Dietitians don't always have the answers. We know what foods to eat and in what amounts for certain conditions, but it's not as cut-and-dried as just following the diet, especially when it comes to weight loss.
Weight management is the first line of treatment for many chronic health conditions. Calories in versus calories out. The formula works, but up to 95% of dieters gain it all back (and maybe then some) within 5 years. Why can't we make it stick?
A Weight Watchers campaign several years ago challenged us to try a "live-it." I liked this because unless you make a lifestyle change, the weight will likely return. At the same time, it pointed out that "die" is ¾ of the word "diet." Dieting is no fun – no one likes deprivation and the feeling of guilt when you "cheat." We tell ourselves we just need self-control. We'll lose weight and then be able to eat our favorite foods again.
When it doesn't work, we blame ourselves. Willpower struggles against environmental factors like the enticing scent of cinnamon rolls and seeing hundreds of commercials for fast food. We are wired to go after foods that are high in calories in order to survive.
Willpower is no match for social pressure either. Seriously, are you going to get a salad when everyone else orders a burger and fries? And what about not wanting to hurt grandma's feelings when she bakes your favorite cookies?
Psychologist Dr. Jenn Berman, host of VH1's "Couples Therapy with Dr. Jenn" and creator of the "No More Diets" app, says our relationship with food is inextricably tied to our experiences and interactions with others. Negative comments about our weight or food choices can be highly triggering. Not because we're weak, but because subconsciously we are rebelling – telling the perpetrator to "stick it where the sun don't shine." We end up using food not as nourishment, but as a weapon against others and ourselves. Ultimately, though, we are the ones who get hurt, as this cycle reinforces low self-esteem and the poor relationship with food.
Eating can also be a coping mechanism. Once in a while it's fine to cheer up with a scoop of ice cream, but downing a pint every night is more than just a bad habit. Berman warns that regularly soothing stress, anger, or depression in this way can indicate an unhealthy relationship with food.
Binge eating (eating excessive amounts of food in one sitting) takes this to the extreme. Interestingly, up to 30% of people seeking obesity treatment qualify as having binge eating disorder (BED).
BED is strongly associated with depression and anxiety and can develop after traumatic experiences like a death in the family, divorce, or abuse. Berman notes that not having enough food to go around as a kid or having it withheld also makes bingeing more likely because on some level, there is fear that there won't be enough later. These conditions can also be mimicked with dieting and food restriction and can play a role in rebound weight gain.
So yes, dietitians can help with the what and when of eating – we're great at it. But if you want to truly change your relationship with food, you need to enlist a therapist to examine the why and how.
Yes, therapy has been my secret weapon to maintaining a 60 pound weight loss. It's beneficial even for those without major psychological issues, as you can learn new tools and skills for overall wellness.
I'm not going to lie – it will take time. Don't fool yourself into thinking you're cured after 3 sessions. Therapy can be emotionally painful but it's worth it if you're willing to take the dive. As Dr. Jenn says, "go and step out of your comfort zone." Let's make this last diet your "live-it."
Note: If you don't think you can afford therapy, in almost every community there are health clinics that work on a sliding scale – you pay based on your income. College psychology and psychiatry programs also offer free or reduced-fee services.
Champaign, IL Area:
University of Illinois Psychological Services Center 217-333-0041
Avicenna Community Health Center 217-418-5888
Champaign County Christian Health Center 217-402-5683
Frances Nelson Health Center 217-356-1558
Today's post was written by Leia Kedem. Leia Kedem, MS, RD, is a registered dietitian and Nutrition & Wellness Educator covering Champaign, Ford, Iroquois, and Vermilion Counties. She appears weekly on WCIA-3/WCIX-49 and is a biweekly contributor to the Champaign-Urbana News-Gazette. She also maintains Facebook and Twitter accounts where she regularly posts health tips and answers nutrition questions for free.