Do you have a sincere desire to become more fit and healthy in 2012, but the idea of exercising outdoors or in a public gym brings you to a dead stop?

Many people who are self-conscious about their size or fitness level find it uncomfortable or even distressing to exercise in public. Maybe they believe that others are looking at them critically. They might think they don’t fit in with fit people. They may even fear someone is going to say something insulting to them.

It’s common to put off walking around the neighborhood or joining a gym, thinking, “When I lose weight I’ll get out there and start training.”

Invariably, that day never comes. Few people can manage their weight without incorporating exercise. Most likely more weight is gained and more precious health is compromised.

Because of society’s bias when it comes to weight, it’s understandable why many people have such fear of exercising in public. Yet most of the beliefs that keep people from moving forward with their fitness are just that – beliefs. Here are some points that are closer to the truth:

. More often than not, people are too concerned about themselves to worry about those around them. In fact, the person whose opinion you fear may herself worry about what others are thinking about her. More likely, however, she’s thinking about other things entirely.

. You are not a mind reader. So you could be completely wrong in your beliefs about what others think, yet you’re allowing those beliefs to rule your life.

. It’s not other people’s thoughts that make us feel bad, it’s our own. It’s important to realize that it’s your own thinking that’s in your way, not the thinking of others.

. Even if you were openly ridiculed early in life because of weight, that experience does not have to rule your life any longer. It was unacceptable for anyone to mock you as a child; it’s equally unacceptable for you to keep ridiculing yourself. Everyone has the right to pursue health and happiness, so it’s important to treat yourself the way you wish to be treated by others.

As a young psychologist, I worked with a very large patient whom I will never forget – not because of his size, but because of his determination. We not only worked on his fitness by walking together, we worked on his thinking about exercising in public.

He wanted to participate in an organized 5K run, but he didn’t want to wait until he was thin. Instead, he decided to train and run it at whatever weight he was on the day of the race.

He was larger than most of the runners. There was no getting around the fact that people would look at him: Race spectators are there to watch the runners.

We jogged and walked for the entire 5K, and we did attract attention.

But it was all positive. Everyone was cheering him on and, in the end, he got his picture in the paper, a ribbon, and a huge amount of pride in himself. Mostly, he felt pride for not letting the thoughts of others keep him from doing what he wanted to do with his life.

So, if worrying about what others think of you is keeping you from being as active as you wish to be, explore your thoughts and beliefs and work at turning them around so that they no longer get in your way. Focus on your goal, be proud of yourself for working on it, and enjoy every minute of it. Let others take care of themselves.

Previously published in St. Petersburg Times

“I can’t seem to get enough motivation to exercise.”  Motivation is something that people find to be mysterious and out of reach – especially when it comes to being able to exercise consistently, instead of in the start-and-stop fashion that many people find so frustrating and defeating.

Yet, having the motivation to exercise isn’t as mysterious as it’s believed to be.  It’s within everyone’s reach.  It’s just that people tend to look for it in the wrong places and have expectations that immediately put them at a disadvantage before they’ve even begun to exercise.

In my experience, the three most common reasons why people have difficulty finding motivation to exercise are the following:

1. They think exercise has to be more intense than it has to be.  “When I lose weight I’ll be able to exercise the way it should be done.”  Barring any medical reason why you’ve been advised not to, exercise can be done anytime and at any body size as long as you realize that the only requirement is that you move consistently, frequently, and easily.  You don’t have to perform any particular type of exercise.  You don’t have to exercise at any particular speed or intensity.  You simply start from your current fitness level and “move” more than that level.  Exercise should not be a strain or feel painful.  If it is, it’s too intense.  So ease up a little, but keep moving until you’ve reached a level where it feels comfortable. For example, if you’re walking at a speed that feels too difficult, uncomfortable, or unenjoyable, slow down until it feels like you’re working harder than usual but it also feels relatively easy.

If you think of exercise as having to be something that’s intense, it’s logical that your mind won’t want to do it.  No one wants to do something that seems overwhelming.  It should be no big surprise, then, that you would resist anything that feels out of reach.  Make it reachable and you’ll keep doing it. It doesn’t matter how simple the activity seems compared to what you see other people do.  If you start at your level, you’ll want to keep doing it.  There will be opportunities to increase intensity later and you’ll still feel comfortable.

2. They think they have few options with exercise and none appeal to them.  Instead, exercise can be whatever you want it to be as long as you move consistently.  You do not have to be a runner, a walker, or a gym person.  Perhaps you’re more of a dancer, a rope jumper, a hiker, a stair climber, or like to jump up and down while watching TV.  You pick the exercise – whatever it is.  Make it your own and you’ll be more likely to want to stay with it because you’ll like it.

3. They only want to exercise to lose weight.  Weight loss alone is not a good motivator because of the short-term nature of it.  If your brain isn’t thinking past losing weight, what will be the incentive to keep being active for the rest of your life?  The person needs to find a long-term reason to exercise in addition to weight control.  The best motivating approach is one which includes a life-time goal of health and fitness mixed with short-term goals that are directly related to the long-term goal.  For instance, frequently reminding yourself that the main reason for exercising is to achieve older age without diabetes, cholesterol, or blood pressure problems like too many people have today, can keep the larger and more important picture in focus.  Try to imagine how the exercise you’re doing each day is insuring that your muscles stay strong enough to allow you to get around independently or  look healthy and strong at any age.

Within this global focus you can have short-term goals that give you an extra push – like walking a little further or lifting a heavier weight today.  With any goal, however, attitude is everything so keep challenges fun and achievable.

Remember, being fit and lean are both important for health, but if you’re only focusing on the number on a scale you’re missing the point as well as the motivation that will keep you wanting to exercise.

In short, motivation is the feeling of wanting to approach something because we imagine it to be a good thing.  Nothing destroys motivation faster than anticipating something negative or even torturous.  It’s human nature to avoid such negative things.

However, the human brain is intelligent and it can think about pleasurable things, also.  So use that wonderful brain and create your own enjoyable ways to move more in your life.  You’ll be surprised how quickly motivation will appear.

By Lavinia Rodriguez, Ph.D.

Previously published in the St. Petersburg Times

Now that Halloween is behind us, the holiday season is off and running. With it comes all the goodies that we so desire and that we so fear will make us overindulge.

But with a little planning, the food conflicts that can drain the joy from the holidays can be a thing of the past. We can use a wealth of solid research about why it’s so much better to control portions instead of falling for the same old failing dieting tactics.

There are researchers who devote their careers to studying what makes us eat more and what helps us push away from the buffet. Food psychology laboratories produce information of particular interest to the food industry, which wants us to eat their products in abundance. But there’s no reason we can’t use this information to gain insight into how we tend to respond to different eating situations so we can better manage portions – and weight.

Some of the research findings:

. Out of sight, out of mind: he more visible food is (like the candy dish on the coffee table or your co-worker’s desk), the more likely we are to eat it. No problem if it’s food you don’t like, but if you love chocolate and have to stare at a bowl full of holiday M&M’s, you’ll probably surrender. The trick here is to make tempting goodies less visible. Using covered, opaque dishes for candy, and open dishes to display fresh fruit will encourage the healthier choice. Also, try keeping nutritious foods in front of the fridge or cupboard while putting the ones you want to control in the back.

. Size matters: The bigger the package, container, or plate you’re eating from, the more you’re likely to eat. The brain seems to be looking for signals to mark the end of eating. Something about seeing an empty plate, bowl or bag helps us feel satisfied whether the container is large or small. That’s why using smaller plates is so effective. So, when going to that big holiday buffet, put your entree on the salad plate.

. Serve and step away: During party situations, whenever possible, serve yourself reasonable portions and then step far away from the rest of the food. The less you look at food, the more likely you will be to feel satisfied with what you served yourself. I saw this in action myself at a party last weekend. Engrossed in conversation with a local chocolatier, I didn’t step away from the serving trays filled with exquisite chocolates. Result: I ate more than I would have if I had invited my conversation partner to have a seat in another room.

. Slow down: It’s takes about 20 minutes for your brain to receive all the physiological signals that you’ve eaten enough. So the faster you eat, the more you’ll eat.

What’s the hurry anyway? There are few things we will do as often in our lives as eat, so let’s sit back, take a deep breath and enjoy. The more you let your body get the full enjoyment out of what you’re eating, the sooner it will say, “Okay, that was good, but I’m done.”

These are only a few research-based tips that you can incorporate into your holiday eating. Use your creativity to come up with others and practice them as you enjoy not just the food, but the people and the surroundings.

Consider the alternative – getting overly preoccupied with weight, food and dieting. When has that ever worked? It’s the gentle, positive, consistent approaches that make for the best results.

The pursuit of thinness long has been a major preoccupation for American women. But why are women trying to be downright slender, as opposed to maintaining a healthy weight?  If it’s for the approval of men, then women seem to be putting themselves through needless worry and discomfort.

I work with a lot of women with body image issues so the question of what men find attractive and what women think men find attractive is of particular interest to me. Many women suffer a great deal believing that they’re not thin enough to be attractive to men.  But are their
expectations shaped by men?  Let’s take a look.

During decades of practice numerous women have told me how they try to avoid being seen naked by their husbands or boyfriends.  Other times I’ve heard women share that they believe they will never find a man to love them because they don’t have the “perfect” body they assume men seek.

Research investigating what body shape most men prefer has revealed some interesting things.  For example, it appears that:
•       Men find a greater range of female body shapes attractive than women do.
•       The body shape that men generally find attractive in women has a waist-to-hip ratio of 0.7. That’s the ratio of a 28-inch waist and 40-inch hips, though the study found that size wasn’t as important as the balance. Men like curves. If you doubt it, consider actor Christina Hendricks, who stars in the television series Mad Men.  Today’s men find her shape incredibly attractive, even though the show is based on 1960’s standards. Interestingly, in a study with blind men, the same ratio was found to be most attractive to the males in the study.
•       The average American man is less bothered by a few extra pounds in a woman than her being what he considers “too thin.”

Apparently, American women consider the most beautiful female figure to be one that is thinner than average while American men prefer a more rounded shape.  Could this be why fashion models are so thin?

So, who are women wanting to please?  Is it men or other women?  Do they even know?  If it’s men, they seem to be missing the mark.  If it’s women, why would that be? What would pleasing other women with respect to body size accomplish? If it’s other women that American women wish to please, why is it worth going through such pain?  These are questions each woman ought to ask herself.

There are men out there who are already attracted to women who themselves are convinced that they aren’t at all attractive. Perhaps these women could profit from looking at what they might be passing up, and reconsidering their distorted expectations.

Of course, there are men who expect their women to look a certain way at all times, and these women have my sympathy and my earnest hope that their husbands and boyfriends can get over themselves. Or that these women can find a better man.

If you’re feeling bold, try asking the men you know what they find attractive in women. I found an informal survey by MSN that indicated most men prefer women who are comfortable in their own skin to those who trowel on heavy makeup and are obsessed with whether their stomachs are flat.

While the best thing for all of us — both men and women — is to accept who we are and pursue having the healthiest and fittest body we are naturally capable of achieving, letting go of any mistaken ideas of what is attractive to the opposite sex is not a bad place to start.

Previously published in the St. Petersburg Times

People being treated for eating disorders and other eating related problems often believe that they’re more dysfunctional than they actually are.  Invariably, I find myself showing patients that many of the behaviors they think are unique and “weird” about themselves are experienced by people they consider “normal eaters.”

Most articles discussing the differences between thin and overweight people focus on the things that thin people do better than overweight people, but what do these thinner people have in common with those that have problems with their eating and weight?

Here are some of the most common misperceptions my patients have about normal eaters:

• They never overeat – The truth is that most people sometimes overeat – it’s normal.  Those people who consider their health and fitness a priority, however, do pay attention to when they have overeaten, try to make subsequent meals more balanced, and try to increase activity.
• They don’t have sweet cravings – Sweet tastes are particularly pleasurable to humans and most people have sweet cravings from time to time.  The normal eater will not panic or get anxious when they get a sweet craving.  In fact, they will readily admit they’re having one since they see no shame in it.  Then they will satisfy it as soon as possible by asking themselves what it is that they want, getting what they want instead of some dissatisfying substitute, and proceed to savor every bite.  Because of how they treat their sweet cravings, however, most of the time they’re able to feel satisfied with a normal portion.
• They have healthy diets – The truth is that just because someone does not appear overweight doesn’t mean that they eat healthily.  In fact, some overweight people eat better than some thinner people.
• They exercise – Unfortunately, most people do not exercise regularly regardless of whether or not they have eating problems.  Sedentary lifestyles are pervasive in our society.
• They eat only when they’re hungry – Although people who don’t have eating and weight problems usually don’t eat when they aren’t hungry, people do sometimes eat when they’re not hungry.  If this were not the case, we wouldn’t have desserts.  Desserts are eaten after a meal – when people are no longer hungry.  Eating when we’re not hungry too frequently can certainly lead to health problems but everyone sometimes eats when they’re not hungry.
• They never gain weight or watch their weight –The truth is that people who are successful managing their weight experience weight fluctuations, too.  It’s normal.  Most people who don’t have eating problems have a weight range that their body goes through as they live out their lives.  However, most of these people don’t focus excessively on it.  They understand that the pattern is normal for them. Typically, the weight shift can be easily attributed to some temporary change in lifestyle (i.e. eating out more or less often, eating or moving more while on vacation, or not having engaged in the usual exercise program). Invariably, the person gets back to their regular lifestyle shifting the weight back to its usual place.  For others, they calmly note the change, its cause, and then consciously set about correcting the behavior that has caused any weight gain by getting back to their healthy lifestyle.
• They never lose control of eating – Although this is generally true, most people have experienced times where they’ve felt out of control with their eating after being ravenously hungry.  Interestingly, a normal eating person might refer to this as simply “pigging out.”  The emotional roller coaster that the binger puts themselves through when they lose control is what makes it a binge.  Feeling a loss of control with eating isn’t seen as a character flaw by the normal eater.  It’s just a function of not having eaten properly to begin with.  In this case, avoiding intense hunger helps prevent the problem in the future.

Understanding that “normal” eaters aren’t perfect eaters can be a relief to those with food and weight problems.  It helps them resolve their eating issues sooner when they know they’re not so different after all.  In fact, the best known professionals in the weight and fitness field don’t do things perfectly themselves.  It may look like they do and they may even suggest that they do, but they don’t.

“Normal” eaters that are mindful of their health pay attention to the behaviors that can take them in the wrong direction with their health and weight.  They do it with a relaxed mind, however.  They use “concern” rather than “self-punishment” and strive for “improvement” rather than “perfection”.  A good average is all that’s necessary.  Expecting that your behaviors be perfect and thinking that you’re different from others because of your imperfections only leads to low self-esteem, frustration, and giving up on achieving health and fitness.  So let’s all strive for good health while accepting our imperfections.  After all, they’re normal.

What we experience as children and teenagers in school can stay with us for the rest of our lives.  If we’re fortunate, those experiences are fun, exciting, and filled with personal growth but that’s not always the case.  For some, memory lane is filled with pot holes, rusty nails, and dead ends.

As a psychologist and expert with weight and eating, I’m able to get to know people more intimately and help them discover what is at the bottom of their weight and eating problems.  In many cases, a weight problem isn’t as simple as just learning the most successful ways to eat and exercise.  Weight and eating problems are sometimes psychological issues rather than simply a matter of overeating and little exercise.  Oftentimes, negative experiences from our early school years can have a long-lasting impact on the person – getting in the way of their emotional and, sometimes, physical health.

Dale, a patient who developed an eating disorder shared the following story:  “I was an overweight child.  Although I’m not fat anymore, I don’t go to school reunions because I don’t have any good memories of those years.  My school days usually began with a feeling of dread.  It wasn’t a matter of IF I would get picked on about being fat that day but WHEN and WHERE.”  Because Dale was no longer overweight as an adult, people would assume that he didn’t have a problem anymore.  Nothing could be further from the truth.  Long after the weight was lost, Dale struggled with eating issues and still perceived himself as fat.  In addition, the emotional impact of his childhood traumas continued to plague him as an adult.  His eating disorder interfered with his progress in college, his intimate relationships, and his general happiness in life.

Children don’t have the psychological sophistication to understand why they are being picked on and that it has little to do with them as people.  They have a tendency to think in more concrete terms.  So, if school mates are picking on them because they are overweight, they automatically believe that something is fundamentally wrong with them.  This belief can grow into believing that they are not worthwhile individuals and this loss of self-esteem is what is carried on into the rest of their lives.

It’s important for the adults in the lives of overweight children to be sensitive and vigilant for signs that they may be having problems at school because they are being treated unjustly about their weight.

A few things to keep in mind are:

• If your child is being picked on because of their weight, speak to them without judgment.  Show compassion and a willingness to listen instead of immediately providing advice.  Everyone wants to be listened to and to feel that the listener wants to understand.
• Focus on the emotional impact of the problem rather than on the weight itself.  It’s the feelings that are hurting.  The child needs help with dealing with the thoughts and feelings that are causing him or her to feel the way they do.  Problems with low self-esteem because of weight prejudice don’t go away from just losing weight – as Dale’s story above demonstrates.
• Deal with the weight indirectly instead of putting the child on a strict diet or criticizing them for what they eat.  This can only add to the problem.  Instead, learn to provide nutritious alternatives for the whole family and engage everyone in a more active lifestyle.  This way the child doesn’t feel “different” at home as well as at school and the changes will make him or her more successful with weight loss.
• Don’t be afraid to get guidance about how to best help your child. Talking to school officials and a skilled professional who specializes in children and teens can be of great service to a family.  They can make a complicated problem much easier to deal with.  When children are having emotional problems it’s usually more effective for the adults to seek help for themselves in order to learn what they can do rather than just taking the child to a therapist.

School is part of our culture and a place where we can learn to cope and socialize.  It’s also where we can experience some of the best times in our lives.  However, we mustn’t forget that, for some, it’s a place where emotional development can come to a standstill.  Let’s be aware of signs in our children that they may be going through difficulties at school that they may not be able to get through without our help.  Let’s help them get through the bumps in the road and come out of it feeling it was a good trip – one where their feelings of worth will remain intact despite the bumps.

A version of this article was previously published in the St. Petersburg Times

“My experiences at the doctor’s office have not been good.  No matter what symptoms I present, or even if I am there for a well check, my weight is always an issue.  I have had recurring headaches for four years now and I can’t count the number of times that I have been told that maybe if I lose weight and exercise more my headaches might go away (this, despite the fact that exercising frequently results in a headache). I do have high blood pressure and have had some difficulty keeping it within normal limits.  I am always told to lose weight, eat more vegetables.  However, my mother, who weighs 115 pounds, has also had difficulty over the years keeping her blood pressure within normal limits.  She is never made to feel like it is her fault.”

These are the words of a client who came to therapy with realistic goals.  She wanted to manage her weight in a reasonable way in order to improve her health but her blood pressure was still too high despite blood pressure medication.  When I asked why she hadn’t returned to her doctor she gave me the above story.  She felt that, when visiting her doctor, her weight overshadowed everything and she was not getting the help she wanted.  This made her feel embarrassed and hesitant to pursue her medical concerns any further.

My client is not alone.  According to the Rudd center for food policy & obesity at Yale university (Rudd Report, 2008), 69% of 2,449 surveyed overweight and obese individuals had experienced weight bias by doctors.  The report states that overweight patients are reluctant to seek medical care, delay medical appointments, and put off preventative healthcare screenings due to this bias.

Apparently one of the factors behind weight bias by some doctors has to do with believing that if someone is overweight or obese it automatically means that they are not eating healthily and exercising.  Another factor appears to be that if someone is overweight it means they don’t care about their health and aren’t trying to do something about it.  However, in reality there are many factors that can explain someone’s weight and there are plenty of thin people who eat poorly don’t exercise.

Some overweight individuals already eat a nutritious diet, some work out regularly, others don’t eat much more than thinner people and many have tried diet after diet putting enormous amounts of effort, time, and money into trying to manage their weight with little success.  Another subset of patients has diagnosable eating disorders, which are emotional disorders – not problems of mere lack of discipline.

We know that overweight doesn’t necessarily mean unhealthy.  It appears that focusing less on weight and more on indicators of health is the best approach in addressing any patient’s concerns regardless of whether they are overweight or not.  A healthy diet and activity level is good for everyone and whether these two factors are being practiced by the patient can be considered in all cases.  If diet and exercise need to be addressed, the subject is best approached with sensitivity.  Finally, an honest and compassionate exchange between doctor and patient might lead to the knowledge that the patient needs direction about where to get help with behavior change rather than just being told they need to lose weight.

Not all doctors are weight biased, however.  Patients can be responsible for making sure that they do not become victims of weight bias by any professional.  Here are a few things you can do to make sure that your medical concerns are addressed in the right way:

• Let the doctor know what healthy behaviors you engage in. You might be prepared with a list of the things you already do to take care of your health.  The doctor won’t assume you don’t exercise if you let him or her know from the start that you walk for thirty minutes daily, for example.
• Ask the doctor if your problem can be caused by anything other than overweight and ask how these other things can be ruled out.
• Think of your doctor visit as an information gathering session.  You have control over what happens. You are seeking answers to your questions and you are screening the doctor to see if you would like having him or her on your team of professionals to help you manage your health.
• If you disagree with the doctor, respectfully say so. Then explain why you disagree. “I can see why you might think this but…..”
• If, despite your efforts to communicate respectfully, your doctor doesn’t respond in a way that makes you feel he or she will make a valuable member of your team, change doctors rather than avoid going to the doctor.  Your health depends on it.
• Make your needs known.  I referred my client to a doctor I know whom I thought would be sensitive to her needs.  Even so, I made sure to contact the doctor to tell her about the patient’s concerns and experience.  I even talked to the doctor’s nurse to make sure that she was sensitive also.  The appointment worked well and my client is happy with her new doctor.

Previously published in the St. Petersburg Times

Do you know a diet book junkie?  That’s a person who seems always to read
the latest diet books while making no apparent changes with respect to
weight, activity, eating, or other behaviors.
They seem to get a kind of high from espousing the wonders of their latest
discovery — “Well, in Dr. Skinny’s book, How to Get Thin and Rich in 24
Hours, it says drinking eight glasses of water before lunch doubles fat
burning!”
Maybe this sounds like you.  You get excited every time you buy a new diet
book, believing that its contents are going to somehow change your weight
and your life.  You remain excited throughout the book – each page seems to
make so much sense!  It’s so exhilarating, you can’t put it down. Some of
these books even have beautiful color pictures of healthful recipes that
you know will be great to eat and definitely produce the weight loss you’ve
been hoping for.
But eventually you get to the end of the book.  What now?
“Hey, I heard there’s a new Rocky Mountain Oysters Diet book out!” That’s
the ticket, you think – another diet book.  But, is it?
Not all books about weight loss have useful and accurate information. Some
are based on ineffective fad diets and gimmicks.  Even if the book is full
of sensible and effective methods, however, that doesn’t mean it will help
you. Only you can do that.
Lifestyle changes aren’t magically absorbed simply by reading a book. And
if, like a diet book junkie, you jump from book to book, expecting magic to
strike, it’s no wonder that your eating and weight problems don’t change.
Ineffective methods never work, but effective methods only work when you
use them.  The books are simply tools; and like a hammer or screwdriver,
they won’t fix anything if all you do is look at them.
Here are some suggestions on how to kick the diet book habit and get more
positive change in your life with respect to health and weight management:
1.      Become more selective about what you read. This means becoming a
better consumer of dieting information. If a weight loss book doesn’t
promise amazingly fast weight loss, doesn’t suggest you have to buy certain
products endorsed by the author, makes good logical sense, and teaches a
program that you can follow for the rest of your life, it’s a good place to
start. Skip those that are based on fads, prescribe a rigid diet plan,
instruct you to avoid the foods you like most, and say you don’t need to
exercise.
2.      Take your time savoring what you read. Stop and think, make notes,
highlight key points, and consider how the book’s suggestions can be
incorporated into your life.
3.      Don’t jump to another book immediately. Finish the book you’re
reading, and put it into practice.  Go back through the book focusing on
what you’ve highlighted and the notes you’ve made.  Follow through with the
suggestions that you would like to incorporate into your life.
4.      Continue using what works for you, and set aside whatever doesn’t fit
your life. If you feel you need more information, the next step may be
another book but, then again, it may not.  It may be trying a class,
searching for health information online, joining a group that does
something active (like hiking), or seeing a therapist for emotional issues
that have been too difficult to solve on your own.
Reading is generally a good habit to have.  However, if you’re reading a
book with the intent of having it help you change something in your life
you have to go beyond just reading it.  You have to use it.
Kick the diet book habit in favor of taking constructive action, and you’ll
notice real changes starting to happen.  Your library of diet books may
stop growing, but who cares?  Your body and mind will be getting fitter.
Isn’t that what you wanted in the first place?