Overeating, Denial, & Their Implications

[jgm]

Excess weight is an extremely complex problem.

I've been overweight most of my life. Perhaps I'm genetically predisposed; I don't know. There are many, many things that contribute to my situation, and I don't think any one of them can be singled out.

I know that as I became more affluent as an adult, I became heaver. Somehow, along the way, I started equating "I can afford it" with "I can eat it." I also know that I used to look at McDonald's ads, and other nonsense, and wonder just who it was who was eating all those Big Mac's. I knew, as a teenager, that a person can't eat like that and keep their weight down. And I know now, that as I began to think it was okay to do that, I began to gain weight. In other words, I bought into the hype. Bad move.

I've recently discovered that I've used food as an indulgence, rather than taking time for myself in other ways. If there's a key to conquering this problem for me, this is probably it. But that road promises to be slow and full of false starts.

I've learned that diet pills are not an answer. You stop taking the pills, you start gaining. (Usually replacing all you lost, and more.) But a few years ago, my own physician was on the bandwagon along with everyone else, until people started dying.

Now I'm at the point where I've got to undo all that. And it's really, really difficult. The medical profession understands embarrassingly little about the problem. A local doctor runs a very successful and very expensive weight loss program, but he continues to deny the reality that keeping the weight off is every bit the challenge that taking the weight off is, and that's only an afterthought on his program. People lose 50, 100, 150 or more pounds, and only if they stay connected (and continue to spend money that most of them don't have), do they keep the weight off. Yet the local medical community looks at him like a guru and refers patient after patient to him.

My insurance company will happily pay for hundreds of dollars' worth of medicine, per month, to deal with the arthritis, etc. that I have , mainly because of my weight, but not one dime for any kind of program to help me do something about it. They were very happy to pay almost $8,000 for knee surgery about 10 years ago, and will no doubt pay for more if I don't get this figured out.

Taking weight off and keeping it off is a massive, difficult, frustrating undertaking. But there's no doubt that as a society, we've got to find a way to do it.

If you're someone who doesn't have this problem, please let me tell you that there are no words in the English (or any other) language you can say to an overweight person that will help them "see the light." Believe me, I've heard it all from family, friends, and complete strangers. I'd be less than honest if I said I don't find some real satisfaction in watching a few of them fight the same battle, with no better results, a few years latter. (Karma can be quite delicious.) So if you're not overweight, don't flatter yourself into believing you have any magic answers. You may simply be one badly sprained ankle (or other major life interruption) away from an extra 50 pounds. (That comment, by the way, was NOT intended as a response to any of the above posts. I'm gratified to see the compassion that some of our members have shown towards people with this problem.)

[Dr. Teeth]

Very sorry to hear about your friend. Diabetes is a rotten disease.

I'm very interested in hearing about peoples feelings about the medical community and obese people/weight loss, but I wonder if it isn't hijacking the thread.

Any chance we could move that discussion to another thread?

[Pan]

[...]Sorry about your friend, Michael. I'm thinking about the culture here, and I have to say that there's nothing inherently harmful about being a foodie-- in fact I'd have to say that if I prepared my own food and cooked at home all the time, I'm more likely to lose weight. Tying together what Steven said to your friend's situation, empathy and understanding are more important than drilling someone.

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I agree on all counts. I'll add that a friend of my recently dead friend, who lived in the same city and therefore was able to spend a lot of time with her, was always a voice of truth to her. In retrospect, she believes she probably could have been more effective by communicating at a deeper emotional level, instead. Because for my friend, the overeating and obesity were symptoms of a deep, unresolved sadness, exacerbated by the problems of her line of work (freelance musician). Of course, we can never know whether any different style of behavior from anyone could have saved my friend, but I do agree that repeated lecturing is unlikely to have positive effects most of the time.

[cats2]

I am sorry for your loss Michael. It is so very sad that your friends weight problem was likely a result of emotional issues.

I have to say, that these comments about the medical community...well, I take it a little personally. Granted, I've never been overweight, so it's difficult for me to say how overweight/obese patients get treated by their physicians. For that matter, I don't know how well my patients take my advice, since I've never been in their situation and can't possibly know what it's like for them. But, I can still try to encourage people. And once in a great while, I see results!

Nonetheless, I routinely calculate a patient's body mass index at their annual exam (I'm a gynecologist). I show them a chart of what is considered normal/overweight/obese for their height. Granted, BMI's don't always work for everyone (muscular patients might have a higher BMI). But, truly I don't have muscular patients. Most of my patients seem very surprised to see where their weight falls, relative to the norm. My patients have an ethnic propensity towards diabetes (Latinas) I give them a handout from the American Heart Association that talks about issues of increased risk of stroke and heart disease for the obese. (in particular, it addresses the higher rates of obesity and sedentary lifestyle in Latinas compared to the general population of the US)

I ask my patients if they do any exercise, and if they have any family history of diabetes/heart disease. I screen my obese patients for thyroid disease, diabetes, and cholesterol abnormalities (and I'm not even their primary care doctor). I offer my patients a referral to a dietician if they are interested. Most of my patients are obese (BMI of 30 or more). I've even bothered to ask my patients to recall on an average day what sort of foods they ate. Some of my patients have said "but doctor, I only eat one time a day!" Of course, when they do eat, they often binge on all the carb-heavy foods. It's hard to do all of this counselling in a busy clinic. There are time constraints. In the perfect world, this would not be a problem, and the patient would get several followup visits to check on their progress and to encourage them. But, that's not the world that I live in. If I recall correctly, for MD's seeing HMO pts, the less number of office visits, the better. (with capitation, the HMO will pay a flat rate to take care of a member for that yr...the more visits, the more expenditure by the MD's office, and hence less income...no wonder they "just throw drugs at pts"...it takes less time and less intensive followup)

The patient responses I've gotten have been discouraging. My patients for the most part are looking for a quick fix...a magic pill to cause miraculous weight loss. When they ask me about medications for weight loss, I tell them it's a means to lose weight, but until they change their lifestyle (how they eat, what they eat, and what sort of physical activity they do), they will likely regain their weight once they stop the medications. I work for a county clinic, so our patients can't afford anything like gastric bypass. Yet, somehow, some of them manage to scrape up the money to pay a private weight loss clinic for prescription diet pills. It's a crutch, because that diet clinic doesn't work with them to change their eating habits.

One of the pediatricians at our clinic has a "lifestyle management" clinic. Yes, it's not called "obesity clinic". He works with a dietician, and tries to get the kids (and their parents) involved in making changes to their lifestyle. Sometimes the kids and parents get it...and they make a positive change.

On a personal level, I too have been frustrated with seeing a loved one who continues to gain weight (I've seen him go from a normal weight to obese) due to poor eating habits (and a previously super-fast metabolism that's slowing down with age). He has a family history of diabetes and heart disease, yet has yet to get checked by his MD. He has already had surgery for a herniated lumbar disk, and continues to have problems with acid reflux. He too has the attitude of "live for now". He lives on a diet of meats/starches/sweets/sodas. He likes things "supersized" versus I like to have a small taste of everything. He hates vegetables. (At least he doesn't smoke.) Too bad I'm married to him. He won't change until he wants to change. It's just the MD in me that's especially worried.

[mizducky]

No, if there is blame to be assigned here it doesn't go to dietitians. It goes to the traditional medical establishment. Fat people are, in far too many cases, committed to avoiding their doctors because their doctors don't treat them as human beings or as individuals. If you're not a fat person, you can't possibly comprehend the absurd nature of visiting most doctors today -- unless maybe you were a woman visiting male chauvinist gynecologists in the 1950s. You can't even have an intelligent discussion with your doctor -- and I'm talking about people trained at Harvard and Yale -- because they don't have even a basic understanding of the studies and research other than the ones they're exposed to by pharmaceutical company sales reps who want to sell statins and PPIs, and by the CDC (which has been caught in lie after lie about obesity and health). There are so many people being prescribed unnecessary drugs and being subject to other radical interventions that plenty of intelligent overweight people stay the hell away as a means of self-preservation -- and plenty of people who really need help don't seek it out.

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Right on to all of that too. I have ranted about much the same things on a frequent basis on my weight management blog. This is by no means to say that there aren't doctors out there bucking the trend, though ...

I have to say, that these comments about the medical community...well, I take it a little personally.  Granted, I've never been overweight, so it's difficult for me to say how overweight/obese patients get treated by their physicians.  For that matter, I don't know how well my patients take my advice, since I've never been in their situation and can't possibly know what it's like for them.  But, I can still try to encourage people.  And once in a great while, I see results!

(Rest of this excellent post snipped solely to preserve bandwidth)

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Bless you, cats2. But alas, you are evidently one of the minority of doctors who does take time to address this issue with your patients in a humane manner. I regret to report that the majority of doctors I have encountered are rather more like the ones Fat Guy rants about.

I even, quite memorably, had one doctor who repeatedly (and with an extremely unempathetic manner) brought up bariatric surgery, even after I had emphatically told him several times that I was Not Interested. And curiously, when I started working on my weight through managing my food intake the old-fashioned way, he pooh-poohed it! It was as if he preferred me going through the expensive hazardous surgery to doing it the healthier way! Thanks a lot, dude, for being so supportive of your patient's own initiatives! You better believe I fired this guy ... but I felt deeply concerned for the rest of his patient base who might not be as ornery as I am.

Edited June 19, 2007 by mizducky (log)

[Dr. Teeth]

No, if there is blame to be assigned here it doesn't go to dietitians. It goes to the traditional medical establishment. Fat people are, in far too many cases, committed to avoiding their doctors because their doctors don't treat them as human beings or as individuals. If you're not a fat person, you can't possibly comprehend the absurd nature of visiting most doctors today -- unless maybe you were a woman visiting male chauvinist gynecologists in the 1950s. You can't even have an intelligent discussion with your doctor -- and I'm talking about people trained at Harvard and Yale -- because they don't have even a basic understanding of the studies and research other than the ones they're exposed to by pharmaceutical company sales reps who want to sell statins and PPIs, and by the CDC (which has been caught in lie after lie about obesity and health). There are so many people being prescribed unnecessary drugs and being subject to other radical interventions that plenty of intelligent overweight people stay the hell away as a means of self-preservation -- and plenty of people who really need help don't seek it out.

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Looks like the discussion will be on this thread, ah well.

Well, Fat Guy, I normally find myself in agreement with you, so I'm interested in what studies and CDC lies you're refering to. I would agree with you that gastric bypass and laproscopic banding don't have very great average outcomes, but I think the health risk associated with obesity are fairly well established.

[Fat Guy]

The most notorious CDC lie was the 400,000 deaths claim, which has been thoroughly debunked but it still blindly parroted by medical professionals. There are hundreds of newspaper and magazine articles tracking the original false claim and all the backtracking. This is just one of them, from the San Francisco Chronicle:

The death toll from obesity is less than a third of the government's previous estimate, researchers are reporting today

....

being obese accounted for 112,000 deaths in 2000, far fewer than the estimate of 400,000 deaths in a separate CDC study published last year.

....

The latest study had another surprising finding: People who are modestly overweight but not obese have a lower risk of death than people of normal weight. Indeed, the fewer deaths from being modestly overweight partially canceled out the deaths from obesity.

I highly recommend two books to anybody who's interested in tracking the insanity of the conventional wisdom about weight and health, diet and nutrition:

"The Obesity Myth: Why America's Obsession with Weight is Hazardous to Your Health," by Paul Campos

and

"Rethinking Thin: The New Science of Weight Loss--and the Myths and Realities of Dieting," by Gina Kolata

The Kolata oeuvre is particularly significant. Her articles in the New York times have systematically dismantled several major AMA and CDC claims about obesity made over the past decade and, taken together, make a strong argument that when it comes to obesity the cure is worse than the disease.

[Dr. Teeth]

Let me say this - I look at any discussion like this as my chance to learn something, and I will try to get a copy of the JAMA artice mentioned in the Chronicle.

I could quibble about a couple points but I'm not sure I need to . . .

Ok, obesity is a distant second rather than a close second to smoking in terms of preventable death.

How does this change the advice a doctor should be giving you? It doesn't make being obese healthy.

You should not be made to feel like a bad person by your doctor for being overweight, and if that has happened it is unforgivable and you have every right to be angry. But a doctor not advising a patient who is obese to lose weight is like a doctor not advising a smoker to stop smoking.

And there is data showing that a doctor indicating that they are worried about a patient increases the chance of their stopping a potentially dangerous habit.

[Abra]

As a person who's struggled with her weight all her life, let me add this. Get a prescription from your doctor for exercise! In my case, my doc wrote a script for a personal trainer, but a gym membership, a Weight Watchers membership, or whatever, is just as good. My CPA, a very conservative dude, was very happy to put the cost of my trainer down as a deductible health expense on my tax forms, just because I have a prescription from my doctor. And my doctor was very happy to give me the prescription, because she totally supports my desire to exercise.

Even though I'm a lot overweight, my "numbers" on a recent physical were actually pretty near perfect, because I get my butt out the door to that trainer 3 times a week. I know, 5-6 times would be way better, and that's what my doctor said, but every bit counts when it comes to exercise. And the fact that we can count it as a legitimate health care expense makes it a whole lot easier to swallow.

We're all foodies here. We can psychoanalyze ourselves to kingdom come, but while we're doing that, and eating well, let's move those bods. It offsets a multitude of sins.

[jgm]

Even though I like my doctor a lot, and think she's an excellent physician, she has never taken time with me to sit down and discuss my life. Even ten minutes, during an annual physical, would reveal to her some important information. If I were not extremely proactive in researching various symptoms, drugs, etc. myself, there's a lot she would have missed. She's never asked me how much exercise I get. She's never asked me what I eat. She's never asked me what I think the problem is. Maybe if she did, she'd learn more about me, and be able to offer advice. She does know, however, the two forms of cancer my 85-year-old father has, and how many breast lumpectomies my mother's had. I do express to her my frustration about my weight, but we don't ever sit and talk about it.

When I told my previous physician I wanted to try Fen-Phen (back in about 1996), she was extremely ready to write out the prescription. I told her I wanted to lose 20 pounds, go off the meds and maintain that for 3 to 6 months, and then go back on and lose 20 more, etc. She would not agree to that, but given the fact that patients tended to develop a tolerance to the drug after 4 to 6 months, it seems to me to be a much smarter approach than just trying to lose as much as I could until the drug was no longer effective. And since all the hunger came back with a vengeance once I went off the drugs, all the weight came back on, too. I don't remember ever being so ravenously hungry in my life. It was absolute hell. I don't think she had any understanding of the challenges involved in keeping weight off, yet the statistics clearly show that most people who take off significant amounts of weight, fail to keep it off.

Until the medical profession starts looking at the problem long-term, which means implementing a strategy that includes maintaining a lower weight, they're not going to be much help. Everyone seems to be focused on "just get it off" without worrying about what happens THEN.

Honestly, some of the people who are the most ill-informed about weight loss issues are physicians. My friends have been put on low-carb diets by their physicians, even though the statistics show that most people on that diet, go back to their old eating habits and put the weight right back on. Another friend asked her doctor about a particular diet she'd seen on TV, and he told her he'd seen a lot of people lose weight on it. Well, of course he did. It was an 800 calorie per day diet! Wake up, doc; those same people almost surely gained back everything they'd lost. And just about any dietician will tell you that an 800 calorie per day diet just isn't healthy.

The public, including physicians, keeps trying to buy into the quick fix. It doesn't work, and never has.

There are times I wish my doctor would just say, "Is there anything I can do to help?" She and I might be able to find a strategy that would. One thing she could do to help, is to make the scales accessible to anyone who wants to walk in and weigh. Most home scales are crap, unless a lot of money is invested in them, and I'd love to see EVERY doctors' office in town, make it possible for anyone to just walk in the door, and weigh on good equipment, in privacy. That, alone, would be a big help.

[Fat Guy]

Whereas, I would remove all the scales from doctors' offices, forcing them to measure health instead of weight.

[onehsancare]

Michael, I'm terribly sorry for your loss.

This is hard, but I think it's important to recognize that, in addition to the social and medical issues related to overeating (and the resultant overweight), the emotional aspect is too often ignored.

I am a compulsive overeater. About three years ago, I began attending Overeaters Anonymous, which helped me change my life. It's a 12-step program that's available all over the world. I'd be happy to talk with anyone about it, or there's a website at Overeaters Anonymous.

I am still a compulsive overeater and don't expect that will ever change--but what has changed is my eating behavior, my thoughts about eating, and my willingness to let go. I still love to bake and I absolutely don't eat sweets. That clarity works for me. I absolutely don't eat between meals. I'd like to reach the point where I don't eat seconds, but I'm not there yet. I absolutely avoid trigger foods--for me, that's pizza, popcorn, and chips.

I'm still a foodie and hope that will never change. If reading about food, cooking well, and eating that good food starts to affect my ability to stay within my eating plan, I'm going to have to choose the sanity over the food. So far, I am thankful that it hasn't come to that.

Carolyn

[JanMcBaker]

On Monday, I got a phone call informing me that a friend of mine who went to grad school with me had died at 45. The immediate cause, I found out later, was an esophageal hemorrhage, but the actual cause of death is the reason I'm posting here. My friend was quite heavy ever since I met her in 1990 and got heavier over time. She was eventually diagnosed with diabetes but pooh-poohed her diagnosis and doctors generally and continued to stuff herself, bringing upon herself a series of symptoms friends of hers recognized as stemming from diabetes. The hemorrhage was the final symptom.

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Pan, please accept my sympathies on the loss of your friend.

I've had a variety of thoughts from the original post, and from subsequent replies. I'm still sorting things out, but I want to start with a question that came to mind when I first read Pan's original post. Do they know how your friend's diabetes and weight caused her esophageal hemorrhage?

[Pan]

On Monday, I got a phone call informing me that a friend of mine who went to grad school with me had died at 45. The immediate cause, I found out later, was an esophageal hemorrhage, but the actual cause of death is the reason I'm posting here. My friend was quite heavy ever since I met her in 1990 and got heavier over time. She was eventually diagnosed with diabetes but pooh-poohed her diagnosis and doctors generally and continued to stuff herself, bringing upon herself a series of symptoms friends of hers recognized as stemming from diabetes. The hemorrhage was the final symptom.

←

Pan, please accept my sympathies on the loss of your friend.

I've had a variety of thoughts from the original post, and from subsequent replies. I'm still sorting things out, but I want to start with a question that came to mind when I first read Pan's original post. Do they know how your friend's diabetes and weight caused her esophageal hemorrhage?

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Well, the friend who spoke with me very clearly felt she knew it. I don't know my friend's doctors, so I can't address what they thought or knew, other than the diabetes diagnosis. The last time I saw my friend in person, she mentioned to me in an off-hand kind of way that a doctor had said she had diabetes and that she thought it was BS and "doctors are nuts." My reaction was to say that if she didn't agree with the diagnosis, then by all means get a second opinion, but that I wouldn't fool around with this. And I left it there and went on to other topics.

I haven't checked all of the potential complications of diabetes, but could speculate that the hemorrhage could have had to do with untreated or insufficiently treated high blood pressure, which often has a genetic component but can be related to being overweight in some people. (For example, my brother finds that when he's below a particular weight, his blood pressure is good, and when he goes above that weight, it's high.) My mother, who has at various times been overweight, though not drastically, has taken medicine for high blood pressure for decades. At a certain point, she was prescribed a medicine she had a terrible allergic reaction to (which would have brought on anaphylactic shock), and she decided to go off all blood pressure medication entirely and try to lose weight quickly. Three months later, at the age of 59, she had a severe cerebral hemorrhage that almost took her life. Needless to say, I take my high blood pressure medicine every day, and now, so does she! (By the way, my mother was lucky enough to be treated at a state-of-the-art ICU at St. Luke's uptown and is fine and still teaching full-time at the age of 74.)

[Pan]

Whereas, I would remove all the scales from doctors' offices, forcing them to measure health instead of weight.

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Why would it be better for a very easily-measured piece of data to remain opaque to doctors? It's just one piece of data. I have a scale that measures not only my weight but the percentage of fat in my body. I will use it every day to see what increases and decreases my weight on a daily basis. I recognize that that data won't tell me whether I have a respiratory disease or not, but I still want to know it.

[gariotin]

I have struggled with weight and body issues my entire life - I cannot remember a time when my mother was not restricting my food choices and amounts. Needless to say, I grew up with disordered eating and still vacillate between periods of healthy eating and eating what I want.

I have gained and lost football teams in my life - 30, 40 , 50, 60 , 70 lbs at a time. The last big loss was 70 lbs back in 1992 and I have just this year reached the weight I was at before the loss. 15 years to gain back 70 lbs - the good news is that is by far the slowest regain ever. I have made some changes in food choices, portions, and exercise that have slowed down the yo-yo significantly.

I never give up trying and have exercized by walking a min of 9 miles a week for the last 15 years, so my overall health, stamina, and fitness is very good. A slight bump in blood pressure and cholesterol once I went thru menapause, but not bad.

I am actually considering the new orlistat over-the-counter, alli, just to get a jump start on losing 20 lbs or so. If the side effects are too bad, I'll say eff it.

All I can say to those who do not have to fight this fight - imagine telling an alcoholic that they MUST drink 3 times a day, BUT they can't get drunk. For those of us with food issues, that is what it is like. I can go for years sometimes eating healthily and keeping things under control, but at some point, it just becomes too much work and I fall off the wagon. It becomes exhausting having to think about every freaking meal I eat, demands too much of my time and attention, and I rebel. And I expect it will be that way all my life. As someone pointed out - the "tension" becomes unbearable.

[K8memphis]

I just got back from a great boost my metabolism night out. We rode our bicycles 30 minutes to our favorite Mexican restaurent. Ate. Rode back.

[purplewiz]

I can go for years sometimes eating healthily and keeping things under control, but at some point, it just becomes too much work and I fall off the wagon.  It becomes exhausting having to think about every freaking meal I eat, demands too much of my time and attention, and I rebel.  And I expect it will be that way all my life.  As someone pointed out - the "tension" becomes unbearable.

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I'm quoting this because it says it perfectly.

It IS exhausting, and sometimes the neverending energy required to continually monitor every meal and every bite eventually takes its toll on the rest of your life. And then there are choices to be made.

Marcia.

[prasantrin]

It IS exhausting, and sometimes the neverending energy required to continually monitor every meal and every bite eventually takes its toll on the rest of your life. And then there are choices to be made.

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That's when counselling comes in handy...

I think most people who struggle with weight and weight loss should start with counselling before even attempting any kind of change in diet. It's difficult to change yourself if you don't really understand why you are the way you are, and most people just don't have the self-insight required to figure that out on their own.

[Ohba]

I never give up trying and have exercized by walking a min of 9 miles a week for the last 15 years, so my overall health, stamina, and fitness is very good.  A slight bump in blood pressure and cholesterol once I went thru menapause, but not bad.

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Granted you say it's a minimum, but nine (not ten?) is just over a mile a day, which can be done by venturing all of half a mile from the house and back again. For most people, especially if their diet is less than optimal, that's really not going to make much of a contribution to their health.

[gariotin]

That's a good point, Ohba.

I had never done any kind of regular exercise - I would join a gym and go for a month or 2 and then stop. I guess what I mean with this, is that I have walked a 3 mile loop a minimum of 3 times a week for 15 years. Some weeks I go 4 or 5 times, but never less than 3 - I live in Boston, so I do it rain or shine, snow or sleet, all year long. So...you are right that it doesn't seem like much, but I think it has paid off by doing it for many years. I know many heavy people who have problems with their knees, or problems walking, or doing physical activity. I currently weigh 220 and have no problem physically - I hike, garden, bike, kayak, etc. I think it is because the regular activity keeps me limber and relatively fit.

[opqdan]

I'm very sorry for the loss of loved ones due to obesity and diabetes related illnesses.

While I am not overweight, my wife is, so I do struggle with this every day. Not from a personal standpoint, but from that of a loved one who worries that the person they care most about in this world could very well develop complications at anytime. Over the years we've been together (dated 6 years, married 5.5 months), she has gained a significant amount of weight, and until we sat down and talked about it, we were never really able to focus on what we could do to fix this. It took me telling her that I was afraid that she wouldn't see our grandchildren (many, many years down the road, we don't even have children yet) if she kept on her current track, for her to actually decide to work to change it.

Not that she was happy with herself. Being overweight is a deadly spiral of feeling sad because of the weight, and overeating to feel better. This is probably one of the hardest things facing overweight people, that others think that they are Ok with weighing what they do, or that they don't care at all. I know now that my wife cared a lot, perhaps too much, and all that did was drive her to eat more.

Since we've talked, we've scaled back what we both eat and we now exersize 6 nights a week. It's actually kind of nice, we get to spend some time together that almost seems relaxing compared to the hectic day, even if we are on treadmills. We've kept it up at the 6 nights a week pace for probably 8 weeks now, so I think we could continue to do pretty good.

I just started reading Mindless Eating yesterday, and I am already almost done (it is that interesting). It talks a lot about why we eat so much more than we need to (things like plate size and social expectations have a lot to do with it). It isn't a diet book, but it does a good job of explaining why most diets don't work, and what you can do to change things so that instead of mindlessly gaining weight, you can mindlessly lose it. I can already highly recommend the book to everybody, especially those serious about their health.

[tejon]

QUOTE(gariotin @ Jun 20 2007, 03:59 PM)

I can go for years sometimes eating healthily and keeping things under control, but at some point, it just becomes too much work and I fall off the wagon.  It becomes exhausting having to think about every freaking meal I eat, demands too much of my time and attention, and I rebel.  And I expect it will be that way all my life.  As someone pointed out - the "tension" becomes unbearable.

*

I'm quoting this because it says it perfectly.

It IS exhausting, and sometimes the neverending energy required to continually monitor every meal and every bite eventually takes its toll on the rest of your life. And then there are choices to be made.

Amen. I have my own issues with food and weight, due to all kinds of things from genetic to metabolic to emotional to habit. One of the most healing, helpful things I ever did was read a book by Geneen Roth, who talks not about diet or restriction but about actually listening to your body and eating in rhythm with it. Sounds simple, but for many of us food becomes either an addiction or an enemy or both, so learning to follow body cues takes a long time. I find when I eat when I'm hungry and do other things when I feel sad, bored, angry, or other emotions (which eating doesn't fix), I'm a lot healthier and feel better as well. Add in a good amount of exercise (good for everyone, regardless of weight), and life feels pretty good.

[Pan]

[...]I just started reading Mindless Eating yesterday, and I am already almost done (it is that interesting).  It talks a lot about why we eat so much more than we need to (things like plate size and social expectations have a lot to do with it).  It isn't a diet book, but it does a good job of explaining why most diets don't work, and what you can do to change things so that instead of mindlessly gaining weight, you can mindlessly lose it.  I can already highly recommend the book to everybody, especially those serious about their health.

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Thanks for the recommendation. I've seen this book recommended before. I think I'll get it.

Good luck to you and your wife!

[gariotin]

Another book that is a thoughtful, provoking read - not just another diet book - is The Philospher's Diet.