NOOOOOO!!! That eardrum shattering scream you just heard was mine after I listened to Oprah Winfrey (I adore her) talk about her very public weight gain with emotional eating maven Geneen Roth. (Oprah on a Time She Forgot Her Loveliness, 5-11-2010)
I hear the thundering herd of hoof beats running for a book THAT IS NOT MEANT FOR OBESITY. And I hear the collective thud a month or two from now, of millions of copies tossed into the failed diet books collection. (Yes, we have those).
Don’t get me wrong – Geneen’s elegantly worded conversation on emotional eating is entirely appropriate for someone with 30 pounds to lose, or binge eating, or anorexia-bulimia. She even says that. Yet the audience was stocked full of morbidly obese people. Like me. And Oprah, God love her.
Certainly obese people have emotional eating that needs to be worked through for successful weight loss. But it is NOT the predominant driving force behind sustained obesity.
“I shamed my fat self”, Oprah said, “when I put myself on the cover of O and said how did I let this happen again”.
OPRAH! YOU DIDN’T LET IT HAPPEN! Anymore than you LET your bladder fill or LET your body go to sleep. This is your brain and body we’re talking about, not your soul.
Yo-yo dieting and weight regain are NOT the result of weak wills. THEY ARE THE RESULT OF AILING BODIES. And frantic brains trying to heal them.
Obesity is NOT a state of feeling badly about oneself – it is a MEDICAL CONDITION…with:
1) Chronic Inflammation, Pain and Exhaustion – Addicted to sugar and caffeine? Maybe you’re an ENERGY addict! It takes additional energy in the form of calories to move your extra-large aching, swollen, inflammed self down the hall. The worse your end-stage illnesses of obesity are (such as sleep apnea, diabetes, arthritis, fibromyalgia, hypothyroid), the longer that hallway becomes. Even if the end-stage illnesses have not yet manifested, the inflammation of obesity is simmering inside you, and exhausting you.
2) Altered Metabolic Pathways – abnormal insulin, leptin, cortisol metabolism (and others) cause the obese person to hold on to weight, be hungry all the time, have higher blood sugar and insane food cravings. Your continuously elevated stress hormones have convinced your trillions of cells to HANG ON TO EVERY BIT OF FAT BECAUSE WE”RE IN A FAMINE!! Don’t you wish you could explain grocery stores to them?
3) Altered Brain Chemistry – Depressed and anxious brains screaming for serotonin and GABA and dopamine driving you possessed toward the chocolate counter. Searching for oxytocin love in all that comfort ice cream and macaroni and cheese. Driven by sleep deprivation, changes in genetic expression and medication effects. Responding to toxic food injury from junk food as addicting as crack cocaine in your brain. This is not emotional eating; this is your brain directing your chemistry ingredients.
4) Severe Vitamin and Mineral Deficiencies – such as (but not limited to) D, B12, A, iodine, fatty acids:
Vitamin D from the sun – a prehormone – manufactured by the cholesterol in your skin when exposed to that beautiful yellow orb in the sky. Vitamin D that gives us energy and happiness and relaxation and protects us from diabetes and heart disease and cancer and obesity. You don’t get credit if you stay indoors and look out the window, or if you live in Cleveland like I do and there isn’t any sun half the year, or if you’re African American and your skin acts like sunscreen. And you’re never going to be able to lose weight with Vitamin D deficiency until it is corrected.
Vitamin B12 from animal proteins (not vegan diets). Blocked from absorbing by all those prescription reflux medications. Vitamin B12 that gives us energy, memory, concentration, happy moods, relaxation.
Vitamin A from fruits and vegetables for our skin and eyes – night blindness, psoriasis, eczema – the 5th leading cause of blindness in the world – not found in junk food, you can be sure, but a good carrot or sweet potato might help.
Mineral and element deficiencies like Iodine – Iodine that keeps your thyroid running and your breast tissues healthy, essential for the production of every hormone. Added to salt in the early 1900’s so you wouldn’t get a thyroid goiter, but now you eat fancy non-iodized kosher salt and sea salt or no salt at all. Iodine that used to be in flour until the 1970’s when it was replaced by bromine (the stuff they gave soldiers in World War II to kill their sex drives!) Makes you tired, in pain, obese, dull.
Essential fatty acid deficiency – I know you’re eating fish 3 times a day, right? Essential means brain function – attention deficit disorder, memory, mood. Essential means skin – eczema, rash, dryness. Essential means inflammation and immune function – cancer, heart disease, arthritis, dementia. My grandmother frying those smelts every week – she knew something!
5) Food sensitivities like 1) gluten from all that fake wheat processed stuff used to thicken, texturize and cheapen your food, 2) corn from the high fructose corn syrup that makes you gain MORE weight than the same caloric amount of sugar; 3) processed soy that slows your thyroid down because it’s no longer recognizable to your immune system. 60% of people with obesity have food sensitivities, aka allergies.
Now…does that sound like ‘”only eat when you’re hungry in a quiet room focused on food” is really going to make a difference?? Treating morbid obesity with emotional eating techniques is the same as treating cirrhosis of the liver with 12-step programs. The proverbial peeing in the ocean.
Here are some suggestions if you are obese.
Get your vitamin and mineral levels checked. Be careful of those who tell you what you should be eating. Pay attention to when you feel sick, what did you eat in the last 24 hours? The hell trinity of obesity is gluten, dairy and sugar. Purify your food and water sources. If you can’t pronounce it or picture it, don’t eat it. It’s making you fat, and that INCLUDES artificial sweeteners. Forget gourmet, aim for plain. Like grandma used to make. Whatever you’re doing now…do the opposite. Get out of the chair. Sleep more. Eat grapes. Watch less TV. Spend more quiet time. Work less. Work out less. Play more. Do nothing that causes physical or emotional pain. Take baths. Dance in a chair. And if you cannot do anything at all, at least get a little sun.
Try 70% dark chocolate EVERYDAY to fool your body about that famine delusion. The heavenly trinity that treats depression…exercise, Vitamin D and dark chocolate. Can you add one in?
There is hope and healing from obesity. One medical condition at a time. Give your emotional soul a rest.
Sara L. Stein, M.D., is a bariatric and integrative psychiatrist who runs Obesity Clinic at Kaiser Permanente in Cleveland, and is the author of Obese From The Heart: A Fat Psychiatrist Discloses (2009). Learn more at http://obesefromtheheart.com