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

It’s so frustrating to go on a diet and lose weight, only to regain it.
Frustrating, but common — studies show 90 percent of dieting attempts fail.
What can we do to improve our chances?
Despite overwhelming evidence that most diets fail, ever more people are
vulnerable to quick weight loss promises that won’t work in the long run.
Most of these people have histories of going on and off diets, over and
over again.
Diets may be one of the few things that intelligent people will keep trying
even after repeated failures.
What do the lucky 10 percent know about losing weight and keeping it off?
The problem is that people usually confuse weight loss with fat loss.
Actually, the faster the weight is lost, the more likely it is that the
weight lost is water or muscle, not fat. A lot of research has been done
showing that fad diets show particularly dismal results.
But it’s fat that people want to lose and they want to lose it for good —
not to gain it all back and have to start dieting all over again.
So don’t just go on yet another diet. First, stop and think.

•••

If you have a long history of on-and-off dieting it’s time to face the fact
that what you’ve been doing doesn’t work.
Maybe you’ve tried a bunch of diets with different names, like the Low Carb
Diet, the Blood Type Diet, the Grapefruit Diet. But consider what was
similar about them. Did they eliminate particular foods completely? Did
they emphasize fast weight loss? Did they not include exercise?
If you are a first time dieter, learn through the experience of others
rather than following them down the road of fad diets that don’t yield
lasting results.
Preparing yourself psychologically in this way will keep you on the right
track to successful weight loss and maintenance, not just this summer but
every summer from here on out.

•••

If you want this next weight loss attempt to be your final effort because
it actually worked, try these tips:
1. Focus on the behaviors (portion control, increased activity, better
nutrition) that help you lose fat, rather than achieving a weight goal
number.
2. Make sure that you include consistent aerobic exercise in your plan.
3. Don’t set a time limit for your goal. Instead, keep your mind focused on
the forest (the rest of your life) instead of the trees (an upcoming
wedding or bathing suit season).
4. Don’t go on a rigid, stringent, fad diet of any kind. If it sounds
depriving, you need to consider something else.
5. Make sure that the eating and exercise plan you go on is one that you
can follow for the rest of your life. For example, are you really going to
be able to keep buying expensive food through the mail?
6.      Your body has genetic limits. You don’t know if your body will be
able to reach the ultimate weight goal you have in mind. Instead, keep
doing what will make you leaner and healthier and let your body take care
of the weight. It will show you what its best weight is.
7.      Take time to keep your fridge stocked with easy to prepare,
nutritious alternatives.  Get rid of those foods that don’t fit a healthy
lifestyle and fill the fridge with luscious, colorful, fresh foods.  It may
require a stop at the grocery store more often but fresh food actually
requires less cooking — or even no cooking — which saves time in the end.
8. Reinforce, compliment, and pat yourself on the back often.  Stop the
criticism and judgment altogether.  The psychology of weight management is
a key factor that is usually ignored.  If you don’t do the right things
emotionally, psychological barriers will continue to get in your way.
You don’t want to put all that effort into losing weight only to regain it
and more. Let’s do it differently this time.

Previously published in the St. Petersburg Times

None of us can be truly objective about our appearance. We we can only
perceive ourselves from within, while other people view us from outside.
Even our mirror image is distorted — it’s not how others see us.
But some people, often those with eating disorders, distort their body
image to an abnormal extent. A person with anorexia or bulimia often
perceives her body size as significantly larger than it really is.
Insisting you are fat when others see that you are emaciated is one of the
classic signs of an eating disorder.
And when the patient’s self-image becomes more accurate, that’s a sign of
recovery. This change happens through the course of therapy and starts with
acceptance of the problem.
But how does a person with an eating disorder start understanding that they
have a distorted view of their body, and that distortion is hurting them?
It starts with the individual’s recognition that the eating disorder has
not given them the happiness and perfection that they were seeking but,
instead, has brought them tremendous pain and suffering. That’s when it’s
possible to face the fact that other people’s perceptions are more accurate
than their own, at least when it comes to body size.
What are signs of a significant body image distortion?
1.      No matter how much weight you lose, you still think your body is too
big.
2.      People describe your size in a significantly different way than you
do.
3.      It’s hard for you to accept compliments about your appearance.
4.      You feel fatter on days when you’re upset and thinner on days when
your mood is good.
5.      You feel significantly heavier or lighter from one day to the next.
6.      You react to adversity by suddenly feeling fat or unattractive.
You don’t have to have a full-blown eating disorder to have body image
problems. Many women and even some men let their focus on their bodies get
in way of living.
It’s also true that there are plenty of people of all sizes and shapes who
never let what they look like get in their way. They may be perfectly aware
that they don’t meet society’s definition of beauty. They just know that
life is too short to worry about not having a perfect body.
Who do you know that worries incessantly about their body image and is also
truly happy and fulfilled? Just like you can’t be both anxious and relaxed
at the same time, you can’t enjoy life when you’re hiding away from the
world, fearful of exposing your imperfect body.
As with any problem, to make positive changes in body image what you need
most are the desire and the determination to change.
Sometimes it takes working on self-acceptance and understanding that having
a fulfilling life is more important than meeting social expectations.
Some people may need a little support from a counselor to start viewing
themselves more realistically and rationally.  Other people may need
intensive psychotherapy.
The point is, it’s possible to change how we see ourselves so that we don’t
let our body image get in the way of life and all the wonderful things it
has to offer.

Previously published in the St. Petersburg Times

Stress is everywhere, and chronic stress is known to be harmful not only to
our emotional health, but also to our physical health. It can affect the
immune system (making us sick more often), the heart (causing high blood
pressure and other heart problems), and muscles (causing problems with
neck, shoulder, and low-back pain), to name just a few concerns.
It can also be linked to overeating, and so contributes to obesity.
Stress eating is a common problem in our fast-paced world, although many
people believe they are alone when it comes to this issue.  In reality,
most people have a tendency to overeat when moderately stressed.  That can
make controlling food portions particularly difficult.
There may be physiological reasons why we tend to eat more and eat certain
types of foods when we are under chronic stress.  For example, research
suggests that certain brain functions linked to chronic stress compel us to
eat. Stress can also compel us to eat faster, potentially increasing the
amount we eat even more.
The types of foods we’re more likely to reach for at times of stress are
the sugary and starchy favorites we might call “comfort foods.’’ These have
properties that affect the brain in soothing ways, making us feel better
and reinforcing eating when we are under stress. So you see — you’re not
alone. It’s just how our bodies are wired to deal with chronic stress.
It’s essential to identify whether stress is driving your overeating. If
you try to control portions with tricks like using smaller plates, but
don’t address the real reason for overeating, such tricks won’t help.
Here’s a quiz to help you decide if it’s stress that’s eating you:
• Do you get irritated over minor things?
• Do you often feel anxious, jittery, and “hyper.”
• Do people get on your nerves often?
• Is it difficult to control your temper.
• Is it hard to focus on and remember things?
• Are you constantly worrying and  thinking about the next thing you have
to do?
If you see yourself in these signs of stress and are having problems with
portion control, there may be a link. We can’t eliminate stress from our
lives but we can learn to manage it.
Here are some tips for reducing stress and portions:
•       Take deep breaths throughout the day, especially before eating.
•       Slow down eating by savoring your food.  Focus on the sight, smell,
and taste of your meal before swallowing it.
•       Try to be mindful if you find yourself feeling “hyper” and
purposefully slow down your movements and actions.  You’ll find that you’ll
still get plenty done.
•       Look at the big picture. Remind yourself of what’s really important
in your life.  Perhaps what you’re worrying about really isn’t as important
as you think.
•       Remind yourself of what chronic stress can do to your health.
•       Manage hunger by eating sensible meals on a regular schedule. Being
hungry just adds to any other stress you’re carrying around and causes more
overeating.
•       Watch the servings. A brain under stress thinks it needs more food
than the body really demands. So, if stressed, serve less than your brain
is telling you.  Wait 20 minutes after having eaten slowly. If you’re still
hungry, have a little more and savor that, too.
• Exercise has repeatedly been shown not only to be a great fat-burner but
also a highly effective stress buster and appetite reducer. Make the time
to use this powerful health tool.
• Do something relaxing every day. Sit outside, meditate, practice yoga,
play – do anything that makes you feel at peace, comfortable, and focused
on the present moment.
Take a deep breath, address the stress in your life, and start on the road
to a healthier lifestyle and natural portion control.

Previously published in the St. Petersburg Times

Many people believe that stigmatizing overweight people will motivate them
to engage in healthy behaviors. But, as we discussed last time in Personal
Best, much of the data about weight bias suggests that this type of
prejudice actually makes people more likely to eat poorly, avoid exercise,
and suffer from depression and poor self esteem that makes it even harder
to lose weight.
So, what’s going on in the head of an overweight person who is the target
of bias?
After years of counseling people with weight management issues, and
studying the medical literature on the subject, I can tell you that I hear
similar experiences echoed over and over.
“I don’t remember a time when I wasn’t overweight,’’ is a common refrain.
Patients tell me that like all children, they depended on their parents for
their meals, and often, their parents didn’t know much about nutrition.
Not that my patients blame their parents — to the contrary, many have happy
memories of being surrounded by people who loved them.
Nor were they necessarily couch potatoes as kids. Many describe being
active, yet still gaining weight.
And then they entered school and the teasing began.
They were called names, laughed at, and were the target of cruel tricks —
all due to their size.
“I believed I was worthless because I was fat,’’ is a common sentiment.
Obesity got in the way of everyday life, turning simple things into
nightmares. How does an obese teen get into the back seat of a two-door
car?
A Friday night with friends turned into the fear that movie theater seats
wouldn’t be big enough. Or worse yet, what if the overweight person’s body
spilled over to the next seat and crowded whomever had the misfortune to
have to sit there?
“Some people would simply avoid sitting next to me because of my size,’’
one patient told me. “I didn’t blame them.  At least they could get away
from me but I couldn’t.’’
Forget about flying. When you’re obese, getting on an airplane just means
looking at expressions of disgust from fellow passengers praying they won’t
have to sit next to you. Asking the attendant for a seatbelt extender is
another misery, to say nothing of how physically painful it is to sit for
hours in a space so small, you cannot move.
Little wonder so many of my overweight patients don’t want to leave the
house.
Most people tell me they’ve tried all their lives to lose weight. They’ve
tried plans offering fast, huge weight losses, but they’ve never been
successful and assumed it was all their fault.
Same for exercising outdoors. Between the discomfort of moving a heavy body
in the heat, and the misery of enduring comments from passersby, the
feelings of humiliation and failure are too overwhelming to continue.
Most of the people I talk to are not looking for pity or making excuses.
They genuinely want to lose weight and take responsibility for their
health.  But they’ve bought into how society views them, and have feelings
of worthlessness and depression that do nothing to help them take
constructive action.
What’s the way out?
The people whom I see succeed are those who can summon the strength to
realize that even if their efforts to assume new, healthy habits are not
immediately apparent to outsiders, their actions do matter. And if they
continue eating healthfully and moving as much as they are able, results
will show.
More importantly, they understand that they do not have to share society’s
negative views of them. People who succeed give themselves the respect and
compassion they need, even when they can’t get it from others.

To learn more about common misconceptions on weight and what research
really shows, check out the Obesity Panacea blog at
http://tinyurl.com/4uyj5zr

Previously published in the St. Petersburg Times

It’s good to learn from our mistakes.  The more we pay attention to what
we’ve done wrong in the past the more successful we’ll be in the future.
This is certainly true when it comes to weight loss and fitness.  And, for
some reason, when it comes to dealing with weight, many people put their
blinders on and don’t look back to see what they’ve done wrong. This only
leads to a seemingly endless cycle of failures.  It’s no wonder most
dieters are frustrated, anxious, and often hungry.
I believe people ought to try to become better consumers of dieting
information just as they try to be careful when it comes to buying
electronics, baby car seats or hair straighteners.  In 2011, wouldn’t it be
nice to stop being frustrated and confused by all the weight loss diets and
products that are thrown at you daily?
With this in mind, I have put together a list of the Top 10 dieting
mistakes I see people make over and over again. If you notice that any of
them apply to you, try to focus on correcting these barriers to your
fitness, and see what kind of progress you can make.
1.      Looking for quick fixes through fad diets. The mind tends to resist
when it feels deprived, and the result is loss of control over food.  The
body needs the right nutrition to function well, and without it,
fat-burning can slow down so that you hang on to fat instead of releasing
it. Quick test: If you can’t picture yourself following the plan for a
lifetime, don’t bother for even a few weeks.
2.      No regular exercise. The people who are most successful with weight
and fitness tend to be active on a regular basis, yet most dieters don’t
take advantage of this wonderful tool.
3.      Undereating. The body has a wonderful ability to slow down its
metabolism when it’s not getting enough fuel to function.  Undereating
means losing fat more slowly, and when normal eating resumes, putting it
back on faster.
4.      Skipping meals. Going without food for too long can result in
overeating due to ravenous hunger and a slower metabolism.  Consider
smaller portions, four or five times a day.
5.      Drinking too many calories and not drinking enough water. Liquid
calories count just as much as the solid variety, only they don’t satisfy
you. On the other hand, not drinking enough water can lead to thirst that
can be confused for hunger.  But being hydrated helps the body perform all
its tasks more efficiently — including fat burning.
6.      Getting too hungry. If you want to control your food intake properly,
a good trick is to not allow hunger to go beyond a “3” on a scale from 0 to
5 (0=no hunger, 5=ravenous).
7.      Eating late at night. At night our body starts to slow down,
readying itself for sleep. Metabolism slows and any calories eaten are more
likely to be stored as fat.  Try to eat your last meal by 6 p.m.  If you
get hungry later it probably means you didn’t eat enough during the day.
Pay attention to hunger at night by eating a light snack but then focus on
eating properly the next day to avoid late night hunger.
8.      Not eating breakfast. After many hours without food the body is
ready to be fed and start burning.  Not eating breakfast keeps metabolism
low, which is why numerous studies show the most successful dieters don’t
skip this meal.  If you think you can’t eat in the morning, start with
small quantities and slowly increase your intake until you are eating an
adequate amount.
9.      Over-focusing on weight and food. This kind of preoccupation with
food can increase cravings to eat. So put the focus where it counts – on
the behaviors of increasing quality of eating and activity level.
10.     Thinking negatively. Judging yourself harshly is self-defeating. Not
only does it affect motivation, but it increases stress levels, leading to
overeating. Instead, pat yourself on the back for every small step forward.

Previously published in the St. Petersburg Times

Millions of Americans dream of the perfect diet pill.  They want something
that will burn fat with no effort, has no side effects, and will keep fat
away for life.
Many drugs have been marketed as diet wonders. But in every case, not only
did the drugs fail to be the panacea expected, they also produced side
effects such as depression, heart attacks, strokes, addiction, and even
death.  Some effects were serious enough to warrant removal of the drugs
from the market.
This year, a new diet drug, Qnexa, has been undergoing FDA review and in
July, an FDA panel voted against recommending approval citing concerns over
side effects.
Most people who use diet drugs have little understanding about their
effectiveness and side effects.  At the same time, they believe that if a
drug has been approved by the FDA it means it’s safe and effective.  But
how many drugs have been pulled off the shelves after the FDA has approved
them?  It’s important to understand that all drugs have side effects, that
FDA approval is not a guarantee of safety, and that the history of diet
drugs has not been good.
Research shows that, on average, people lose no more than 5-10 percent of
their weight while taking diet pills and this is if they are taken in
conjunction with “healthy diet and exercise.” Yet, millions of Americans,
even ones who are not obese, turn to diet pills to lose weight.  In most
cases, these are people who have turned to diet pills in the past, but have
regained their lost weight.  These yo-yo dieters unrealistically believe
that the next, new diet pill will be the one that works.
Most studies also show that even if the medications initially seem to
produce modest weight loss, in time they lose their effectiveness. And lost
weight is usually regained when the medications are discontinued.
Patients are supposed to be told that it’s extremely important to learn
good eating and exercise habits while taking diet pills.  Here lies the
real problem and it’s psychological in nature.
Humans have an uncanny ability to deny that anything bad could happen to
them. They can easily fool themselves into thinking that they will not be
the ones to experience negative consequences of diet drugs.
So, if you’re not concerned about the health risks of diet pills, then
consider this:
Diet pills are more likely to get you what you don’t want (weight gain)
rather than what you want (weight loss) because they:
•       Give a false sense of security. People depend on diet pills to take
care of the entire problem, and then believe — despite all evidence — they
won’t regain the weight.
•       Waste time. Most people on diet pills put little, if any, effort into
changing the lifestyle factors that made them heavy in the first place.
Before long, you’ve gone back to the old ways and regained the weight.
•       Benefit the wrong people. Even if the drugs don’t work in the
long-term, pharmaceutical companies still make a great deal of money,
especially if customers keep losing and regaining.
Diet pills have a limited effect on weight, they have no effect on behavior
change, they have poor long-term effects, and they psychologically
encourage people to think short-term.
Research results shows that  gradual lifestyle changes result in far better
results than diet pills.  It’s time to recognize the problems with diet
pills and give up waiting for the next panacea.

Originally published in St. Petersburg Times 9-25-10