Alison Pelz, LCSW, RD, CDE

Weight Loss Surgery Support Group

2012-09-27T13:12:00.000-06:00

This past week I had the privilege of presenting a talk on mindful eating at the St. David's Weight Loss Surgery Support Group.

Two things that I want to share you with you:
1. The St. David's Weight Loss support group is a must for weight loss surgery patients.
If you have had weight loss surgery or if you are thinking about having weight loss surgery attending a support group is useful tool. Knowledge=power.
2. The neat thing about attending this support group is sharing or talking in the group is optional. So, if you are not comfortable talking in front of others, you don't have to. AND you will still get a lot out of the group just by listening to others.

At the St. David's support group they usually have a guest speaker on a variety of topics such as tips for eating after surgery, dealing with emotions, plastic surgery, etc. The group is open to those who are thinking about having weight loss surgery or those who have completed surgery. It doesn't matter if you had your surgery completed at St. Davids, at another clinic, out of state or the country--all are welcome. This group meets monthly, Monday evenings 6-7:30 pm at St. David's Hospital downtown. To find out more go to: St. David's Weight Loss Support Group.

I almost forgot...the cost of the group is FREE!

Life without ED by Jenni Shaefer

2012-08-08T07:00:00.000-06:00

I have not read Life without ED (yet), but many of my clients and colleagues agree that it is a must read. This book is widely recommended in the field of eating disorders.

Schaefer struggled with an eating disorder for many years. Now recovered, she shares her story. Learning about someone else's struggles and recovery can be so powerful for those in the thick of their eating disorder-- it potentially can reduce feelings of shame, guilt and isolation.

Yoga for Depression & Anxiety-Great Article

2012-04-18T08:00:00.000-06:00

I encourage many of my clients who struggle with depression, anxiety, diabetes, eating disorders or other eating problems to try yoga*.
Often times when people think of yoga they envision trying to get their body in a pretzel-like position and understandably this is deal breaker for many. Or maybe you are very uncomfortable in you body and the thought of going to class sends your heart racing.

I am not a trained yoga teacher and have only dabbled in yoga myself. But, my experience has been if you take yoga at a yoga studio (not at a local gym) there is usually something for every body. In fact if you go to a good yoga studio the atmosphere feels very non-judgement and nothing like a typical gym.

We have two really great yoga resources here in Austin:

Yoga Yoga (The front desk staff can recommend a class for you, they rent mats and your first class is free.)

Yoga RX (Caroline, owner of Yoga RX, gives individual instruction and specializes in working with people with body image disturbance and eating disorders.)

Below is a link to an article with an interview with Amy Weintraub author of Yoga for Depression. To read more about how yoga can help reduce symptoms of depression and anxiety click here.

*Please talk with your doctor before starting a yoga program.

Cultivating Joy to Aid In Recovery from an Eating Disorder

2012-04-16T08:00:00.000-06:00

Often when working with clients one of the first things that I do is have them start participating in activities that bring them joy on a daily basis. Life is so busy that often we forget to have fun. Preoccupation with weight, shape and dieting is often associated with an eating disorder or other eating problems. This preoccupation can be draining and exhausting and leaves very little room for fun.

Here is what to do:
1. Create a list of things that bring you joy (10-20 items). Your list may include: Being outside, talking with friends, listening to music, working in the garden, reading, watching a movie, crafting, dancing etc. Include things on your list that are helpful to your well being rather than harmful (Overspending or drinking alcohol are examples of harmful activities).
2. Make time in your day to practice one or more of these activities for at least 10 minutes per day.
3. Do something on your list EVERYDAY. It may feel forced at first, that is normal.

Don't expect that the joyful activities will eliminate the unwanted eating behaviors. The idea is to give the eating disorder or undesirable eating behavior some competition.

Once you have cultivated this practice of purposely bringing joy into your life on a daily basis you will have developed some strong coping skills. Strong coping skills are an invaluable resource when recovering from an eating disorder!

Great On-line Resource for those with Eating Disorders, Emotional or Compulsive Overeating or Diabetes

2012-04-12T07:00:00.000-06:00

The Center for Mindful Eating is a great resource. They have a series of recorded and live seminar on topics for people who struggle with eating. Topics include mindful eating with diabetes, non-hunger eating, mindful eating and weight loss surgery and much more. You can listen to the presentations right from your own home. Best of all they are FREE!
Please visit their website at: The Center for Mindful Eating

Another Great Article on Mindfulness

2012-04-10T07:00:00.000-06:00

If you have diabetes, an eating disorder or other related eating-problem you may find this article encouraging:

"A major benefit of mindfulness is that it encourages you to pay attention to your thoughts, your actions and your body. For example, studies have shown that mindfulness can help people achieve and maintain a healthy weight. "It is so common for people to watch TV and eat snack food out of the box without really attending to how much they are eating,” says Chesney. “With mindful eating, you eat when you’re hungry, focus on each bite, enjoy your food more and stop when you’re full.”
Click here to see the article in full.

Simple Ways to Practice Mindfulness for People with Diabetes, Eating Disorders or Eating Problems

2012-04-02T07:00:00.000-06:00

Mindfulness can be practiced anywhere!

Last post I discussed how mindfulness can be beneficial to those who have diabetes, eating disorders or other eating problems.

Let's take a look how to practice mindfulness.

Remember mindfulness is focusing attention on one thing at a time. So, mindfulness can be practiced virtually anywhere and anytime. Literally these mindfulness practices only take a minute!

Examples of how you can incorporate mindfulness into your day:
1. While you are waiting in line notice your feet. How they do they feel in your shoe? What temperature are they? How do they feel standing on the ground?
2. Wherever you are notice what the different colors or shapes surround you.
3. If you are sitting in traffic notice the different shapes and sizes of the different cars' tail lights.
4. Take ten breaths and visualize what the breath may look like on an exhale and inhale.

It is normal for your mind to wonder during these exercises. Do your best to bring your mind back to focus.
Know that it gets easier the more you practice mindfulness.

I encourage my clients with eating problems to practice mindfulness on a regular basis. That way when they are faced with an anxiety provoking situation they can "call up" the mindfulness practices more easily.

Mindfulness for Eating Disorders, Diabetes & Weight Control (Part 2)

2012-03-26T07:55:00.000-06:00

I know my last post was on mindfulness (See "Great Article on Mindful Eating"), but mindfulness has proven to be so helpful with my clients who have eating problems, diabetes or eating disorders, I decided to dedicate my next few posts to mindfulness.

When people hear the word "mindfulness" what often comes to mind is a person sitting cross-legged, with a far out look on their face repeating mantras with incense burning in the background. Some people may practice mindfulness in this way, but I think for most of us it can be a lot simpler than that.

What is mindfulness? In it simplest form it is focusing attention on one thing.
Words that may be used as synonyms for mindfulness include: purposefull awareness, focus, concentration, sustained attention, presence, staying in the moment, observation and neutral observer.*

Why practice mindfulness?
-It increases the probability of new behaviors by creating and stabilizing new brain circuits. Mindfulness can change your brain.
-Helps us get freed from reactivity, habitual thoughts and negative habits.*
What I have noticed in my personal experience with mindfulness is that it brings a lot more clarity and joy to my everyday life. And, hey, who couldn't use a little more of that?

How can mindfulness help people who struggle with eating problems, eating disorders or with diabetes?
-It reduces anxiety and stress (Often a trigger for overeating or disordered eating behaviors.).
-Mindfulness can improve mood (Again often a trigger.).
-Allows for pause (Giving yourself time to focus on one thing sometimes is all it takes to make a different more positive choice.).

*From the seminar "Mindfulness Strategies for Changing the Brain-Tools for Rewiring Depression, Anxiety & Toxic Lifestyle Habits". Presenter and author Donald Altman, MA, LPC. To find out more go to www.OneMinuteMindfulnessBook.com

Great Article on Mindful Eating

2012-03-19T12:58:00.001-06:00

Many of my clients who have diabetes, an eating disorder or are trying to control their weight tend to struggle with eating mindfully.

Most of us eat very mindless. We eat while we are working, watching TV, driving, texting, etc. Mindless eating often leads to overeating and making poor food choices. Eating while distracted doesn't allow us to fully enjoy the food we are eating.

"Mindful eating is not a diet, or about giving up anything at all. It’s about experiencing food more intensely — especially the pleasure of it," explains Jeff Gordinier in his recent article "Mindful Eating as Food for Thought" in the New York Times.
Go to Mindful Eating Article to read Gordinier's article in full and learn practical tips for mindful eating.

Finding Fun Physical Activity

2012-02-28T08:00:00.000-06:00

As a follow-up to last week's post, "Focus on Fitness, Not Weight Loss", I wanted to share this article about how to incorporate FUN physical activity into your life. Remember your fitness level may be more important to good health, than the size of your body!!

Read this article "Find Your Fitness Passion" to learn more about how to find ways to move your body that feel good and that are fun: http://experiencelife.com/article/find-your-fitness-passion/

Focus on Fitness, Not Weight Loss

2012-02-23T08:41:00.000-06:00

A few weeks back I watched a webinar (sponsored by the Psychotherapy Networker). The presenter was Dr. Linda Bacon, a researcher, professor and author, and she talked about the myths surrounding obesity.
Dr. Bacon emphasized that physical fitness rather than body weight was a more important indicator of health.

What I understood from Dr. Bacon's talk was that people with who are overweight, but are fit have similar death rates of those who are thin and exercise. In other words, if you are overweight and exercise regularly you are no more likely to die than people that are in a "healthy" weight range.

The problem that I see in my practice and Dr. Bacon pointed this out as well, is that more often than not people will exercise to help with weight loss, and when the attempts at weight loss through dieting fail (Remember there is not much scientific evidence that dieting works in the long-term.) the exercise stops as well.

So, my message to people, of all sizes, is if you want to increase your chances of living longer focus on fitness and less on weight loss.

To find out more about Dr. Bacon and her book Health at Every Size visit her website at: http://www.lindabacon.org/

Three Myths about Eating Disorder, Not Otherwise Specified

2012-01-23T07:00:00.000-06:00

1. Myth: Most people with eating disorders either have Anorexia Nervosa or Bulimia Nervosa.
False. The majority of people with eating disorders are diagnosed with Eating Disorder, NOS (not otherwise specified) and not Anorexia Nervosa or Bulimia Nervosa.

2. Myth: Eating Disorder, NOS is not a serious eating disorder.
False. Eating Disorder, NOS can be life threatening and cause just as much suffering to the individual and their family members as other types of eating disorders.

3. Myth: Treatment Options for Eating Disorder, NOS are not the same as for Anorexia or Bulimia Nervosa.
False. Treatment options are about the same for Eating Disorder, NOS as they are for Anorexia or Bulimia Nervosa. Treatment options include: outpatient, partial hospitalization, hospitalization and/or residential treatment.

Here are some resources for outpatient treatment options in the Austin Area: http://www.aead.com/.
Resources for residential treatment: http://www.edreferral.com/

To learn more about Eating Disorder, NOS please go to: http://www.something-fishy.org/whatarethey/ednos.php.

If you or someone you know has an eating disorder talk with your doctor or an eating disorder professional to get help.

Inspiring Story about Weight Loss

2012-01-20T07:00:00.000-06:00

I want to pass on this inspiring story about one Austinite's journey with weight loss. Once weighing more than 500 pounds, Hattie Montgomery, in her article "Determined to Live" discusses her triumphant story of weight loss.

What excited me most about Montgomery's article is her sharing with readers the emotional struggles she had with losing weight. So often the emotional component of losing weight is not talked about.
Whether you struggle with controlling your diabetes, emotional eating or with overeating this story is inspiring to all who read it!

To read Montgomery's article please go to: http://experiencelife.com/article/determined-to-live/

Expect Lapses When Trying to Change

2012-01-17T07:00:00.000-06:00

The definition of lapse is a temporary decline from the expected outcome. Say for example you are trying to stop overeating and if you have an episode of overeating that is considered a lapse.

It doesn't matter which habit or behavior you are trying to change...arguing with a spouse, quitting smoking, improving body image, recovering from an eating disorder, starting an exercise plan, etc....LAPSES are part of the change process.

I like to introduce the concept of lapses to clients early on in our work, because it sets the expectation that behavior change is a PROCESS and that road bumps are NORMAL when we are trying to make changes in our lives.

The next time you try to change a behavior expect lapses, because they will happen. If you expect them you won't feel so defeated, they will be easier to navigate and most likely you will be more successful at changing the behavior.

Dr. Anita Johnston Coming to Austin (Part 2)

2012-01-13T07:00:00.000-06:00

I had the privilege of attending two of Anita's workshops and found them both helpful in my clinical practice and in my personal life. Anita is a dynamic speaker she makes use of storytelling, myths and metaphors in much of her work.
I must admit when I first heard Anita talk I thought to myself 'How can the use of storytelling be helpful?'. What I have learned is that storytelling, use of myth and metaphor is a powerful tool--it allows humans to connect to themselves in a different way than conventional talk therapy.
When we watch a touching movie, for example, we often identify with characters, have a strong emotional reactions and have a shared emotional experience.

Because Anita includes non-traditional methods in her work with women I think attending her seminar is
a unique experience for any woman struggling with body image disturbance, disordered eating or obesity.

Here are the details of Anita's upcoming workshop:
Seminar: The Wise Woman's Way into 2012
Date: Saturday, January 21, 2012
Time: 10:00 am to 5:00 pm
Location: Norris Conference Center, Austin Texas
Cost: $129 in advance, $149 at the door
Register online: http://dranitajohnston.com/
To pay by check call Elissa at (512) 779-3121 or email elissashapiro@yahoo.com

New Year's Resolutions: Why don't they work?

2012-01-11T08:00:00.000-06:00

Answer: Our brain gets in the way.
If you think it takes mere willpower to keep a New Year's Resolution, you are barking up the wrong tree. Changing a habit is much more complex than just willpower.

Consider the following about our brains:

1. Our brain seeks immediate reward. For example, kicking the habit of smoking: Smoking a cigarette gives your brain an immediate pleasure response. (Your brain secretes a chemical called dopamine that is associated with pleasure.) NOT smoking the cigarette is very unpleasant to your brain in the short term. One of the main functions of your brain is to keep you happy even if there are long-term consequences.

2. Habits are hard wired into our brain. A habit is something we do over and over again. Our brain knows it well. In fact, the neuropathway gets stronger the more we repeat the habit. It goes something like this: Your brain senses that you are feeling uncomfortable, your brain "tells" you to smoke a cigarette and then your brain notices that you feel better after you smoke. The behavior is then repeated thereby making that pleasure pathway in your brain stronger.

There is some GOOD NEWS.
There are some things that you can do to improve your chances of changing a habit for good.
1. Repeat the new behavior over and over again, effectively trying to change the wiring in your brain by building a new pathway.
2. Practice stress management on a daily basis. When we are stressed out we are more vulnerable to falling back into old habits. (Remember our brain wants us to feel good.)
3. Practice healthy habits on a daily basis that give you pleasure , such as exercise, hobbies, connecting with others, etc. (Makes the bad habit that we are trying to change a little less appetizing to our brains.)
4. Cut out other practices that are associated with the habit you want to change. For example, if you always take a smoke break outside during your work day, don't go outside on your breaks.

Remember changing habits is less about willpower and more about TRAINING YOUR BRAIN!!!!

Dr. Anita Johnston is coming to Austin (Part 1)

2012-01-09T19:07:00.000-06:00

Calling all women!
If you are struggling with body image issues, disordered eating or just feeling disconnected...you won't want to miss this upcoming seminar "The Wise Woman's Way into 2012" hosted by psychologist and author Anita Johnston of the 'Ai Pono Eating Disorder Program of Hawaii and Elissa Shapiro, Clinical Social Worker and Movement Facilitator of Austin.

Date: Saturday January 21, 2012
Time: 10:00 am to 5:00 pm
Location: Norris Conference Center, Austin Texas
Cost: $129 in advance, $149 at the door
Register online: http://dranitajohnston.com/
To pay by check call Elissa at (512) 779-3121 or email elissashapiro@yahoo.com

To learn more about the workshop and Dr. Anita Johnston go to: http://dranitajohnston.com/. To learn more about Elissa Shapiro go to: http://www.bodyvida.com/about_us.htm.

Mixed Messages in the Media about Eating Disorders?

2011-12-16T11:31:00.002-06:00

I'll say! The View this morning had a segment on eating disorders AND dieting.

I was pleased to see the hosts interviewing Tracy Gold, an actress. They were interviewing her about her struggle with Anorexia Nervosa when she was in her late teens. Gold was also there promoting her reality show on eating disorders (I have not watched her reality show-so I don't know if it would be harmful or helpful for those struggling an with eating disorder to watch.).
Gold's brief interview on The View included discussion on common feelings that a person with an eating disorder experiences (shame, guilt and loneliness,), signs and symptoms of an eating disorder, etc. All in all I thought Gold provided an accurate and helpful interview about eating disorders.

Right after Gold's interview as The View was breaking for a commercial the announcer said something like "Coming up after the break...Hungry Girl* will be here to talk about Christmas recipes".
Really??? REALLY.

*I believe that "Hungry Girl" has a cooking show, books, etc.on dieting and low-calorie cooking.

Starting College & Eating Disorders

2011-08-23T11:36:00.003-06:00

Sometimes the stress of starting college can exacerbate a preexisting eating disorder. Or it can be a time in a young adult's life when an eating disorder begins.

Starting college is an exciting time. It often symbolizes new beginnings. It can mean gaining independence from parents and moving away from home, meeting new friends and fostering new interests. It is the gateway to adulthood.

Although, starting college or returning to college is exciting, it is normal to feel anxious about it, too. Starting college can feel overwhelming—navigating a new living situation and relationships, the added responsibility that comes along with independence and just being a “small fish in a big pond”.

This transition to college for some can be really tough. An eating disorder can be a maladaptive way to cope with this transition. A maladaptive coping skill is something that may reduce stress in the short-term, but can have harmful physical and psychological effects in the long-term.

If you think you or someone you know has an eating disorder (For signs and symptoms of ED go to: http://www.something-fishy.org/isf/signssymptoms.php ) it is important to get help right away.

To get treatment for an eating disorder:

Talk with with a trusted friend, family member, doctor, spiritual leader, etc. and ask for help. You don't have to do this alone.
Seek a specialist who treats eating disorders (Doctor, psychotherapist, dietitian, etc.)

To locate specialist in the Austin community go to www.aeds.org or to find services on the UT Campus go to: http://www.cmhc.utexas.edu/.

Orthorexia: More Than Just Healthy Eating

2011-08-14T12:11:00.005-06:00

A few weeks back at the Austin Eating Disorder Specialists meeting I attended an excellent talk on Orthorexia. I will share a little of what I learned about Orthorexia.

What is orthorexia?

How I understand the definition of orthorexia is being obsessed with eating healthy. You may be thinking what is wrong with that? But, orthorexia takes on a rigid and righteous quality to the healthy eating. The person suffering from orthorexia spends a great deal time of thinking and planning out healthy foods to be eaten. Orthorexia can become so severe that it diminishes the individual's ability to focus on other things (The person with Orthoreixa can only focus on eating healthy.) such as occupation, relationships, etc. It can be medically dangerous, because food choices become so limited that it leads to malnutrition.

How does Orthorexia differs from Anorexia Nervosa or Bulimia Nervosa?

People with Orthorexia are fixated on healthy eating (not on losing weight) while those who have anorexia or bulimia are more focused on calories and losing weight.

If you or someone you know is suffering from Orthorexia please seek professional help immediately. To find a specialist who treats people with Orthorexia in the Austin area please visit The Austin Eating Disorder Specialists' website: http://www.austineds.com/.

For more information on Orthorexia please visit:

http://www.orthorexia.com/

People Who Have More Triggers for Binge Eating Before Gastric Bypass Surgery Lose Less Weight at Six Months Post-surgery.

2011-03-31T12:51:00.004-06:00

A recent study published in the Jan/Feb issue of Surgery for Obesity and Related Diseases (www.soard.org/) suggests that people who have more triggers for binge eating prior to surgery tend to lose less weight at six months postopertatively than people who have less triggers.

What is binge eating?

According to the Mayo Clinic (www.mayoclinic.com/) binge eating is:

Eating large amounts of food

Eating even when you're full

Eating rapidly during binge episodes

Feeling that your eating behavior is out of control

Eating a lot even though you're not hungry

Many people who binge eat may experience feelings of guilt, shame, embarrassment, depression, anxiety and/or hopelessness associated with binge eating.

What to do?
Weight loss surgery may limit your ability to binge eat (at least at first), but does not necessarily change the urge to binge eat. So if you struggle with binge eating and are planning to get weight loss surgery (Or just want to stop binge eating, because it feels so rotten.) go get help before you have the surgery.
There are tons of self-help books on reducing binge eating (See Gurze Publishing at www.bulimia.com/index.cfm. Psychotherapy especially, cognitive-behavioral therapy, can help eliminate binge eating as well.

Learn "Pre-dieting" Skills Before Embarking on Weight Loss

2011-03-20T17:34:00.006-06:00

I was delighted to receive my most recent issue of the Psychotherapy Networker, a professional magazine for therapists. It is loaded with articles on the psychology of weight control, diets and keeping lost weight off.

One author and esteemed psychologist, Dr. Judith Beck, hit the nail on the head in her article, I Think, Therefore I Eat. She writes, "It's too difficult for most people to change their eating plan and simultaneously learn the skills that will enable them to stick to it".

Dr. Beck has developed a 5-stage plan for weight control. She recommends practicing skills to keep healthy habits in place before changing any thing about their eating. Brilliant.

Her first stage is the most important one: Develop pre-dieting skills which includes learning how to stay motivated, getting use to new eating habits, dealing with hunger and cravings and relapse prevention.

So the idea is that if you have mastered say dealing with hunger and cravings before going full force into changing how you eat and exercise you probably will have more long-term success.

The only gripe I have about her writing is the use of the word “diet”. The word diet makes my skin crawl, but it gets the point across to readers. (The word diet assumes a starting and an ending point to healthy eating versus a lifelong change.)

To learn more about Dr. Judith Beck please visit her website: www.beckinstitute.org. She has authored : The Beck Diet Solution: Train Your Brain to Think Like a Thin Person and the workbook The Complete Beck Diet for Life.

Overcoming Mind Hunger Group Starting October 5th

2010-09-30T08:31:00.001-06:00

Overcoming Mind Hunger Group is facilitated by Alexa Sparkman, dietitian and Jeanne Sivertson, psychotherapist. It is a great resource that we have here in Austin to help those get off the dieting roller coaster. The Overcoming Mind Hunger program is not a diet program. It is a holistic program to help people make peace with food.

Overcoming Mind Hunger is a great program for people who:
-Are chronic dieters
-Emotionally overeat
-Compulsively overeat
-Feel they are “addicted” to food

To get more information about the program visit them on the web at: http://www.mindhunger.com/index.htm.

Also check out a great explination of why dieting doesn't work: http://www.mindhunger.com/dietsDont.htm.

Great Resource for Books about Eating Disorders & Related Issues

2010-09-16T11:45:00.002-06:00

One of my favorite resources to refer clients to is Gurze Publishing (http://www.bulimia.com/). Gurze has been publishing books about eating disorders and related topics since 1980.

Gurze publishes self-help books, workbooks, DVDs and audio programs on such topics as:
Anorexia & bulimia nervosa,
Binge eating
“Emotional” eating
Exercise
Body image
Midlife

They also have several blogs on their website including blogs about recovery, nutrition, advice for parents and much more. Most of the blogs are written by experts in the field.

There is something for everyone on this website whether you are struggling with an eating disorder, emotional eat or are trying to get off of the the dieting roller coaster.