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Why can’t you keep your weight off? — The 8 Essential Rules for Weight Maintenance

29 Oct

Recidivism among dieters has prompted major revisions in treatment methodology as researchers discover the significant contributions of genetics, psychology, and environmental factors to eating behavior. More than 85% of Americans have dieted during their lifetimes, yet the majority of diets offer little flexibility to accommodate the biopsychosocial components of the dieter’s life. Weight regain is virtually inevitable under these circumstances as self-regulation and emotional management deteriorate. No longer can the traditional focus of nutrition from the calories in versus calories out approach; exercise; and cognitive behavioral therapy (CBT) be considered the gold standard intervention trifecta. Studies report a 98% relapse (weight regain) rate following weight loss. Approximately 50% is gained back after three years and the rest gained back after five years. While discouraging, we can learn a lot from the two percent who are successful maintainers. What do they do? How do they think? Where do they differ in regards to behavior? Research accessing the lived experiences of successful and unsuccessful maintainers offer rich details that those of us who are actively engaged in the weight loss process and preparing to embark into maintenance can begin applying.

 

1.     Be constantly vigilant: The dedication you implement during weight loss must continue during maintenance. The effort you put toward your health cannot stop once you have reached your goal weight. Ask what you are doing now that you are willing to continue with when you achieve your goal. Defensive pessimism, a concept described in the weight loss literature, explains the adoption of an approach with a foothold in reality. Successful maintainers anticipate threats that may occur, know that there will be times they struggle, and plan ahead accordingly. Any goal that is met with commitment is one we will work toward with a “no matter what” attitude. Relying on motivation for goal achievement will lead to disappointment—we will often “not feel like it” or “not want to” do something, but those who keep on keeping on understand the fleeting nature of feelings. With practice, they can more easily move past them and onto how happy and encouraged they will feel if they follow through with what they know is in their best interest. Self-determination theory classifies these types of goals as intrinsic. Weaved into the fabric of our lives, intrinsic goals parallel our core values.

 

2.     Develop a support system: Not only is support the number one factor contributing to well-being and resilience, it is a primary element in maintaining commitment to weight maintenance related behaviors. While research shows that responsibilities in other contexts, such as familial, relationship, career, etc. can create tension that can lead to goal-compromising behaviors, having a support network minimizes the negative effects of goal threats.

 

3.     Challenge your ingrained beliefs and behaviors: Most individuals who have been on and off of diets for most of their lives acknowledge the entrenched beliefs and meanings around food often created in childhood. Food as comfort, food as love, and food as a stress reliever are three of the most commonly held attachments to food. Many of us grew up hearing “clean your plate” or “you can have dessert when you finish your dinner.” Throwing away food was unacceptable. On the other hand, many are brought up in households of abundance. Food was always available and access unconnected to hunger. In essence, it was used as a pacifier when negative emotion was experienced (i.e. getting a cookie from during a time of upset). Successful maintainers become conscious of their motivations to eat and begin rewriting their narratives about food and the relationship they want to have with it.

 

4.     Self-monitor: The National Weight Control Registry is a wealth of information from over 10,000 individuals who have lost and maintained their weight for significant periods of time. Self-monitoring is one behavior you will hear them mention repeatedly as critical to their weight maintenance success. Practical aspects of monitoring include consistent weight tracking, monitoring of portions, engaging in regular exercise, and setting boundaries around eating practices. Emotional monitoring to avoid engaging in stress eating or eating for reasons unrelated to hunger include practicing awareness and management of stress, choosing more effective methods of dealing with negative

emotion, but also being flexible and compassionate with one’s self when setbacks occur.

 

5.     Adopt a growth mindset: Carol Dweck, a researcher from Stanford University, has studied the difference between a growth versus a fixed mindset and its impact on goal achievement. Individuals who take steps toward their goals with a growth mindset focus on discovery and exploration and believe that through learning they can develop skills and enhanced knowledge and proficiencies. It encourages persistence and expectations of failure for the purpose of greater success. We learned to walk by falling! A fixed mindset, on the other hand, encourages one to give up easily and reduces the likelihood that grit will be extended toward mastering something new. The concept of neuroplasticity and the manner in which we can be active participants through adulthood in changing our brains should provide ample evidence and motivation to continue learning! The growth mindset spurs individuals to be on the lookout for opportunities, and expansion of one’s biases and normal ways of behaving increases gray matter in the areas that matter most too. Your prefrontal cortex will thank you! Finally, successful maintainers adopt a non-perfectionistic approach. While they may not like failure, they embrace it and give themselves permission to experience it; they allow versus avoid painful emotions and disappointment, thus positioning themselves toward greater pleasure; and they are grateful for their successes.

 

6.     Be structurally flexible: Successful maintainers understand how rigid food rules and depriving themselves of their favorite foods creates more cravings, more urges, and the propensity to binge. They realize that they can’t eat whatever, whenever, but they plan for indulgences in moderation. Structured flexibility gives them a sense of control without the belief that willpower will carry them through the tougher situations. They learn to ask questions of their cravings and check in with themselves to understand what might be driving their urge to eat. They practice recognition of black and white/all or nothing thinking as well as distorted thinking that propels them toward mindless or emotional eating. For example, the use of “I choose not to” versus “I can’t eat that” feels empowering and more intrinsically motivating. Being structured but flexible means having high expectations in combination with the understanding that uncertainty is inevitable and will require reflexivity and responsiveness rather than impulsivity.

 

7.    Develop a toolbox of strategies: Different contexts demand different strategies. What is effective in one situation may not be appropriate for another. But successful maintainers know that they have the choice to change their environments or change the way in which they respond to them. In some contexts, an “if__________, then____________” approach can work well. This is called an implementation intention. For example, “If Don asks me if I want some dessert, then I will say ‘no thank you’ and excuse myself.” In other contexts a more flexible, responsive approach is needed. This could mean drinking more water when a cravings is felt; pausing to really assess physiological hunger; repeating a motivational, empowering mantra; asking a question to increase awareness; and/or slowing down during a meal to fully experience satisfaction and reduce overeating. In essence, successful maintainers create rituals—new patterns of behavior that help to create lasting, meaningful change.

 

8.    Master mindfulness: Successful maintainers describe how they’ve acquired a new sense of themselves—about their bodies, about their minds, and about their lives and what is important to them. As they have practiced opening up to new experiences, objectively assessing their circumstances, and observing their behavior less judgmentally, they see their lives through new lenses. They practice being present, more compassionate, paying attention, deepening their awareness, avoiding avoidance, and intentionality. Through such practices, a successful maintainer can recognize that different identities sit down to eat sometimes – identities based on prior learning, on comparisons of self to others, and ideas about what others believe.

 

Don’t miss out on the discussion! Tell us about your emotional triggers and the biggest difficulties you’ve had as you move toward your goal of weight loss OR if you’re working on keeping it off! What bogs you down and gets in your way?

Joining The Diet Doc for our free workshop!

19 Sep

Joining The Diet Doc for our free workshops ea. month?Go to powhow.com to set up your free account. http://ow.ly/p1Af9

Happiness huh? How can you be more happy

19 Sep

Happiness huh? How can you be more happy? New podcast on TheDietDoc! http://ow.ly/p10JZ

Happiness huh? How can you be more happy

19 Sep

Happiness huh? How can you be more happy? New podcast on TheDietDoc! http://ow.ly/p10JZ

Stress is the story you’re writing!

11 Sep

It never ceases to amaze me how often I hear the words “I’m stressed” or “I can’t” or “I’ll be happy when…” or the piles of negative comments or unempowered language that we use to describe our circumstances and “lot in life.” We create our internal physiology just by how we view who and how we are. If you are stressing about your weight, your bodies, the number on the scale, you’ve embodied the little scientist standing in the lab concocting the just-right mixture of unhealthy body chemistry that leads to the problems you want so badly to move further away from. If you want to lighten up physically, you have to lighten up emotionally and mentally. The stories you are writing are antagonistic and harsh, and your bodies live these stories out. Time to re-read, revise, and revive your story.

peakofmind

Stress doesn’t happen to us folks….our thoughts happen and they create stress. But guess what– we control our thoughts!

The story you create will convince you of what and how to feel.  It goes in that order– event, thought, feeling, behavior.

“Five clients cancelled their appointments with me this week, Kori. I’m completely stressing about how to make ends meet this  month.  Then the quarterly tax bill rolled in and now I feel completely out of control. I can’t concentrate. My sessions with the clients who are showing up are suffering….I don’t know what to do!”

Event: clients cancelled

Thought: I’m can’t make ends meet this month

Feeling: Overwhelmed, anxious, out of control (STRESSED!)

Behavior: Catastrophizing, ruminating, and poor concentration and performance.

Not ideal.

Task #1: Identify the facts (evidence based)

Fact: 5 clients cancelled

Fact: tax bill was received

Task #2: Identify and dispute the distortions and irrational beliefs

Not fact:…

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Maximize your Metabolism with some Damag

10 Sep

Maximize your Metabolism with some Damage Control! http://ow.ly/oKs0S

Starving, Stressed, and Stockpiling

1 Sep

We’re involved in a crisis. It’s epic. It’s huge. Just like we are.

We’re starving. Yet we’re fat. Ironic.

We’re suffering from a severe deficiency. As much as we eat, and we’re lacking nourishment.

Our bodies are deprived and I argue it’s because we’ve lost our minds. Literally.

When I hear “Kori, I’m hungry…all the time”, as a nutrition consultant, I go automatically to the structure of the diet. The nuts and bolts– what are you eating, when are you eating it, how  much are you eating when you’re eating. I’m looking at the blood sugar response they are creating based on these components of their intake. This is not a comprehensive list, of course.

The second place I go though, and the fact that I’m a therapist makes this a bit less daunting for them (or it’s the reason they’ve come to me in the first place), is straight to the heart of the matter. The heart, and what I’d argue is the center of our wisdom. What’s in there is what we’re constantly trying to feed, except the nourishment (or what we’re mistaking for nourishment) we’re giving it often leaves us feeling more empty, more deprived, and more hungry.

So we’re starving. But it’s not for lack of food. We’re starving for contentment, we’re starving for authenticity, we’re starving for connection, we’re starving for competence, we’re starving for worth, we’re starving for freedom, we’re starving for the creative capacity to be ourselves in a world that says we’re not good enough as we are, we’re starving for presence, we’re starving for attention. (By the way, as I was typing this my cat jumped on my lap and didn’t stop meowing in my face until I paid attention to him. The second I met his eyes, even without touching him, and spoke softly to him, he stopped crying, laid down, and fell asleep).

Wrapped up in this spiritual starvation (and by this I just mean the “whole” of who we are) is the stress response. When I say we’re starving for attention, I am not referring to the attention we get from others, although this is likely an unfortunate reality in our automated, digital world, which has us developing less genuine relationships with others; I’m speaking to the attention we’re giving the moments of our lives– the awareness with which we approach each situation, event, person, task, meal. The attention we put into this second, right now determines our embodiment– the essence of our being, how in tune I am to what’s occurring around me and inside of me, and how open I am to experiencing this experience. Sound a bit hokey?

Consider the results of a published in Gastroenterology assessing the concept of “dichotomous listening.” (Imagine being at work and trying to listen to the individual on the phone when your boss walks in and starts talking about some new ideas he’s been wanting to share with you– I know you’ve been there). In this study the subjects were given a mineral drink when in a relaxed state, and then again when exposed to the same sort of situation as the one described above. Absorption for sodium and chloride was tested for both conditions. Absorption in the small intestine occurred at a rate of 100% for the relaxed group. Care to guess the rate for the distracted group?

Zero.

Paying attention to two things at the same time resulted in 0% absorption. (Now think about what happens when you inhale your meal sitting in front of the television with your computer on your lap checking for text messages on your smart phone).

Now back to the stress response. Something similar happens when you’re in fight or flight mode. First, remember how this response came about- it was necessary and useful when we were at risk of being eaten by lions. The threats of the 21st century are far from life-altering. Well, let me rephrase. What we are perceiving as threatening in the activities of our daily lives do not necessitate the kill or be killed reaction. Second, digestion stops when we’re in stress mode. There’s a reason that the opposite mode, governed by the parasympathetic nervous system, promotes “rest and digest”, and aptly, the “feed and breed” activities. When you’re stressed out, all you can think about is sex, right? (I had to go there). Finally, the stress response prompts fat storage through an increase in cortisol production which dumps glycogen, then glucose into the blood stream, causing a subsequent release in insulin, and when insulin is released you cannot burn body fat—it prompts fat storage.

Which brings me to the stockpiling effect. Most of us appear to be living in big bodies, yet we’re not at all operating with big minds. We’re not big thinkers– curious, inquisitive, open, captivated by ourselves and others. No, instead we’re mindless automatons just doing what everyone else is or what everyone else says we should, and eating what others say is best for our bodies with no clue as to the effects. So we’re stockpiling fat and we’re stockpiling meaningless information, and we’re doing it in a less than thoughtful or aware way. Fritz Perls, an 1800’s, astute psychotherapist and father of Gestalt Therapy, said, “awareness cures.” I couldn’t agree more. Particularly when you consider what’s involved with assimilation of the food we eat.

Wrap your brains around this: the cephalic phase digestive response (CPDR) relates to the “experience” of eating– the textures, the aromas, the colors, and the satisfaction surrounding a meal. It is,  in essence, a digestive mechanism that originates from the tops of our bodies– cephalic means “of the head.” Recall the last time you were google-eyed over the brownies you saw on your friend’s Pinterest board  or when you drove by Jimmy John’s (their marketing is brilliant) and caught a whiff of their “free smells.” Catching that fresh baked bread aroma wafting through the air and you may have noticed an instant salivary response. That’s the CPDR in action! Just by noticing a food, smelling a food, and then if you actually decide to eat, and are tasting and chewing the food, your body releases increasing amounts of saliva, gastric and digestive juices, pancreatic enzymes, hormones involved in appetite, and so forth. So this is great, right? Our bodies are pretty darn efficient and know what they need to function well. Except, what if we’re not following Fritz’s advice, and we’re operating like we’re living in the Zombie apocalypse?  Oblivious, stressed out, checked out, and maxed out? And what if we’re freaked out about not losing weight quickly enough or the “right” way? And what if we’re obsessed with the Food Network and spend all of our time stockpiling recipes and drooling over pictures in magazines of meals that we “can’t eat” or “won’t fit our macros” or maybe even making them but stockpiling them for later “when we’re not dieting anymore.”

I’ll bring your full circle. Are you paying attention?

You’ve created the optimal metabolic position for fat storage outside of any caloric considerations.

Nourishment travels far beyond food. Our brains and our minds must experience pleasure through the food, by way of awareness and presence to function in a manner that says, “I’m full.” You know what it feels like when you’ve had a heart to heart with your best friend? You feel full. You feel nourished. There is no gnawing hunger ‘for more’.

We can experience the same and cure our deprivation crisis with awareness.

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