictated menus and schedules, which distract me from my inner rhythms of hunger and satiation?

Food Group or Caloric Restriction = Thin = Better Health?


Thin, very temporarily yes. Better Health -No - Plus, studies show that the best way to gain weight AND to develop an eating problem is to restrict your diet (see below). 

Major Cause of Obesity Epidemic: Weight-Loss Attempts

  • Research on 17,000 children showed that twins who embarked on one intentional weight loss episode were two to three times more likely to become overweight compared to their non-dieting twin counterpart. Furthermore, the risk of becoming overweight increased in a dose-dependent manner, with each dieting episode. #1
  • A 1999 report on 4,193 women and 3,536 men participating in the Finnish Twin Cohort Study revealed that dieters were several times more likely than non-dieters to experience major weight gain (more than 22 pounds) during a follow-up lasting 15 years. (pp.31) #2
#1. Alison E. Field, S. Bryn Austin, C. Barr Taylor, Susan Malspeis, Bernard Rosner (2003)

#2. Korkelia, M., A Rissanen, J Kaprio, TIA Sorensen, & M Koskenvuo (1999)

According to a 2007 Meta-Study (a study of 31 other studies, internationally)

  • Diets do lead to short-term weight loss, on average of 5%–10% of the person's body weight
  • These losses are not maintained
  • The more time that elapses between the end of a diet and the follow-up, the more weight is regained.
  • Among patients who were followed for two or more years, 83% gained back more weight than they lost
  • In studies with the longest follow-up times (of four or five years post-diet), the weight regain trajectories continued to increase suggesting that if participants were followed for even longer, their weight would continue to increase. #3
#3 Mann, T., Tomiyama, AJ, Westling,E, Lew, AM, Samuels, B. (2007) Medicare’s Search for Effective Obesity Treatments in American Psychologist Vol. 62, No. 3, 220–233

Fat Phobia Kills

A study of 36,000 students in Minnesota found that negative body image is associated with a higher suicide risk for girls #4

#4. American Association of University Women (1990). Shortchanging girls, shortchanging America: Full data report. Washington, DC: American Association of University Women.

Overweight girls are far more likely to engage in dangerous practices (fasting, smoking, vomiting, taking laxatives) to lose weight than normal weight girls #5

#5. Wertheim, E., Paxton, S., & Blaney, S. (2009)

The Mayo Clinic researchers note that many adolescents with eating disorders have had a history of being overweight or obese #6

#6. Sim, L.A., Lebow, J, & Billings, M, (2013)

A longitudinal study published in 1999 showed that girls who dieted severely were 18 times more likely to develop an eating disorder #7

#7.  Patton et al (1999)

Even here in Aotearoa New Zealand:

Studies indicate that although 75% of 15 year old girls were ‘healthy weights’ 68% of them wanted to weigh less #8

#8. Worsley, Worsley, McConnon & Silva (1990)

Of the girls that reported dieting, most had started prior to the age of 13 years. #9

#9. Fear, Bulik & Sullivan (1996) 

We have known since the 70's that dietary restriction sets a dangerous trend, And we now know that this trend is far more "dangerous" than the "obesity epidemic" that gets so much more press but that fails to mention that the health risks of obesity are much more related to a lack of physical exercise than to BMI. It is perfectly possible to be "fit and fat"" where it is less possible to be "fit and dieting."

Why Do We Keep Trying to Lose Weight by Restricting Food Types or Intake?


In spite of all this, our drive to diet and get thinner and thinner is getting worse not better. And our children and teenagers continue to get the wrong messages

  • Parental messages about body image and teasing by others (e.g. peers and/or family) have been highly correlated with body image dissatisfaction and eating disorder symptoms #10

#10. Thelen and Cormier, 1995

Because Dieting is Addicting

Compulsions and addictions are defined by one's inability to stop behaviour in spite of known harmful consequences. Given all of the evidence above, why would anyone want to deliberately deprive themselves of food anymore? We know it causes eating disorders, suicidality, and ultimately either death or greater weight gain - this evidence isn't even new. Yet we keep doing it - why?

Dieting, like many addictions, creates false promises. Like gamblers who know full well that the odds are against them, most dieters think they can buck the odds because the false promise - thinness and an end to weight discrimination - is too seductive to ignore or dismiss. The pain of continuing to suffer teasing, discrimination, and judgments overshadows the likelihood of dieting failure. No one wants to really believe they can't diet their way to thinness - it feels too hopeless, too awful. And although exercise offers an escape from most of the physical health risks of a high body weight, it can't promise a quick perfect body. And we humans are famous for looking at the short term results and ignoring the long term, if it doesn't suit us. A gambler makes one big win, then continues to gamble until it's all gone and then some - this is the same thinking as "diet think."

More Myths

BMI, or the Body Mass Index, was originally developed as a statistical tool to study large populations over time. It is completely irrelevant to individual weight and does not even distinguish between weight caused by fat or muscle. Similar to that old fashioned standby, the Metropolitan Life Height and Weight Charts, the original uses for which these devices were developed has gotten completely distorted. Met Life was originally an actuarial study - a statistical population study based on people who buy life insurance. What happened to scientific measures - controlled, double-blind studies that limit the variables they measure? When it comes to weight, our scientific standards seem to take a back seat. This is because no one, including doctors, is immune to cultural pressures, assumptions and stereotypes. Although medical practitioners the world over are trained to used the BMI now as they were the Met Life Charts in the past, they are rarely taught that they are highly inaccurate in evaluating individual weight and fitness.

One of the medical criteria of anorexia nervosa: body weight 15 % below a weight that is considered "normal", is met by the majority of models and beauty contestants.

So, What Size Should I Be?

Since there are no clear markers for healthy body weight that are free from highly questionable social standards, I would maintain that healthy body weight is highly individual and relative, given the various causes of weight gain

Perhaps it is best to consider the size a person naturally returns to after a long period of both non-compulsive eating and consistent exercise commensurate with the person' s physical health and condition. We must learn to advocate for ourselves and our children to aspire to a naturally determined size, even though that will often mean confronting misinformed family, friends, and media advertising again and again.

If you want to know if you are fit, ask yourself how you feel. Do you have energy or do you drag through the day? Are you physically active at least a half hour a day (this means pushing yourself to do something that causes you to pant and sweat)? If not, consider increasing your level of physical activity in such a way that it is woven into your day (e.g. walking or cycling instead of driving).

The benefits of regular physical activity have been demonstrated scientifically again and again - as have the disadvantages of restrictive dieting. It makes sense that we need to be active - we were hunter- gatherers for 100,000 years and had to travel huge distances to follow the edible flora and fauna. We're supposed to move around - and then we're supposed to eat! 

Are you Overeating?


Do you feel overstuffed a good deal of the time, or do you rarely let yourself feel hungry? Do you eat to cope with issues that have nothing to do with hunger? 

What is Non-Compulsive Eating?

Simply stated, non-compulsive eating means eating when you are hungry and stopping when you are satisfied. This involves being able to distinguish emotional hunger from physical hunger, and satiation from over-fullness. This approach, combined with regular physical activity, over the long term,will bring about a healthy ratio of fat to muscle, even if you don't end up looking like a fashion model.

Thursday, November 28, 2013

Healing from Childhood Abuse, Trauma and Neglect (Part 1)

When searching for counselling and therapy to heal the wounds of trauma, childhood abuse, and/or childhood neglect one can be faced with an overwhelming myriad of choices.   Most treatment techniques (both  medical and psychological) that are studied scientifically take into  account that a significant percentage (actual numbers vary based on condition or treatment being studied) of those being studied get better spontaneously simply because they believe they are being given a  (called the placebo effect).

A number of new approaches that take into account the recent discoveries of neuroscience, made possible by modern brain imaging techniques, have been shown either scientifically (in placebo controlled randomised blind or double-blind studies) or anecdotally (based on empirical observations and patient/client reports) to be highly effective in a shorter period of time than conventional "talking only" therapy. All of these approaches, of course, need to be integrated by a skilled and experienced clinician, into an overall treatment style and plan that will include talking therapy as well as a healthy respect for the power of the therapeutic relationship and the need for the therapist to earn the client's trust by creating safety.

Below I list some of the approaches that have been shown to be effective  with survivors of adult trauma and childhood physical, sexual, and emotional or psychological abuse, plus a link to another blog entry I wrote on effective  approaches for those suffering from the effects of "poor affect regulation",  commonly caused by emotional neglect or the unavailability of reliable  soothing in early childhood.  I only list those methods that I have personally learned and tried and observed to be effective, and the reasons (if known) that they work. 

Affect regulation treatment approaches are also useful with survivors of trauma and/or childhood abuse. The basis for this is  described in a separate blog entry (Learning to Comfort and Soothe) as they are more generic therapy approaches used for a broader range of problems and causes.  Since writing that entry, I have been learning about "memory reconsolidation" which claims that rather than going through the painstaking process of learning to "regulate" out of control feelings, one can "re-write" the implicit memory itself so that feelings become self-regulating, as they would have been if the original "dysfunctional implicit memory" hadn't been laid down in the first place. I will explore this in depth in another blog entry (coming as soon as I finish writing it).

I mention anecdotal or scientific (placebo-controlled) in brackets next to the name of each approach to identify the type of documentation of  effectiveness. I include approaches that have primarily anecdotal evidence because it is extremely difficult to measure approaches to complex trauma and dissociation in a laboratory setting. In my opinion, there are too many uncontrollable variables once you try to measure treatment effects with this population, especially since it isn't ethical to in any way limit access to anything that might help simply because it could confound the scientific evidence of your study.  The DNMS, Sensorimotor Psychotherapy,  and Ego State Work, for example, have ample anecdotal evidence presented in scientific journals as controlled case studies, and are based upon modern scientific insights into the brain,  but that is not the same as evidence based on rigorously controlled scientific studies.

Ego State Therapy (anecdotal)
Founders: John and Helen Watkins
The concept of segmentation of personality into discreet parts of self has been around for many years, but has only recently been validated scientifically by new brain scanning technologies. These technologies, by measuring blood flow patterns in the brain, demonstrate how ego states are formed by neural clusters repeatedly firing together (and therefore "wiring together"). 
Such neural nets form the basis for most implicit learning - such as learning how to ride a bicycle - a skill that improves and eventually "clicks" as the neurons, which fire together in the same pattern whenever riding is practised, form a network with a particular skill set. When such a neural net forms in the context of a relationship, it will develop a unique point of view and way of behaving.
Ego states exist as a collection of perceptions, cognitions and emotions in organised clusters. An ego state may be defined as an organized system of behaviour and experience, whose elements are bound together by a common principle. Ego states may also vary in volume. A larger ego state may include all the various behaviours activated in one's occupation, whereas a smaller ego state might be formed around a simple action, such as using a mobile phone. They may encompass current modes of behaviour and experiences or include many memories, postures, feelings, etc., that were learned at an earlier age.

The human mind is a collective "family of self" within a single individual. How well these "family" members get along, and how effectively they cooperate can vary considerably from individual to individual. 
This segmentation has been called many names over the years, depending upon which psychological theory is being used. In Freudian language we are all divided into Ego, Id and Superego; Jungians refer to "complexes" which are described almost identically to ego states; Transactional Analysts talk about the internal Parent, Adult and Child; and Psychosynthesis refers to "sub-personalities." Ego states exist on a continuum of separateness, with the most extreme dividedness being caused by the most extreme early relational trauma.
Although everyone has ego states, those states formed in response to loving supportive experiences do not tend to require psychotherapeutic intervention. When ego states are more split off and engage in internal battles, Ego State Therapy can be employed to help resolve some of these conflicts, often using techniques found in conflict resolution, group or family therapy, to enable a kind of internal diplomacy. This approach has demonstrated that complex psychodynamic problems can often be resolved in a much shorter period than with analytic therapies. 


PLEASE NOTE: The techniques described here have been integrated into PSITM (PsychoSomatic Integration), an overall approach I teach for working with trauma and abuse survivors. PSITM is described here in more detail.  

More approaches to come....to be continued

Friday, February 17, 2012

Improving Body Image

"If we place pornography and the tyranny of slenderness alongside one another we have the two most significant obsessions of our culture, and both of them focused upon a woman's body." -Kim Chernin
Body image involves our perception, imagination, emotions, and physical sensations of and about our bodies. It s not static- but ever changing; sensitive to changes in mood, environment, and physical experience. It is not based on fact. It is psychological in nature, and much more influenced by self-esteem than by actual physical attractiveness as judged by others. It is not inborn, but learned. This learning occurs in the family and among peers, but these only reinforce what is learned and expected culturally.

In this culture, we women are starving ourselves, starving our children and loved ones, gorging ourselves, gorging our children and loved ones, alternating between starving and gorging, purging, obsessing, and all the while hating, pounding and wanting to remove that which makes us female: our bodies, our curves, our pear-shaped selves.

"Cosmetic surgery is the fastest growing 'medical' specialty.... Throughout the 80s, as women gained power, unprecedented numbers of them sought out and submitted to the knife...." - Naomi Wolf

The work of feminist object relations theorists such as Susie Orbach (author of Fat is a Feminist Issue, and Hunger Strike: Anorexia as a Metaphor for Our Age) and those at The Women's Therapy Centre Institute (authors of Eating Problems: a Feminist Psychoanalytic Treatment Model) has demonstrated a relationship between the development of personal boundaries and body image. Personal boundaries are the physical and emotional borders around us.. A concrete example of a physical boundary is our skin. It distinguishes between that which is inside you and that which is outside you. On a psychological level, a person with strong boundaries might be able to help out well in disasters- feeling concerned for others, but able to keep a clear sense of who they are. Someone with weak boundaries might have sex with inappropriate people, forgetting where they end and where others begin. Such a person way not feel "whole" when alone.

Our psychological boundaries develop early in life, based on how we are held and touched (or not held and touched). A person who is deprived of touch as an infant or young child, for example, may not have the sensory information s/he needs to distinguish between what is inside and what is outside her/himself. As a result, boundaries may be unclear or unformed. This could cause the person to have difficulty getting an accurate sense of his/her body shape and size. This person might also have difficulty eating, because they might have trouble sensing the physical boundaries of hunger and fullness or satiation. On the other extreme, a child who is sexually or physically abused may feel terrible pain and shame or loathing associated to his/her body. Such a person might use food or starvation to continue the physical punishments they grew familiar with in childhood.

Developing a Healthy Body Image

Here are some guidelines (Adapted from BodyLove: Learning to Like Our Looks and Ourselves, Rita Freeman, Ph.D.) that can help you work toward a positive body image:

1. Listen to your body. Eat when you are hungry.
2 .Be realistic about the size you are likely to be based on your genetic and environmental
history..
3. Exercise regularly in an enjoyable way, regardless of size.
4. Expect normal weekly and monthly changes in weight and shape
5. Work towards self acceptance and self forgiveness- be gentle with yourself.
6. Ask for support and encouragement from friends and family when life is stressful.
7. Decide how you wish to spend your energy -- pursuing the "perfect body image" or enjoying
family, friends, school and, most importantly, life.

Think of it as the three A's....

Attention -- Refers to listening for and responding to internal cues (i.e., hunger, satiety,
fatigue).

Appreciation -- Refers to appreciating the pleasures your body can provide.

Acceptance -- Refers to accepting what is -- instead of longing for what is not.

Healthy body weight is the size a person naturally returns to after a long period of both non-compulsive eating* and consistent exercise commensurate with the person' s physical health and condition. We must learn to advocate for ourselves and our children to aspire to a naturally determined size, even though that will often mean confronting misinformed family, friends, and media advertising again and again.

*Simply stated, non-compulsive eating means eating when you are hungry and stopping when you are satisfied. This involves being able to distinguish emotional hunger from physical hunger, and satiation from over fullness. Link to: Compulsive Overeating for more information. Link to: Bibliography to view sources.


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Bibliography

The Obsession: Reflections on the Tyranny of Slenderness, by Kim Chernin, Harper & Row, 1982.

BodyLove: Learning to Like Our Looks and Ourselves, Rita Freeman, Ph.D., Harper & Row, 1988

200 Ways to Love the Body You Have by Marcia Germaine Hutchinson, EdD , The Crossing Press, 1999

Fat is a Feminist Issue: A Self Help Guide for Compulsive Eaters, by Susie Orbach,

Hunger Strike: Anorexia as a Metaphor for Our Age, by Susie Orbach, Norton Books, 1986

The Beauty Myth, by Naomi Wolf, Doubleday, 1991 to buy click: The Beauty Myth

Eating Problems: a Feminist Psychoanalytic Treatment Model, by The Women's Therapy Centre Institute, Basic Books, 1994