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Healthy Weight



1. The High Achiever who has lost and regained weight feels a deep sense of personal failure. This personal shame INCREASES the emotional attachment to food.

2. The High Achiever’s goal orientation and responsibility to others makes it difficult to prioritize one’s own health.

3. The High Achiever who intellectualizes emotion will feel vulnerable when he/she stops using food to cope with it.


–Dr. Tricia


Clare had a high-octane lifestyle. She was extremely busy trying to juggle the demands of her family and career while also coordinating care for her mother-in-law.
Clare came to me after years of yo-yo dieting. She had lost and gained 40-70 pounds several times. She commented that she remembered being “chubby” as a kid. Clare began to worry about her body at age 9 and started her first diet by age 12. I warned her that this would not be a quick fix approach. She said “let’s be honest. I know what to do. I know every diet strategy in the book. If knowledge were the problem, I wouldn’t be here.”
First, Clare and I looked at her stress level and her schedule. Most people who want to lose weight assume that they will begin the process as they always have--with food modification and exercise. The most crucial factors are actually stress levels and scheduling considerations. These aspects lay the foundation for success. Most people who emotionally over-eat do so in times of higher stress. While it is necessary to learn additional ways of coping, attempting to decrease yo-yo dieting without lowering accompanying stress becomes an uphill battle. The strategy of scheduling self-care (i.e., time to exercise, regroup, and have healthy food available) needs to be consistent enough for change to occur and flexible enough to adjust to daily challenges. This segment of change required Clare to learn how to disappoint others, do less than 100%, and set clear boundaries in order to make space for a healthier lifestyle. While we addressed the stress and scheduling variables, I asked Clare to begin adding healthy food into her diet. She tended to skimp on vegetables, so we discussed which ones she liked and fast options for preparing them. This strategy helped to shift her out of the dieting mentality, which is always deprivation focused “what can I eat, what can’t I eat.” Focusing on getting nutrition helps a person to shift into a health focus rather than a weight-loss focus. Further, the strategy of adding more nutritious foods first changes the ratio of space available in one’s tummy for “junk” food. The biggest challenge to Clare’s success was her ongoing self-loathing. For every client, shame has to be resolved BEFORE weight-loss will occur. We used cognitive-behavioral therapy to chip away at the deep-seated beliefs Clare had about herself, especially those resulting from her size. Intertwined with this process was psychoeducation about the cultural patterns of weight-bias and weight expectations. I asked Clare to listen for the number of times she heard weight-based conversations and comments among her friends and colleagues. Clare’s lightbulb moment came when she realized that she deserved compassion rather than criticism, affirmation rather than shame, unconditional love rather than earned praise. As her perception of herself changed, she was able to implement the strategies we discussed on a more consistent basis and was able to bounce back more quickly when she slid into old patterns.


"I am a good girl. I am a bad girl.”—You just assigned your moral value to a banana? “It is good food; it is bad food.” Then, obviously you lack judgment if you eat “bad” food. “I messed up at lunch; I might as well throw in the towel for the rest of the day”. That’s going to help. The problem with dichotomous thinking (either/or; black/white) is that it does not allow for real life to happen. Growth and change necessitates flexibility to hurdle the speedbumps and keep on going. Moderation with food requires being in the middle of a continuum. Most of all, flexible thinking allows us to maintain motivation and see ourselves in a positive light throughout the change process.
Most high achievers will over-estimate the amount of time that they will be able to exercise, the amount of weight they will be able to lose, and the ease of dealing with negative emotions. It is unrealistic to plan for 1 hour of exercise, every day, for the rest of your life. Look at your schedule and what you can achieve on an optimal day. What does it look like on the worst day? Use that information to pursue a health pattern that can be maintained as a lifestyle.
A lot of popular literature suggests that telling people of your intentions will enhance your accountability. For people who have struggled emotionally with weight, telling others increases vulnerability in an already difficult process. Often the person begins to feel that their food choices are being scrutinized, even if that is not the case. If you want friendship support, it needs to be only from people who will not say a word about your weight, your food, or your exercise.
Well-intentioned people can throw you off-course by saying “you look great!” “Wow, you’re getting so skinny.” These “compliments” can trigger people emotionally and cause them to revert into old patterns. Train those around you not to comment on your weight.


LIE: The lie that sustains yo-yo dieters is the “The Last Supper.” The last supper consists of the following thought process: "I am going to start dieting tomorrow. This is the end of me ever overeating again. This is absolutely the last time I am ever going to have as much of my favorite food as I want." The "last supper" can last a night, a week, a month or longer. I recently talked to a client who had begun gaining a lot of weight prior to a bariatric surgery because everyone (and herself) was telling her to get the most of her favorite foods while she could still eat. The lie is that we actually believe our behavior will suddenly shift. It doesn’t matter if we have told ourselves the last supper lie for years; THIS time it will be different.

TRUTH: Even in the process of positive change, the change often occurs gradually—with fits, starts, and dips rather than in a radical spontaneous remission of the problem. There will be times, even when you are doing well, when life happens and you find yourself overeating before you know what happened. As you develop new coping strategies, there will be a gradual shift away from overeating as your default response.

LIE: The “Bait and Switch” occurs when one justifies an unsustainably fast weight-loss approach by saying that she will switch to moderation. “I am doing only protein now to get the weight off. Then I’ll start eating in a more balanced, healthy fashion.” People use this lie to convince themselves that they can lose weight fast AND turn it into a lifestyle. This assumption defies the learning curve that is inherent in long-term weight maintenance.

TRUTH: For long-term weight balance, the process of losing weight is fairly similar to the process of maintaining it. One needs to learn how to eat sugar without going on a sugar binge, how to make exercise into a habit, how to continue eating healthy on the morning after an ice cream and cookie binge. The learning curve isn’t sexy. It isn’t filled with rapid, euphoric pay-off; hence, the bait and switch lie. If you can get around the lie and dive into the learning, you give yourself the opportunity to win for a lifetime.

LIE: “I need to weigh myself to keep on track.” This may be true for those who have never had an emotional eating problem. For people who link weight to self-esteem, weighing NEVER works. People use this lie because they are scared or they want immediate gratification for weight-loss efforts.

TRUTH: Here’s the data from 15 years of experience. If people weigh themselves and have not lost as much weight as they anticipated, they go eat. If people weigh themselves and they have not lost any weight, they go eat. If people weigh themselves and they have lost weight, they go eat. If people weigh themselves and the scale is the same, they go eat. Do you sense a theme? The eating may occur immediately or a few hours later. You may make it through the rest of the day, and then succumb the next day. For people who have used the scales to measure their self-worth, their success, their discipline, and their attractiveness—getting rid of it takes a huge leap of faith. Weighing yourself will not make you lose weight; treating your body with respect will help you lose weight.

LIE: “When I lose weight, it will be easier for me to go make friends. I will start more hobbies. I’ll have more confidence at job interviews. I’ll finally be able to get into a great relationship. People will hold their breath and swoon as I walk down the street.”

TRUTH: Here’s the problem—losing weight is exciting. Maintaining weight-loss is boring. It’s not bad, but it’s like brushing your teeth. No one applauds. People who believe that a great life will occur AFTER they’ve lost weight set themselves up to gain it back when life is not as perfect as they anticipated

LIE: This lie is not your fault. It results from a deeply entrenched belief in American culture that weight is simply a matter of self-discipline. If you get all of the variables correct, you lose weight. I have seen people ignore factors of genetics, polycystic ovarian disease, the dichotomous thought pattern of our diet ridden culture, and the fat-shaming that makes people go eat to deal with the pain. Instead, the conclusion is “I am lazy, I am not trying hard enough, I am fundamentally broken.’

TRUTH: Yes, you do have control over your choices; however, when you fail to recognize all of the factors that are NOT under your control, it sets you up to feel really bad about yourself and you….go eat more cake to deal with it. There are many wonderful, intelligent, creative, and disciplined people who struggle with their weight. Welcome to being a human being.


When your weight has been painful, because people have ostracized you or you have felt deficient, it is common to begin seeing your IDENTITY based on the number on the scales. You are not just a number on the scales. You are not a clothing size. You are not the amount of fat you can pinch nor the amount of cellulite you can see. You are creative, tenacious, impatient, kind, logical, humorous, opinionated, introspective, spiritual, intellectual, emotional, responsible, rebellious, dedicated……You are. You are much, much more than your weight.


Feeding the Hungry Heart

By Geneen Roth

Books by Geneen Roth speak to the emotional experience of eating. This book is one of her earlier ones and remains a cornerstone resource for those who experience shame associated with their eating behaviors.Buy Now



Rethinking Thin

By Gina Kolata

You know how all of the diets promise different results than all of the other diets? The author examines the claims with well-done scientific research that compares groups of dieters. If you are trying to break the dieting mentality, this book will help you along the way.Buy Now



Remember that struggling to maintain health habits does NOT mean you lack self-discipline. This area tends to get neglected because of your tendency to prioritize the areas in which you feel more successful.

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