Q: I have a patient who lost about 100-pounds over a two-year period, and kept it off for 9-years, at a stable 120 pounds. The reason she consulted me, is because she recently gained 25-lbs from emotional eating. (Consequently, she tried extreme dieting to lose the weight, but without success.)

I'm having her read your book, Intuitive Eating. But she is scared and really focused on losing weight. I'm not sure where to go with this (her current weight is considered "overweight"). Any thoughts from your experiences?

A. Focusing on an external number (weight) undermines the Intuitive Eating process, which is a process of inner attunement.

Given the history you describe, (a stable weight for 9 years with a recent increase from emotional eating)— it would be likely that your patient will normalize to a lower weight with Intuitive Eating.

Here's what I do with my patients in this type of situation. First, I ask these series of questions.

What do you think would happen to your body if you:

1. Consistently took care of yourself (adequate sleep, et.)?
2. Stopped binge eating?
3. Managed your stress?
4. Participated in physical activities that you enjoy?
5. Nourished it consistently?

In general, the response to those questions, is "my weight would be less". Yes, likely.

Then comes the tricky, tough part. It's important to have realistic expectations. So, I tell my patients the following:

"You don't get to pick when this will all come together. Your body needs to trust you—that it will be adequately and consistently fed (but every time you diet, this trust is broken and you need to start anew).

Lastly, you don't really get to pick exactly what weight your body will settle.

Instead, it's better to focus on how this process of taking care of your body feels (as it will help temper the urgency about weight loss)."

Keep in mind that it was your patient's reactive dieting, (in response to her binge eating and weight gain), that in part, created this problem. I say this not to blame, but rather to foster compassion and the patience, she will need, to achieve authentic health.

_____

Copyright © 2010 by Evelyn Tribole, MS, RD  Published at www.EvelynTribole.com

Rights to Reproduce: As long as you leave it unchanged, you don’t charge for it, and you include the entire copyright statement, you may reproduce this article. Please let us know you have used it by sending a website link or an electronic copy to Etribole@gmail.com.