Thursday, June 9, 2011

How Can Weight Issues Be Related to an Underlying Mood Issue

Through observation, I sometimes think that Weight Issues is actually a "symptom" of an underlying Mood Issue.  Hence, in order to deal with the weight issue effectively, one must deal with the underlying mood issue.  Sometimes, it can be due to depression and anxiety and the weight issue is actually the secondary problem.

Why?

Most of us can relate to one of the core values of our society and that is, "eating is an entertainment".  Look at our reality cooking shows on TV at present like Masterchef and  My Kitchen Rules.  When we have a celebration, what is one of the first thing we think about.  Yes, you are right.......FOOD.

So, what I want to do is to introduce to you to a concept of "comfort eating", which all of us can relate to some extent I am sure.  In this scenario, we are not eating to survive or for hunger.  We are eating for enjoyment, comfort, or just because we are simply bored or depressed.  Sometimes, this can be a very subconscious process. 

So, how can we manage it?

Being aware!  Sounds simple, but being aware is half of the battle.  Simply practice what we call "mindful eating". 

One of the principle which I apply to in my clinical practice with regards to weight loss it to Keep It Simple (the abbreviated KIS method).   The core of weight management is to be aware, to find the motivation, and to follow a method which is simple, achievable and sustainable in order to form a new habit.

How many days of consistent behavioural change does it take in order to actually change a habit?

Some literature states 50 days and some 66 days.  This will probably depend on the person and what type of behavioural change we are talking about.  The exact number of days is not so important however.  What is more important is for you to realize that it does take some time for the brain to "install" the new behaviour through consistent repetitive effort.  This rule applies to any new skills that we want to acquire eg driving a car, learning the timestable, or learning to play a musical instrument.

So start by keeping a food diary for 1 week to help you to become more aware of your eating habits.  Do you "comfort eat" regularly?  How, What, and Why do you "comfort eat".  What are the triggers?  Is it related to your mood?  Learn to become more mindful when you eat.  The good news is that you do not need to be mindful forever, because once you have acquired the new and improved habit, you can then stop being mindful and let your mind run on autopilot again.  Does that make sense? 

Try to be aware of what you are eating ie the carbohydrates, fats, vegetables, fruits, comfort food, and the high GI foods.  It is important not to feel guilty or ashamed about your food diary as "what is, is".  We learn to accept "what is, is" and if we do not like it, then we can change it.  We always have a choice.  We learn to observe our behaviour without judgment of ourselves....This is real criticism...."observation without judgment".

Next step is to have a simple plan which is achievable and sustainable.
(Please see your Doctor before entering any weight management program.  The Doctor needs to check your food diary before starting.  Questions like, are you nutritionally deficient? What medical problems do you have? Is the following plan suitable for your current eating regime?  Do you have a medical condition like thyroid that can cause weight gain? Are you emotionally unwell and require counselling? etc.)

The following plan is just a generalization only and help to point out some of the principles behind behavioural change surrounding your diet.  Please do not try this without the guidance of your Doctor.

I like to think about it as the Rule for Eating

(In essence, the message below is simple.  Eat a little less carbohydrates, less fat, less simple sugars and more vegetables, have regular meals, do not skip meals, and do not overeat.)

1 When you are hungry, you should eat
2 When you are full, you should stop
3 When you are eating Carbohydrates and Fatty Foods and when your Doctor decides that it is in excess, then cut down by 1/3 (ie you still have 2/3 of your usual amount).  Remind yourself that this is the 2/3 rule.
4 Replace the 1/3 with vegetables
5 With High GI foods (ie anything sweets) and when your Doctor decides that it is in excess, use the zero to half rule.  If you feel motivated, then avoid it.  If you have to have some, then have it.  Do not feel guilty about it. Just have 1/2 of the usual amount.
6 Remind yourself that "Food is NOT an entertainment"....well okay sometimes.
7 Monitor your progress with your Doctor
8 Keep motivated and to do this, you have to remind yourself of WHY you are doing this.  You have to find that "hook" in order to keep yourself motivated.  It may simply be to keep healthy or to have more energy, and for some, it maybe for your kids or grandkids.  Whatever it is, you have to find it.  Motivational counselling might help here.  We will explore this later in our blog.
9 Aim for at least 30mins of "incidental" exercises a day ie park further out when you shop, walk to the shops instead of driving, and take the stairs instead of the lifts.  It is amazing how frequent little things that you do will add up to something significant.



Dr Vin
Family Doctor

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