Childhood Obesity News has been discussing the work of Drs. Connie Guttersen and
Mark Dedomenico, authors of The Love Diet. Their work has shown that no one can really overcome obesity until her or his underlying emotional problems are addressed, and in most cases the emotional problems revolve around the inability to love oneself.
They estimate that between 15% and 20% of overweight people are binge eaters, and that includes most who are classified as morbidly obese. Although the 20/20 Lifestyle Program does better than others, binge eaters are still the most challenging population segment, and there are even special groups for them within the program.
An old saying tells us “You can’t live on love,” but you certainly can’t live without it, either.
This is why 20/20 is so psychology-intensive. The object is to break the shame cycle so the patient can go on to develop self-acceptance, self-respect, and self-love.
A recommended strategy is the “act as if” method, known in some circles as “Fake it ’til you make it.” For instance, act as if you like to exercise. Patients are directed to “pretend, for the next two weeks, that you love yourself” and great things happen. Dr. Dedomenico says, “If we can just get people to like themselves, we’re halfway home to making them well.”
What does a self-loving person do? She or he practices mindful eating, which can mean any one of a number of things, like the plate-size trick mentioned yesterday. Mindfulness is an important concept here, in the sense of thinking about actions rather than doing them automatically.
One example is the evening habit of drifting to the kitchen to browse among the cabinets or refrigerator shelves, but it can be broken in about two weeks. Drs. Dedomenico and Guttersen also explain the roles of planning and tracking in overall mindfulness.
In the eyes of these obesity experts, the microbiome is a major player. It appears that when obesity and diabetes (and even depression and anxiety) run in a family, it is because particular microbes were either passed along or were missing from the inherited mix.
Because gut bacteria are anaerobic, they are hard to study in a laboratory. Although we don’t yet know exactly which bacteria need to be present or their optimal proportions, still it does seem evident that when the species are out of balance, the bowel can absorb as many as 180 extra calories each day, which adds up to a 15-pound weight gain per year.
The pathogenic bacteria inside us are known to produce endotoxins, so 20/20 patients are urged to drink at least 64 ounces of water per day to flush that stuff out. Of course, this is not a unique perspective, as there is probably not a nutritionist on earth who would deny the importance of adequate hydration. Even on the most basic mechanical level, a stomach full of water can delay hunger.
Get a move on
Motion is essential. Not every morbidly obese person can immediately jump into gym workouts. But everyone should be taking at least 5,000 steps per day, with the intention of working up to 10,000. Any step total less than 2,500 Dr. Dedomenico dismisses as “sedentary.” He recounts the frustration he felt in the early days of this 24-year journey, when a group of women in the program stalled out and stopped losing weight.
After extensive and careful questioning, he understood what was going on. The women had changed their lifestyles, but not necessarily for the better. In fact, they had managed to prove that working out can, ironically, have negative consequences.
What happened was, all the women hired outside help for the gardening and housework they used to do. Meanwhile, they went to the gym in the morning and then rested on their laurels, or on something else, for the remainder of the day. Some of them were down to 1,500 steps.
After that, Dr. Dedomenico made sure to put a pedometer on everyone.
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