STRESS EATING: RUNNING ON EMPTY
Stress is society’s greatest modern affliction. We have completely lost control of our workdays. A workday used to be dawn to dusk. It used to be from the time you arrived at your workplace until you went home. It used to be 5 days a week. Not anymore. We work constantly, 24 hours a day, 7 days a week. We work at our jobs, in our homes, at school, in traffic, at the grocery store. We work shopping on the Internet.
When we are resting, we are working: making lists, setting goals, reviewing today, and planning for tomorrow. We are not resting.
We continually increase our workload because work is addicting. We physically experience an increase in adrenalin, and energy and focus that expands our productivity. It’s a rewarding feeling to do a good job at something.
We add more work so we can feel even better. We start multi-tasking: the dishes, and the laundry, and the homework and the science project.
We add more forms of communication: television, radio, email, Internet, regular mail, newspapers, magazines, cell phones, voicemail, text messaging.More lives to keep track of, including people we don’t even know. Pretty soon, there is no time and we are multi-tasking every task, including some that should be enjoyable.
We read while we eat, we talk while we drive, we work on three things at once. Simple pleasures are eroded by a sense of urgency and the need for more adrenalin to keep us going. No time to say, “Hello”, “Goodbye”.
We work this hard because our society sets up overwork as a model of success. “Supermoms”, mandatory overtime, full-time students with full-time jobs.
One day I saw a 40-ish single mom who was working two jobs, going to school full-time and raising her children. She was exhausted, stressed, depressed, gaining weight and forgetting things.
“Why are you doing all of this”, I asked.
“For my kids, so I can get a better job.”
I looked at her without any humor, and replied, “If you live long enough”.
We are operating at a level of INTENSITY that causes DISEASE.
We have lost our ability to play, and live and love. We have lost our ability to experience emotion because we are so busy working. We have lost the ability to relax, and think and be alone with ourselves. We have lost the ability to feel content with our circumstances. We have forgotten how to look at the sky and wonder about the stars.
We have lost the ability to experience emotion when we are under severe chronic stress.
Hard at work and numbed out to everything and everybody.
When it’s time for me to relax and have fun, I often cannot. Unless I eat. Then I relax. The food pours out dopamine and GABA and serotonin and acetylcholine into my parched brain until I am positively serene. Am I relaxing because I’m healthy? Or am I relaxing because the food just drugged me into forgetting what I was doing.
For the five or ten minutes that you are stress-eating, your brain is transported to a lower-stress zone. You give your body, your brain, and everyone else in your life a break from the jagged energy you are projecting.
If you are eating all the time in response to stress, “all the time” is simply a reflection of HOW STRESSED YOU ARE!
Just in case you thought this was only about your own personal stress, there’s more. You can also absorb other people’s stress, particularly if they are close to you. Stressed people have a tendency to pour out their problems in rapid-fire succession, one after another, with great energy and emotion.
Relief from stress is about learning to say no: no to demands, no to internal goals, no to family expectations, no to overzealous work projects. Saying no does not mean quitting your job in a bad economy, nor does it mean walking away from a difficult supervisor and getting fired. Saying no means acknowledging your physical and emotional limits and respecting them.
Relief from stress is about recognizing your body’s signals. When you cannot sleep, and you cannot relax, and you cannot stop thinking about work, you are overworked.
The solution to stress and overwork lies in learning and practicing proper endings. To be able to say this is my workday and I am now off. This is my homework time and it is now over. The day’s work has ended and this is my sleep time. This is my stress, and this is yours and I cannot accept it. These are boundaries, yours, mine, and ours.
The solution for stress is to recognize that for your body, rest is as essential as exercise.
For your brain, quiet is as vital as thinking.
For your spirit, solitude is as healing as company.
The solution to stress is to accept your humanity and all its limitations.
excerpt from Obese From The Heart: A Fat Psychiatrist Discloses ©Sara L. Stein, M.D 2009 http://obesefromtheheart.com
NOOOOO!!! An Open Letter to Oprah on Obesity
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
I Know I Am Obese; Where Do I Begin??
This is the question I am most often asked. My patients come dragging in reluctantly, sent to Obesity Clinic by the primary care doctor or their own frustration and failing health. They are certain they will be given a lecture and a diet or told to go have surgery. They are surprised when they leave my office with directions to eat chocolate, take these supplements, get some more rest, and stop working out so hard.
"WRONG" says the medical world and the diet industry and every magazine you read. Restrict your diet! Quit eating things you crave! Work out harder! No pain, no gain! YOU MUST SUFFER!!!
Puhleeze. As if obese people aren’t already suffering. Apparently all those skinny trainers and nutritionists and doctors think we were having a great time during those lonely nights by the refrigerator or trying to run in gym class with our thighs chafing.
I have news for you if you are obese. You have suffered enough. You have struggled enough. It isn’t difficult to lose weight, it’s just different than what you have been told.
By the time a person has become obese, they have an ailing body, even if there are no visible end-stage diseases such as diabetes or hypertension. Pain, inflammation, changes in metabolism, nutritional deficiencies, altered brain chemistry. It’s not fun to be morbidly obese. It hurts physically and emotionally.
If you push a broken body (or a broken car) too hard, it breaks down further. To your body, exercising and nearly starving feels like incredible stress. So does divorce, bankruptcy, unemployment, problems with your kids, or working two jobs. Your brain doesn’t make a distinction between one bad stressor and another bad stressor. To your million-year old brain, bad stress means the famine is coming. (Remember that one? 7 lean years?) "OMG,” says your brain to each one of your body’s many trillion cells, ”We’re starving to death…HOLD ON TO OUR FAT!!! We need it!"
Ever see the program where the fat people stop losing weight as the workouts get harder, until they go home, relax and eat? It’s called stress relief.
Welcome to the No-Stress Zone. Here’s where you start, and this is the first of many blogs that will help.
You start by determining what very small change in your food you can make today that will not send your brain into a starvation frenzy. If you drink 5 sodas a day, can you drink 4 and one water? If you skip breakfast and binge every night, could you move a little food earlier in the day? My first change was drinking coffee instead of lattes. And if I really wanted a latte, I would have one.
Next, what movement can you do that WILL NOT HURT?? Can you stretch a little in your chair? Can you walk a little? I started out cycling my legs in the bathtub – it was the only place I didn’t have pain.
Finally, what joyful or relaxing moment can you treat yourself to today? When’s the last time you heard music you loved, or called someone you care about? Or took 10 minutes to read something beautiful?
And when you wake up tomorrow, do this again. A little further. A little longer. And again the next day, and the next.
That’s it.
That’s the secret to losing weight with obesity.
Small, easy, sequential changes that add up over time. And give your body and your mind a chance to heal with each small adjustment. From my husband who lost over 100 lbs: “Tell them this is the first of many small changes they’ll make, and they’ll be surprised how easily they rack up.”
Now that didn’t hurt, did it?
Trading Sex for Food – Tiger’s Search for Dopamine?
So Tiger Woods is a sex addict and goes to rehab…and gains 30 pounds.
Maybe the food there is great, but probably not; or maybe he’s sitting around doing nothing, but probably not. The food isn’t as good as fine dining, and certainly not good enough for fine golfing. Plus, he was photographed going for a run.
So why is he eating so much?
He can’t help it. His brain is screaming for “substances”. Not sex – dopamine and oxytocin and serotonin and norepinephrine and endorphins…he has the brain of an addict. Here’s the breaking news. So do we all – it is what enables us to experience blissful pleasure.
I understand Tiger Woods. Well, maybe not his choice in sex partners, but I understand the insane cravings. He craves sex. I craved food. You might crave alcohol or drugs or tobacco or gambling or shopping or working or exercising or rage…
Our brains have a built-in reactor system to determine “things-that-make-us-feel-really-great”. We respond to life’s greatest pleasures with a chemical explosion that rocks our world. Without this internal nuclear reactor, we would ho-hum through every moment of our lives. With the reactor, it only takes one orgasm to love sex. It only took me one chocolate chip cookie to love food.
The moments of an orgasm or a taste of chocolate are fast and fleeting – the natural timing of brain chemicals. Like fireworks. If you blink, you miss them. We quickly return to our baseline mundane and uninspired living. Boring is our neutral. (Some people call it calm, most addicts call it boring).
And here’s the really bad news, known to every addict of any substance. The bliss level is never the same as the first time. Your brain accommodates to stimulation – good, bad or ugly. You get used to sex or chocolate or CSI or winning. And it takes more and more of your substance of choice to get the same level of explosion. When I was four, it only took one cookie to reach nirvana. Nowadays I would need an entire factory. After awhile you can’t get there at all. Unless you keep changing it up a bit.
So why would anyone keep doing a substance that isn’t even bringing them joy anymore?
You only have to look at Tiger to understand. He looks depressed. It’s the day after the binge, and he’s crashing. And while it’s tempting to say ‘of course he’s depressed, look what he’s done to his life’, the reality is that much of what is happening in his depressed brain is a biochemical rebound of misery. It takes a nanosecond to explode feel-good chemicals in your brain; it can take weeks or months or years to replenish them. Forget the highs. He keeps using to stay at neutral. Anything to avoid the crash.
I feel for the guy.
There really isn’t any difference between us. Our brains all crave reward, stimulation, excitement, curiosity, feeling good. Even to point of overindulgence.
Life is filled with joys that can create the same explosion of feel-good chemicals, without destroying your life or health or emotional well-being. Exercise will release dopamine and keep the level high for more than a day, unless you do it for a living and have attached the stress of daily life to it. Music, art, love, petting your animal, aromas, company, movement, prayer, meditation, playing with your children or grandchildren, and many others. It may not be as dramatic or intense the first time around, but it sustains you with a deep and abiding joy.
And it stops the cravings.
Is Kevin Smith Too Fat To Fly? Thoughts on Obese Discrimination
What difference does it make if a fat producer is kicked off an airline? Isn’t that a private issue between the passenger and the company? If he didn’t fit in the seat, he should get off the plane, right?
Wrong.
This one had me from the first tweet. Even if I had to ask my husband who is Kevin Smith other than a guy with 1.6 MILLION followers on Twitter? (Answer: a producer of movies that teen & 20 & 30-somethings love).
A lifelong big guy, returning home after speaking at MACWorld, is seated as a standby on a Southwest Airlines Oakland-to-Burbank flight and then summarily ejected because he is a “safety” problem. One that involves the width of his body in his seat. (I still don’t get that one, what’s the safety problem?)
Of course, they saw his body habitus when they ticketed him at the gate for standby. They sized it up again when they seated him. They saw that his seatbelt fastened without an extender and his armrests went down. They polled the two ladies on either side who didn’t object to his presence.
Yet they made him get up from his seat in front of 150 watching people, retrieve his carry-on luggage from the overhead compartment and get off the plane. Like the bad kid being sent to the principal’s office.
And he was FURIOUS!!! And tweeted all night long.
I’m pretty confused about this. I like Southwest. I fly them, their seats are comfortable, their service is pleasant. They were extremely nice to my 88 year old father who needed some extra assistance last fall. But I am also a person with lifelong obesity. And there have been times in my life, 90 lbs ago, when I needed a seatbelt extender. I did my best to stay within the boundaries of my seat and be invisible and non-offensive.
So why can’t the airline just say they screwed up?
Instead Southwest has created a public relations disaster in which they blog their apology by making fun of his comedic character “Silent Bob” and his real-life angry persona. They titled their blog “Not So Silent Bob”, and defended their customer size policy while intimating that his badmouthing the airline publicly was oh-so-unfair. Unfortunately, they also explain the parameters of the customer size policy which, in this case, appear to have been applied arbitrarily if indeed he successfully buckled and put his armrests down. I’m guessing he was profiled more on his hoodie & pants-on-the-floor look than his actual size.
Blaming the fat guy for discussing the anger-causing events never works well for the merchant. You’d think they would just say, “we made a mistake, you fit in the seat, we’re really sorry, we misapplied the policy, we’ll make sure it doesn’t happen again”. Doesn’t require they rescind the policy, just acknowledges they were overzealous in its application.
The story doesn’t end there – it gets worse.
Smith put up a long, rambling, profane “Smodcast” (his name for his podcasts) of the events. The ‘AHA!’ moment occurs more than 50 minutes into the rant.
On the next flight, he had two paid seats of his own. An obese young woman was seated in the third seat; his paid-for, empty middle seat between them. After she was seated and settled, the attendant took HER to the principal’s office. Where she was told that she had to ASK PERMISSION from our fat producer to spill over into his empty seat, or she would be ejected too. And next time, she should purchase two seats. Different flight, different crew, different passengers (except for our angry producer).
Bullseye! Kudos to the airline. You have now effectively destroyed the very shaky self-esteem of yet another fat person who will invisibly skulk away into the night in shame, never to fly your airline again without paying double.
Now I’m furious. Once is a misapplication of a policy. Twice is a pattern of pointless and opportunistic discrimination. No wonder they didn’t apologize. They feel righteous in their contempt for adiposity.
And so do hundreds, if not thousands, of commenting passengers on forums, blogs, tweets. Thousands are in support of the producer (and by proxy, the woman on the second flight); some vow to boycott the airlines forever. But thousands others have seized the opportunity to be venomous and verbose slayers of fat people. (often anonymously, gee I wonder why).
The language is at best intolerant and unforgiving. Those are the people who are talking about being uncomfortable on an airplane. They have a point, although it could be expanded to include passengers who drink, smell of cigarettes or perfume, have screaming babies, or crack chewing gum among other encroaching habits.
At its worst, however, the language in these comments is frightening and revolting, almost horrific. If you changed the word fat to black or Jewish or female or gay or Muslim….the rhetoric would sound illegal. These people aren’t commenting about their crowded seat. They are taking the opportunity to express mindless, revulsive hatred against a group they feel is inferior to them.
Southwest needs to take a step back from this sizeable group, and from their uneven and discriminatory enforcement of “customer size policy”, and return to the idea of helping ALL people navigate the often difficult world of airline travel. With dignity and respect. Just the way they treated my dad.
If you have been a victim of obese discrimination, you are not alone. It is the last unanswered prejudice. Do what Kevin Smith had the bravery to do. Tell your story, even if just to a friend or a family member. Be assured that you do not deserve to be hated or hurt because of your weight. Or your skin color, religion, sexual preference, gender, political beliefs…
So to answer the question about why we should care because a fat producer got kicked off a plane…
Maybe we should care because it is uncovering the worst in us, both individually and corporately.
Sara L. Stein, M.D.
Author, Obese From The Heart: A Fat Psychiatrist Discloses (2009)
On Childhood Obesity and Genetics – It’s All in The Family!
Today at noon First Lady Michelle Obama unveils a new Nationwide Initiative on Childhood Obesity. About 1/3 of our children are overweight, 1 in 5 are obese. In some states, the numbers are nearing 50%. These numbers go up as people age. Currently 60% of adults in our nation are overweight and 30% are obese.
Clearly this is a progressive condition. It’s getting worse. We’re getting worse. More people are getting fatter and sicker as they get older. The prevalence of obesity has risen 3000% in the last couple of generations. That is NOT an explosion of genetic illness.
It is convenient and absolving of responsibility to think that our DNA is causing obesity. While there are genetic obesity syndromes, they are rare – estimated at 1 in 7000 obese people. These syndromes present very early in childhood and are often accompanied by other developmental conditions. That means that 6999 out of every 7000 obese persons have to find another reason for their overweight besides their genes!
The genetics of obesity is how your body distributes fat, and what shape you are. Apple vs pear is genetic. Gaining weight as a result of eating too much is not.
Still, for those of you who insist on genetics as a cause of your obesity, you’re right. Sort of.
Most of the genetics of obesity involves on-off switches that regulate metabolism, inflammation, energy. Low quality foods, nutritional deficiencies, artificial additives and preservatives can flip the gain-weight or the do-not-lose or even the burn-calories-slower switch. If you are obese and dieting, it may not be your imagination that you are not eating much and still not losing weight.
Obesity IS generational and familial and cultural. We become overweight because we are served certain foods in an environment that encourages us to eat. It might be low quality food, or it might be the highest calorie home cooking of our dreams. We overeat because we attach meaning and emotion to our food, whether it’s the SuperBowl, Christmas or a funeral. Quickly we learn to use food to regulate our emotions, our energy, our happiness on a daily basis.
What about exercise? You need it! Your body is designed to move, and without movement, you become ill. It gets better though. When you combine healthier foods with movement, those on/off gene switches go back to where they are supposed to be, and your body weight begins to readjust. It doesn’t take starvation and boot camp and pain. It may just take a few less preservatives, a little more home cooking, and a walk after dinner. And a good nights sleep.
So what do you do for you and your children and your family? Here’s the good news.
If you come from a family that has always used food as a measure of the joy and sadness of life, try music instead. Use food for fuel, not emotional fullfillment. Use love as comfort, not ice cream. Use movement to blow off steam, not potato chips. Use prayer and meditation to find your bliss, not cookies. Use your family as your support, not your frustration. In the end, all we have is each other. With or without the meal.
Now you can live with that, can’t you?
INTRODUCTION
(from Obese From The Heart: A Fat Psychiatrist Discloses c2009 all rights reserved)
Who is this book for?
Maybe it is easier to tell you whom it is NOT for.
If you are looking for a good diet, consider these suggestions:
- If you have a few pounds to lose, try a balanced diet with meal plans or suggestions that suit your lifestyle – join a gym, go for a walk, stop drinking soda, drink tea, find a diet buddy or online support group, practice relaxation.
- If you have a significant amount of weight to lose, go to your doctor, a nutritionist and start moving, even a little. Learn how to lose weight the healthy way, and try it. Make sure you do not have a medical condition that is causing the extra weight.
The rest of you, read on.
- Read on if you are morbidly obese by medical standards and you have not successfully managed your weight.
- Read on if you feel hopeless, helpless and defeated by your weight and your attempts to lose it.
- Read on if your appearance does not reflect the way you feel inside.
- Read on if others have reacted to your appearance before you even said one word to them.
- Read on if you feel alone because of your weight or if your weight is a response to feeling alone.
- Read on if the pounds you gain reflect the pain and emptiness you feel in life.
- Read on if you have put your life on hold because of your weight or you have resigned yourself to living a better life in some other year or in some other universe.
- Read on if you believe you are going to die because of your weight and you have not been able to change your ways.
- Read on if you feel that there is an inner you clamoring to emerge; the you that accurately reflects your soul, the you that looks the way you feel.
This book is as much my story as your story. They are not different. We may have been born in different cities or countries; we may eat different foods or work in different vocations. We may worship with different languages and customs. We may be different ages and different sizes.In the end, all we have are our relationships.
Underneath our exteriors, we are all the same. We love, we hate, we celebrate, we grieve. We play, we learn, we create. We have relationships that sustain us throughout our physical lives – relationships with people, with ourselves, with food, with our spiritual selves.
If I believe that my body serves to keep me separate from you, then I can never be connected to you, even in intimacy. We are connected by our emotions, by our energy, not by our bodies. Anyone who has ever felt another persons joy or suffering, whether in person or in the media, feels that connection. Why else would we weep over illnesses, or wars, or disasters, or crimes that affect those we have never met, in places we have never been?
We are all connected. My health reflects your energy. My love is an expression of your loyalty. My blessing is the song of your heart. And so it goes.
When you are tired, I am in pain. When you are alone, I weep. When I am isolated from the flow of the universe, I cannot fill up, no matter how much I eat.
“The Greatest New Year’s Resolution of All: When I Grow Up, I Want to Be A Chocolate Chip Cookie”
I never wanted to be a fat psychiatrist when I was little. I wanted to be a chocolate chip cookie. It never occurred to my 3 year-old brain that some starving teenager might polish me off in one big bite. I didn’t care that it was a physical and spiritual impossibility for a human being to transmutate into baked goods. (Although some people do figure out how to become root vegetables, but they’re not in this blog).
I cared that I became what I loved.
That got me thinking about New Year’s Resolutions. New Years Resolutions are these active, goal-setting, forward-motion plans. Kind of like football games. I’m going to move down the field and beat the enemy. Pumped up and rearing to go! Starting tomorrow, I’m going to lose 50 pounds, work out every day, read 10 books a week, go to bed early, donate all my extra time and money (even if there isn’t any). Starting tomorrow, I’m going to be a better person. Like maybe Mother Theresa.
Aside from the obvious “it’s been done”, if I became a Saint, would my friends and family and coworkers even recognize me? I think they’d all be standing around watching my stomach and taking bets on when the alien pops out.
I know from the last few decades that New Year’s Resolutions never quite stick with me. The other team always wins in the end. There has to be a way to improve the odds on these resolution outcomes.
Maybe we could make resolutions for each other instead. They would probably be a lot less stringent (unless you have very rude friends). I can’t imagine my husband saying “You have to lose 50 pounds next year”. Aside from being a nice guy who would never say such a thing, he knows he would be risking his life with a bonehead observation like that. Instead, he would give me a resolution that somehow made us both happier. Like more nookie. Or sleeping in. Or cooking together.
What about my coworkers? Maybe they would nail me. “You should see 30 more patients a week and work until 11 pm every night.” Nah. They would say, you should make sure you take lunch everyday, you need the break.
Ok then, my sisters. Certainly years of sibling rivalry will takes it toll. “You should cook and clean and no glass slippers for you!” Nope, not that either. They don’t care who cooks and cleans in my house or what high-style pumps I wear. They might say “we should go for lunch” or something like that.
And forget my friends… they are totally there for me. That’s why they are my friends.
So basically, nobody out there is looking at my past 12 months of life and sneering. Nobody is saying I have failed. Nobody is telling me I am a bad person. Nobody is setting crazy perfectionist goals. Except me. I am the critic and the criticized. I am the abuser and the abused. I am my own Cinderella and my own wicked stepmother. (By the way, I am a stepmother and I don’t consider myself the least bit wicked. Ok maybe a little strict, but hey, I like things orderly). And certainly, no one else is saying that the road to self-improvement should be paved with suffering.
Quite the opposite. My family and friends would design New Year’s Resolutions for me that increase their ability to nurture and love and laugh with me. That improve the quality and the heart-centeredness of my days. They would make sure I celebrate my life and time, and I would do the same for them. Their mandate would be for me to sit back and enjoy the ride.
They would want me to return to the simple joy of being instead of the rigor of becoming. Which is a guarantee that I will move myself closer to my life’s purpose.
I think I might be able to stick to those.
So here are my New Year’s Resolutions… In 2010, I vow:
To follow my heart and do what I love
To do what honors me and brings out the best in me
To do what helps me and nurtures me
To do what makes me laugh
And by so doing, I will love and cherish and honor and help all of us together.
Happy Healthy Prosperous New Year to all of you!
Doctors and Obesity: What Can You Do?
Doctors are as puzzled about obesity as the rest of society. I know this because I am a physician and I am also obese.
For the doctors, you give patients all of the wisdom you gained from years of studying, the best coaching you can muster, and they fail to improve. After awhile, simple human nature takes over. Obese patients seem unable to follow directions, fail to lose and maintain weight loss, keep getting sicker, and they ruin your day. For the doctor that means frustration that turns into anger, then resentment, then resignation and apathy.
The real problem for doctors is that they don’t have the proper tools for treating obesity. Current treatment for obesity addresses lifestyle – portion size, food selection, exercise – all necessary for weight loss. But actual obesity is a brain disease – disordered neurotransmitters trying desperately to manage a very stressed supersized body with toxic and inadequate nutritional substrate for fuel. Pushing the gas pedal harder doesn’t get a broken car to run faster or better. The good news is that brains are plastic, they can heal.
So what can the obese patient do? Your doctor hates fat. If that’s true, you are partners, and can forge ahead trying different options together. Some will work for you, some will not, some will work for awhile. Address the addiction and depression/anxiety and emotional eating that invariably accompany obesity. Watch out for medications that increase your appetite. Move a little, change something everyday, reawaken your curiosity, eat the highest quality food you are craving – you will eat less of it.
Hopefully your doctor is mature enough not to hate fat people. If that is the case, change doctors. You do not need to endure additional suffering.
Go forth in good mental health!
Sara L. Stein, M.D.
Author, Obese From The Heart: A Fat Psychiatrist Discloses
reprinted comment in response to LA Times article October 22, 2009 | 11:23 am
Extra pounds, and attitudes about them, can affect doctor-patient relationships
Posted by: Sara L Stein, MD | November 05, 2009 at 08:28 AM
What have you done for yourself today?
It’s way too easy to forget about your own needs, even when your brain and body are screaming inside you for fresh air and rest and joy and movement.
I was in the ER with my dad yesterday, always sudden and always scary. He’s fine, we left before he got jumped by some lurking virus. I came home and made green minty tea and had dark chocolate and then sat in a hot bath with music and bubbles. Well actually, I turned on the jets and the bath salts foamed like crazy and went all over the bathroom like some bad Lawrence Welk intro, and my 175 lb Newfoundland puppy came in and was trying to catch them with his tongue, but I was afraid the salts would give him the runs so I was trying to get him to quit it, and yelling for my husband who was in the garage installing some computer thing and didn’t hear that this 6-foot dog is trying to climb in the tub with me.
And I laughed and laughed and laughed.
And then I felt better, and slept all night.
(transferred from the Forum, originally posted Nov 2009)
