Losing weight: Truly a balancing act (página 2)

She realized:

"I was as heavy as I"ve ever been in all my
life…"

It was then when she decided to consult
with me as an eating disorder specialist.

"Frankly — Elisa stated — until now I
never saw myself as being a fat person.

"At home, my three sisters and my mom had
to fight the battle of the bulge, but I always managed to control
myself maintaining a reasonable weight.

"But it seems as if lately I"ve lost
it."

The process began

The initial — didactic —
phase:

During this stage our patients are
instructed on the phenomenology of weight and its regulation and
how the organism accumulates and/or disposes of the energy it
consumes. (See my articles about The role of education in
treating eating and its disorders).

Me, fat?

Old, time-honored notions and beliefs are
analyzed, scrutinized, and discarded as the person begins to
appreciate in depth the enormity of her dilemma and the uphill
battle she will face in order to achieve permanent
results.

It"s also during this period that the
patient is familiarized with the Eating Adaptive Strategy of our
species. (See pertinent articles)

Repeat:

In order to succeed knowledge is
essential…

Not a diet but a plan
to fit the person

Not a diet but an eating plan is developed
to adjust with flexibility to each individual, her personal
needs, life stage, and lifestyle.

This phase lasts until the patient feels
comfortable enough to enter the next stage.

The active weight losing
phase:

During this period the patient confronts
(often during therapy) the emotional aspects of eating and its
protean symbolisms.

The dietary plan becomes more structured at
this point — without having to endure feelings of hunger or
deprivation.

Here is when the patient learns how to deal
with the frequent obstacles erected by closely related persons
(so-called "well meaning friends") who — witnessing her
progress — challenge the patient, her chosen method, and her
convictions.

Despite the efforts of the "saboteurs",
techniques designed to counteract these common obstacles, result
in Elisa"s self-confidence remaining unthreatened and her will to
succeed survives intact.

Relapse prevention and the maintenance
phase:

This is the most important aspect of the
Program, as it aims at preparing the individual to resist
relapses or falling into the vicious circle of the yo-yo dieting
that, for physiological reasons, is usually the sequel of all
forms of dieting.

You lose it, but you must gain it back!
(Often with a bonus).

Not for us…

There are some important fundamental
principles to apply during this relapse-prevention
phase.

Here are some:

• Understanding that losing weight is
  easier to achieve than keeping it down.

• That food is not only nutrition but an
  often habit forming and handy palliative for dealing with
  angst and stress.

• That suffering the pain of hunger in
  order to lose weight is self defeating.

• That certain foods are unnatural and do
  not constitute part of the eating strategy of our species.
  That such foods are senseless to eat and detrimental to
  everyone"s health and figure.

• That for those, in any plan to lose
  weight, the last few pounds are the hardest to go.

• That learning how to lose weight is
  like learning another language.

• That losing weight without
  reconstructive psychotherapy is wasteful at best, since it
  seldom yields permanent results.

• That a "permanent cure" is always an
  individualized, elusive goal, and that it takes time to
  achieve.

• That the Plan is a lifelong change in
  eating strategies.

Discussion

During a conference at Northwestern
University in Evanston once I heard one of the leading experts on
eating disorders say:

"In a fat person there is always a
schizophrenic [individual] waiting to get out".

In making this particular observation Hilde
Bruch (its author) was wrong.

But, if one works around the semantics it
can be recast this way:

"A fat person is an unhappy individual
eating her way through adversity in order to cope with stress and
feel better".

Realities

Today we are confronted with a perplexing
and enormous obesity pandemic ("Globesity", some call
it)..

To confront it, academia has offered very
little hope, unless one decides to accept as being serious, their
often confounding and confused, recurrent press releases and
investigation reports.

Besides endless repetitions of the obvious
magnitude of the obesity situation, academicians often dabble in
absurdities:

Gut flora, babyhood infections, different
types of fat, genetics, and other unlikely causes are "suggested"
(never proven) as causes for the obesity epidemic while, in the
process, sidestepping obvious considerations.

For example, ignoring the deleterious
impact of fast foods and sugary beverages on the individuals"
weight, or their dogged persistence in the arbitrary and improper
use of the BMI.

About the
BMI

The BMI is a useless research tool that,
despite its futility, maintains itself as the yardstick, in
academic circles, to measure the presence and severity of obesity
as a clinical condition, something that it was not designed to
do. (See my articles to this effect).

But who cares, when
the purpose is to impress?

Diets and pills

Diets have failed us miserably and
medications for their part run a second, not distant and yet a
hazardous, place on this race.

The Gym

It"s a proven fact, that it"s not what you
do at the gym, but — what and how you eat what you eat — what
really matters.

Bariatric surgery as a remedy, is no
remedy

It"s a surgical procedure; it entails
risks, does not address the individual dynamics and often —
quite often — fails. (See my articles to this
effect).

So that the proverbial Emperor is found in
the end, to be naked.

In
summary

This brings us full circle to where we
began, when we I said that losing weight is a balancing
act.

Let"s see why

Let"s observe Nature and what it
communicate to us.

We live by the sea. When we swim we see the
great variety of birds that glide through the skies searching for
their food.

They are lithe, graceful and never
fat.

It"s so because they maintain an
instinctive and programmed homeostatic balance between what they
ingest, utilize, and store.

Their eating strategy is circumscribed and
specific.

For us is
different

As a omnivorous species — for countless
reasons — we"ve long lost the ability to keep this equilibrium
which we managed to maintain, as the birds and other animals do,
in times remote.

Now we find ourselves in the conundrum that
an equilibrist would find herself if she were fat.

We eat too much of tasty and calorie laden
foods.

We eat for pleasure and not to aliment our
bodies.

We eat for pleasure and often as a
"sport".

See my point?

References

Larocca, F: (1984) The Psychiatric Clinic
of North America issue on Eating Disorders W. B. Saunders &
Co.

Larocca, F. E. F. (2007)
Las dificultades inherentes con el control del sobrepeso en
monografías.com

Larocca, F. E. F: (2007)
Del por qué el perder de peso es asunto tan elusivo en
monografías.com

Larocca, F. E, F.: (2007)
De por que el perder y el controlar el sobrepeso es como aprender
otro idioma en monografías.com

Larocca, F. E. F: (2007) El Sistema
Fiduciario en monografías.com

Dwyer, J and Larocca, F. E. F: (1974) When
a Child is too fat. Patient Care VIII-6- 158-76

Cassell, D, and Larocca, F. E. F: (1994)
The Encyclopedia of Obesity and Eating Disorders. Facts On
File

Larocca, F. E. F: (1991) A Public Primer on
Eating and Mood Disorders Midwestern Medical

Larocca, F. E. F: (1986) Eating Disorders:
Effective Care and Treatment Ishiyaku Euroamerica

Larocca, F. E. F: (1986) Eating Disorders:
The Facts in New Directions for Mental Health Services # 31
Jossey-Bass

Larocca, F. E. F: (1986) Una
Introducción a las Disorexias en Médico
Interamericano 5:12 27-30

Larocca, F. E. F: (2007) Los Trastornos
Malignos del Comer en Psikis.com y en
monografías.com

Microsoft Encarta 2007 (CD/DVD) List of
recommended reading

Larocca, F. E. F: (2010) Hobson"s: The only
viable Option in the treatment of fatness Sistema Límbico
Blog

Autor:

Felix Larocca