Relax--relapse is part of recovery

A lot of my clients are addicts with serious addictions. I've noticed that they all relapse at some point, some more than others. Even the clients who have been sober the entire time I've worked with them and who I view as very stable, went through phases of relapse after relapse. This article confirmed what I have been telling my clients for a while. Don't get so down on yourself about a relapse; it is part of the recovery process.

What is most important is to learn from the relapse and to catch it as soon as you can. Because you relapsed the one time, doesn't make it okay to go on a bender! Ask yourself questions about it: what led to the relapse; did I try all of my coping skills first in order to avoid relapsing; what was I telling myself in the moment I decided to relapse. The answers to these questions will help the next time you are faced with a similar situation.

I am using the words addiction and relapse, and many of you may be feeling like this doesn't apply to you, however, we all struggle with things that we wish we could have more control over. This could be smoking, eating too many fatty foods, or avoiding exercising. It's up to you how you want to see these issues and if you are ready to make permanent changes.

Mindful Eating

This is a great article on increasing mindfulness when eating. Well, it introduces the idea of being more aware when eating, although it doesn't actually give suggestions on how to do it. We do seem, as a culture, to promote disconnecting our minds and our bodies. Everywhere we see commercials, billboards, and people we know multitasking rather than tuning in to what we're doing. Especially when we are eating. If we enjoy food so much, why don't we pay more attention to it? So rather than focusing on work or the TV during meals, try enjoying and tasting the food. You might notice yourself getting full.

The article also has suggestions for how to make food last longer in our systems, such as eating more fiber, protein, and fat. It is actually possible you could eat more than you think you should; you just have to know what to add to the meal. When reading the article, try to ignore the suggestions for other articles to read that they sneak into the middle of the article you're reading. This tends to take away from the initial message they are sending.

Fatty Food = Cocaine

Interesting article. It would be rather challenging to treat compulsive eating as an addiction, though, since we have to eat to survive. A person can cut out alcohol much more easily than food. I guess it goes back to trying to be responsible in our choices. When you are an alcoholic and go out to eat, you can't order a drink. Perhaps when you go out to eat and you know you cannot stop eating the mac and cheese once you start, you have to order something different.

Improve Self Esteem and Mood in 5 Minutes

I came across an interesting article in Psychology Today: http://www.psychologytoday.com/blog/the-science-willpower/201005/stepping-outdoors-boosts-mood-self-esteem. This study finds that people are benefited by just 5 minutes a day of outdoor activity. The study also claims that the benefits decline when increasing the amount of time spent on and intensity level of the activity. Apparently the purpose of the study was not to measure physical health but to focus on mental health instead.

There are some good points to be taken away from this, however. If you are a person who feels like there's little point in exercising if you can't fit in a full hour, it may be time to reconsider your approach. Even 5 minutes will help you feel better about yourself. When I have been talking to people lately about body image, overeating, and exercise, I have been noticing how often the concept of needing to "fix" a "problem" is brought up. We tend to view our weight gain or food issues as a huge imposition on our lives and our happiness. It quickly becomes overwhelming and frustrating to think every day about all the "shoulds" and "should nots" or the "good" and "bad" choices we make.

If you are making changes in your life, start slowly and define small goals. I think we all have experienced how the "all or nothing" approach works in our lives: "I ate that donut this morning, so I might as well just have McDonald's for lunch and start over tomorrow" or "I didn't work out on Monday or Tuesday, so I'll start fresh next week and work out 5 days in a row." Instead, try to think about it as having a new chance every moment to make choices that epitomize what helps you feel good and support who you want to be. So exercise for those 5 minutes and eat that donut, and maybe you will exercise for another 5 minutes later today and have a salad for dinner.

Post Traumatic Body Image Disorder

I have been thinking about the barrage of "perfect" images, ideas of what we "should" look like, eat, drink, do that are constantly shoved in our faces daily. We're all suffering from the impossibility of living an ideal that no one actually embodies. What would we tell our dog or cat if he wanted to look like a wolf or a tiger? "You're perfect the way you are; it's not possible for you to be that." Well, it's not possible for me to look like a model. I will never grow 5 inches and lose 20 pounds (which, by the way, would be really unhealthy). It's not even possible for most models to look like their pictures. It's all airbrushing and makeup.

It is possible, however, for me to be happier, more self confident, and more self satisfied than any model. How do I do this? By accepting myself, as I am, in this moment, and doing things in my life that are true to who I am and want to be. This is not easy, but there is good news. In each new moment, we have another chance to try again.

Coping With Those Bad Days

The last few weeks were rather rough for me, and I have been wondering what was different that caused them to feel so challenging? What could have helped me to get through the day? I think a big part of it was the level of perceived support from others in my life was lower than what I normally feel.

I could probably have remedied the situation by simply asking for more support. Most of the time, the people who love us are perfectly willing to be there if we tell them we honestly need them to be. They cannot read our minds, though, and it actually shows a lot of strength and humility to know when we need help and to ask for it.

There are times when a friend is not available, so it is also good to have some back up ideas for when it is only up to you. The following article has some suggestions for simple methods of improving one's mood: http://health.yahoo.com/experts/drmao/6715/going-up-7-pointers-to-lift-a-bad-mood/. You may have some similar skills that already work for you. The trick is to make them readily accessible for those days when you are sitting at your desk about to cry!

Waist to Height Ratio vs BMI

If anyone has ever calculated her BMI, which only takes into account one's height and weight, it may have been frustrating that the BMI ignores gender and muscle mass. These factors make a huge difference in a person's perceived health. I'm sure we've all seen some female trainers at the gym who look rather thick because they are SOLID MUSCLE! If we look at these women's BMIs, they may border on the obese categorization, which is ridiculous.

Review this article about the Waist to Height Ratio: http://www.livestrong.com/article/93638-whtr-the-new-determinant-health-risk/. This hopefully will replace the BMI, as it more accurately calculates a person's health. Apparently the most dangerous area to carry one's weight is in the waist, which is why this measurement is more useful. This is unfortunate for those of us who happen to gain weight first in the waist region ("No I'm not pregnant; I just look like it when I gain weight!"). There is some wiggle room, though. There are more categorizations, such as basically 3 ranges of healthy weights, one for underweight, and 3 ranges for overweight. This at least feels better to look at than the BMI chart, in which one is either healthy or one of 3 labels for overweight.

Food Cravings

I thought I would share this blog post from Dr Judith Beck regarding what to do when food cravings surface:

"This past week, I met Jon socially, at a party. We had known each other slightly. He told me he had read my cognitive therapy books on dieting and wanted me to know which technique had helped him the most. It had been emailing his "diet buddy," when he was tempted to eat something he wasn't supposed to. With his permission, I cut and pasted below an old email he forwarded to me.

Okay, I really want to eat the pizza in the kitchen. Everyone (okay, not everyone) in the office is having some but I already had lunch. My sabotaging thoughts are back....It'll be okay. I'll make up for it later.
But I really know it's NOT okay. Not if my goal is to lose weight. I don't want to fall back in to the habit of eating extra food just because it's there. It's what I used to do.

Hey, it happened again. The craving went away as I was typing this email. I'm actually fine. I feel like...it'd be nice to eat the pizza. But I know I won't. Back to work.

It was important for Jon to email his diet buddy like this. After doing so about ten times in a row (over the course of several days), he really learned that cravings do go away. He doesn't have to eat. Now he doesn't need to email his diet buddy very often, either. He knows that telling himself, "No choice. I'm not eating this [food] I hadn't planned" and engaging in a compelling activity makes his cravings go away, every time."

I think we often have people that we ask for permission from when it comes to skipping a workout we know we really want to do or eating something we probably will regret. Perhaps we can start forging relationships with people who will support us in our healthier efforts and encourage us to avoid those donuts in the lunchroom, as opposed to saying "go for it, it's okay, you ate healthy yesterday."

Happy Cinco de Mayo!

There's not much I love more than Mexican food, so the idea of a day established to celebrate that culture and cuisine, sounds awesome to me. Then the questions arises, if I go out tonight, how do I make it an experience I do not regret tomorrow? Avoiding margaritas and chips with salsa is not an option, I'm sorry.

I was reading the Biggest Loser website last night on how to survive eating out at restaurants. I was dismayed when they suggested avoiding the chips and basically any tortillas. Their solution for everything seems to be "make it into a salad." They even recommended avoiding guacamole! Again, not an option for me. And avocado is so good for you!

I do not have any magic solutions, but I do have some tips. I have not decided yet if I will follow these because Cinco de Mayo is only once a year, after all. However, it is easy to justify a reason to overdo it any day of the week, I've found. I need to mentally prepare myself for it being my sole responsbility to moderate myself. My husband seems to have an innate ability to be moderate with food, and on the off chance that he is not on this particular day, it will not have the least affect on his waistline or self esteem.

First of all, decide prior to going, whether it will be a one or two margarita kind of night. It is much easier to order a second after the first one has already made it's way through your brain. Deciding ahead of time can take the responsibility off your somewhat-alcohol-muddled mind. If they automatically bring out chips, decide how many you will eat and put them on your plate. It is too easy to mindlessly go back to the basket chip after chip. While you're eating them, try to pay attention to the taste and the enjoyment they give. Take breaks between the chips, sip your drink, breathe deeply. Check in with yourself a few times while eating. Are you breathing at a normal rate? Are you scarfing or savoring the food?

When you get your entree, it may be a good idea to put half of it in a to-go box right away. Chances are, you're not starving by this point because of the chips and margarita. You could save this food for lunch tomorrow or even a snack later. It is better to split up meals into smaller portions as opposed to gorging yourself. When I am eating Mexican food, I try to avoid eating every last piece of tortilla and if there's a side of rice, I usually avoid it. At least in my opinion, the cheesy beans, guacamole, and salsa are the best parts. Decide for yourself, what are your priority foods and how do you best enjoy them? Have fun!

The Dreaded Yearly Check Up

I am not sure why I view it with such trepidation - I've never had a particularly bad experience or menacing news from my doctor- but I still would prefer to not go. The visit always involves something uncomfortable and violating, which we are taught to view as necessary to monitor our health...and I am not just talking about the physical part of the exam.

The first step in the appointment is to get weighed. No comments are made about my weight...it is jotted down quickly and we move on to get my height. Yes, I am still short. That has not changed in the last year. My blood pressure and temperature are measured, and I appreciate that the nurse tells me what these are and that they are normal.

When the doctor finally comes in she asks me how I have been eating, drinking, and exercising, even though I already wrote these pieces of information on the yearly update form when I first arrived. I do not know if I am projecting, but I get the impression that my doctor is hoping I have no concerns and that I just say I'm being healthy. Don't get me wrong, I like my doctor. She doesn't pry too much and is matter of fact about what she does. It is possible that some people feel more able to tell their doctors when something is concerning or that they need help with their eating or exercising. I do not, however, feel that able to share this with someone who I see once a year and I know is in a hurry to get to her next patient.

I thought about this and realize that for a lot of people the primary care doctor is the only regular access to someone who may be able to help in this area. That is what your doctor is there for! So forget about the other patients that may be waiting and look out for yourself. Ask for a referral to someone who may be more able to spend the time with you or ask your doctor what she knows. My visit next year may be longer, but at least I will have more control in what occurs.

Feel Better About Yourself Today!

I think we often use food and exercise to punish or reward ourselves. Self deprecation may be the way we connect socially with people. Neither of these practices serves to improve one's often fragile self confidence. In the following article is featured a list of methods for bettering your self image. http://shine.yahoo.com/event/makeover/simple-non-cheesy-ways-to-make-over-your-self-image-1335396/

A lot of the techniques I have suggested to clients before and they have reported to me that they help. I had a client that swears by affirmations, but you have to say it to yourself several times a day, and say it like you mean it, even if you're not yet convinced that it will work. Every time you catch yourself indulging in negative self talk, try one of the skills listed in the article to counteract the ways you put yourself down. Don't put it off until a better day, start now!

Skinny Chicks

I often read books about fitness and nutrition because there is usually something of value I can pull from them. One of the books I have enjoyed (but also wanted to throw across the room a few times) is called "The Secrets of Skinny Chicks: How to Feel Great in Your Jeans- When It Doesn't Come Naturally." The book profiles the diets and workout plans for several women who are very thin and work very hard at it.

What I like is that it stresses that even women who are very thin treat themselves to glasses of wine and chocolate; they just factor it into their daily calorie count. It is also interesting to see that women to whom we may think being skinny comes so naturally, well, in reality, it may not. The women in this book work quite hard at remaining thin.

That said, it is a frustrating book as well. Most women are not going to have the time to devote 4 hours a day to working out. It also often is not the best choice to subsist off 1200 calories a day. What I pull from this is that I need to make a choice about what it most important to me.

Do I want to avoid my favorite foods most of the time and spend most of my free time working out? No. I do not. I enjoy food and socializing outside of the gym too much. When I feel bad about myself, I try to remind myself of this choice and be satisfied with how I choose to live my life.

Eating Disordered Behaviors

I found a study on cnn.com about eating disorders. The article explains that, because of the strict criteria required to give a person an eating disorder diagnosis, many insurance companies will not pay for the treatment a person may need. Many people may not meet the actual criteria for an eating disorder, but that doesn't mean that a person's relationship with food isn't harmful.

Severely restricting fat and protein intake is unhealthy. If you have irritability, dry skin, fatigue, dull and brittle hair and nails, digestive complaints, and an inability to lose weight, you may be suffering from essential fat deficiency. Add some avocado, nuts, seeds, salmon, or other healthy fats to your diet! Protein deficiency is indicated by fatigue, difficulty building muscle, loss of hair, and mood swings.

Chronic dieting can also be very stressful for one's body. One may notice difficulty losing weight despite low calorie intake and frequent exercise. Sometimes the body holds onto fat stores and slows the building of muscle when calorie intake is not high enough. One may also have vitamin deficiencies and brain chemistry imbalances. If you have trouble allowing yourself to eat more, you may benefit from a counseling relationship to help you work through this resistance.

Fight depression: Every day tips

This is a pretty good article I came across today at www.health.com: "10 No-Cost Strategies to Fight Depression." It details a few simples steps to take that may help diminish mild depression. One of the tips is to maintain a routine. I know that if I have a few extra days off or I'm home sick, it seems so much more difficult to go back to my regular work and exercise routine. Of course one needs to take care of herself when sick, but sometimes forcing myself out of bed in the morning and going about my day as if I'm feeling 100 percent can lead to me actually feeling happier and more like myself.

Exercising is another good tip. I would add that it helps to find exercise that you truly enjoy. I know that it can be hard to get myself to work out sometimes, but just getting changed into my workout clothes is often the most difficult step. Once I'm changed and ready to go, I do it and I feel so good (most of the time). Afterwards I feel great. If I dreaded every workout and hated it throughout the entire session, it would be so much more difficult to continue to do it! Look into yoga classes, dance classes, walking with a friend, doing push ups while you watch TV...anything that you might actually keep up with and enjoy.

Eating at the Speed of Boring

I have known for a while that I am a fast eater and that it is so much healthier to eat slowly. Eating quickly leads to a stress response, which limits oxygen intake and inhibits proper digestion. Because of this knowledge, I am consciously attempting to eat more slowly.

If I am mindful and aware of my food, even when I'm trying to eat slowly, I find that I am still finishing my meal quickly. Perhaps it is because I am enjoying it so much I want to focus on just eating? I can employ tricks to force myself to eat more slowly such as chewing my food so many times or putting my fork down between bites. This ends up leading to boredom with my meal and that isn't good either, as I am not getting my required amount of pleasure from the food.

So I have been playing with different ways to maintain that awareness, pleasure, and slowness of my meals, but every person is different and different techniques may work better for each of you. For me, I am noticing that if I keep in mind the word "savor," I accomplish my food goals more easily. If I savor that food, I am fixated on the enjoyment of the taste and wanting to make it last. I would be interested in others' solutions.

Breathing for Anxiety Relief and Weight Loss

The article "Breathe Through It" in Women's Health Magazine outlines the benefits from regular, deep breaths. It may seem simple, but there are some specific techniques that can be easily learned and used for, among other things, weight loss and anxiety. So when you're in a particularly anxiety-inducing situation, don't forget to breathe! It signals to the brain that you're breathing normally, therefore, there's no need to be in a "fight or flight" response. It's important to breath regularly and deeply while you're eating as well. If we hold our breath as we shovel the food in, a stress response is triggered and our bodies stop digesting our food properly. This can lead to digestive troubles such as heartburn and stomach aches, as well as food being stored as fat in our bodies.

Chronic Dieting

I came across another article today that caught my eye. It is featured in Women's Health magazine: "Losing Weight Help: Why Fat Comes Back." Many people trying to lose weight seem to restrict their diets severely and force themselves into very strenuous exercise patterns that very few people will ever be able to maintain. This may work in the short term, but then when the dieting period is over, the weight may come right back. This article has some good points in it in regards to this issue.

Some important things to remember: eating less often leads to the body maintaing stores of fat. Our bodies have not evolved in all the ways we may think it should have. In the past, humans went through periods of not being able to find sufficient supplies of food. Our bodies react to this by storing up the fat we have existing on our bodies and burning off muscle for energy. If you are eating too little, you might have a more difficult time maintaining muscle and burning fat. Skipping meals is also dangerous. Always start out your day with breakfast to get your metabolism going. Again, skipping a meal, particularly at the beginning of the day, can trigger the body to go into "starvation mode" and hold onto your fat. If you cannot manage several small meals throughout the day, aim for your biggest meal to be around midday. This is when the body is in it's peak calorie burning time.

If you do decide you need to lose weight, try to listen to your body. If you are craving something, eat it. Maybe you need some nutrient in that food. Otherwise, you're wasting energy stressing about those "bad" foods. Try to find a diet and exercise plan you can maintain, otherwise the weight will always come right back.

"No Fat" Clothes?

I was looking at cnn.com this morning and noticed a link to an article promising how to "Look thinner in 'no fat' clothing!"Please peruse: http://www.cnn.com/2010/LIVING/homestyle/03/31/never.look.fat.again/index.html?hpt=C2
I was naturally curious, as I believe many women would be. In general, I understand the idea. Perhaps if women (or men) knew how to dress in ways that best flatter their bodies, they would feel better about themselves in general. I support that idea, however, I also wonder if this is just perpetuating the idea that women should look a certain way. The article promotes the idea that "fat is bad" and "if you are fat and go out in the world looking fat, you offend people."

Shows like TLC's "What Not to Wear" seem to put a more positive light on what they do. In this show, a woman's friends and family nominate her as someone who could use help in the fashion area. It begins in a rather humiliating way with the nominators and the nominee watching secret film footage of the nominee. Then the hosts throw away all of this woman's existing wardrobe. The show does, however, have a message that leads to more confident women. A woman may be a great person on the inside, but if she dresses with the purpose of just covering herself up instead of celebrating who she is as a woman, it leads to someone who is self-conscious about her appearance. I think the "no fat" clothes are attempting to do what the TLC show does, but they do not pull it off in the most uplifting way.