Managing Weight in a Common Sense Manner
Alvy Newman, B.Sc., M.H.A.
Tips for Divorcing or Separating Parents
Treena Cook, M.S.W., R.S.W.
Welcome to our Spring Newsletter.
In addition to the wide range of services we provide through your Employee Assistance Program, in 2012 we are particularly focusing on health and wellness. Our associates have broad experience in providing group programs and we are pleased to work with your organization in developing health and wellness programs. In this edition we are also providing updated information on how to access your Employee Assistance Program as well as an updated list of the services available through your Employee Assistance Program for you and your family. We invite you to contact us for more information about the range of EAP services available to you.
Virginia Palmer, Editor
Treena Cook, M.S.W., R.S.W.
Be honest. It’s important to acknowledge real events without exposing them to all the details. Use language and concepts your children can understand. Tell them in neutral terms about what has happened.
Let the child know that it is not their fault.
Listen attentively. Let them know that whatever they think and feel is okay. Encourage them to express all their feelings – both negative and positive – about what is happening in their family.
Asking your child about friends of theirs whose parents are divorced is a way of exposing your child’s assumptions and fears about divorce and its impact. This creates an opportunity for you to clear up misconceptions and provide reassurance.
Recognize that it is normal for most children in the early stages to want their parents to get back together. Keep your kids’ feelings separate from your own. Don’t make your child your confidante. You need family, friends or a counsellor for that role. While it’s okay for kids to see their parents upset, getting too emotional can make kids feel responsible for your feelings.
Children are sensitive to their parent’s mood and feelings and will only discuss with you what they think you can handle. If you feel devastated, angry or frustrated about your divorce, your children may steer clear of the topic. If you are openly angry with the other parent, your children will feel like they can only share negative reports about the other parent because this is what they think you want to hear.
If you feel that you may get too upset yourself, think about asking someone else (relative, friend, counsellor) to talk with them.
Children experiencing a loss which they can’t control, like adults, they may need to blame one parent or the other – or both – for what is happening. Be open and ready to answer any questions they might raise and help them to address their concerns.
Reassure your child that they will be taken care of. Many children may worry that if their parents separate there won’t be enough food or shelter or clothing. This may be especially true if the majority of the conflict between their parents has been about money.
Once you have separated, do not use your kids as messengers between you and the other parent. There are many other ways to communicate. And resist questioning your child about what is happening in the other parents home – kids resent it when they feel like their being asked to “report back” on the other parent.
Do not talk critically or express hostile feelings about the other parent to the children or around the children. The single biggest factor in long-term adjustment for kids of divorce is the level of parental conflict that they are exposed to.
Expect resistance and difficulties as kids adjust to a new partner and/or their children. New relationships, blended families, and remarriages are among the most difficult aspects of the divorce process.
Keeping the lines of communication open, while providing and prioritizing one-on-one time between parents and kids, and carefully watching for signs of stress can help prevent problems from developing.
Suggested resources for parents:
Putting Children First: A Guide for Parents Breaking Up
(McDonough and Bartha)
Treena Cook, has a Masters in Social Work and is a Registered Social Worker who provides individual, family and marital therapy for adults, children, and adolescents. Treena is also a Certified Mediator who offers mediation services for formalized separation agreements and parenting coordination; conflict within in-tact families; and workplace. Treena is an experienced assessor conducting custody and access as well as parenting capacity assessments for family court purposes. Treena works with children and families going through separation and divorce and develops interventions with high conflict families through a number of EAP Programs.
QUINTE COUNSELLING SERVICES INC.
Being overweight is one condition where the jury is still out on the nature (influence of genetics) vs nurture (environment and lifestyle). Debate and evidence is certainly pointing to body size and shape as a combination of what genes were passed and the contribution of psychosocial factors in your life. That said, weight treatment addresses lifestyle behavioural changes and concentrates on decreasing food acquisition and increasing activity levels. The purpose of this article is raise awareness of the limitations of current treatments and to offer guidelines on how to seek help for your weight management goals when what you are doing on your own does not seem to work.
Being overweight or obese can have both emotional and functional symptoms. Chances are it will be one of these symptoms or their consequences that will lead someone to seek help. You should approach this problem in a common sense manner as you would do for any health problem to be solved – Identify the symptoms causing the most distress, consider what caused it, ask yourself how long it will last, what will be the consequences if you don’t do anything at all, and can it be cured or at least controlled? And then choose your source of help accordingly.
Weight Management Strategies
Weight management strategies are categorized according to the level of outside help involved and range from just managing on your own (self help), to seeking advice and support from others trying to lose weight (peer support), to individualized advice from allied health and medical practitioners (professional led programs), and finally for those who are at least 100 or more pounds overweight to the extreme of bariatric surgery to either prevent food intake or prevent food absorption or both.
Weight loss involves going on a diet. There is a saying that ‘diets don’t work’; and in practice this certainly seems to be true. Since there is no clear definition of ‘dieting’, it means something different to each of us. But in general it means eating less than you are used to, and less than you need to maintain current weight. Most dieters do not stick to the plan long enough to achieve their goals, and even if they are successful in losing weight, they return to their former dietary and activity habits which results in weight rebound. Therein lies the problem. But, if this formula of calories in less than calories out is followed for an appropriate amount of time, and if you manage to lose significant poundage that it is not just water, — and if you do not then return to your pre-diet eating and activity patterns, then yes, diets can work.
Diets offering the quickest results invariably require the complete elimination of one or more food groups leading to feelings of deprivation and sometimes they demand such a stringent depletion of nutrients that they put the body into starvation mode. This is particularly true of diets
What Kinds of Services are Provided Through the EAP?
Counselling for Work Issues
Grief and Bereavement Counselling
Addiction Assessment and Counselling
Chronic Pain Management
Counselling for Seniors’ Placement Issues
Individual Solution Focused Therapy
Marriage and Relationship Counselling
Counselling for Child and Adolescent Issues
Counselling for Survivors of Sexual Abuse
Family Life Education
Weight Management Counselling
specifying 800 calories or less per day. For example think of diets with only meal replacement drinks. Not only is this very dangerous, but almost impossible for someone to stay on such a restrictive plan for only a week or so before losing motivation. And while the scale may show a loss of a many pounds, it will be water weight lost and not fat burned. That may be fine for someone who wants to drop five pounds before an important event but it is neither safe nor effective for long term healthy results. Even more highly motivated dieters tend to stay on a diet for less than 2 months which is why commercial weight loss programs typically offer 6 to 8 week programs. The drop-out rate is so high that it makes better business sense to run shorter programs as participants may become repeat customers – and they often are. A typical dieter may lose weight but the odds are they will return to their pre-program way of life and gain all – if not more – weight back within a short time. Then the cycle starts over again. Weight loss, weight regain, and so on. It is called yo-yo dieting.
One of the key factors that prevent people sticking with their diet plan; certainly the most crucial, is if the program dealt only with food restriction or an exercise regime and did not address the psychology of eating. Chances are it was a fad diet and was too restrictive and /or had too short of a time frame for success. Such a strict diet puts pressure to show results too quickly, and the inability to conform leads to feelings of failure and guilt. There is a well known phenomenon in human behaviour known as the ‘what-the-hell-effect’ and dieting is no exception; it manifests in overeating or going completely off the plan when some forbidden food rule of that particular diet has been breached.
Self Help Strategy
First attempts at weight loss typically involve self-help strategies and these are dominated by trial-and-error manipulation of food intake and activity levels. It is unknown how successful self-help methods really are because most research into weight management selects clients who are already seeking help from commercial programs. Research reports show over 90% of overweight and obese individuals claim to use self-help methods. Much of the information is found in popular diet books but these should be labelled ‘user beware’, as there is no way to control how accurate the information presented is. It is at this level that many FAD diets are tried and rejected.
QUINTE COUNSELLING SERVICES INC.
What is known about self-help methods from a large and long running USA database is that those who monitor their weight and their food intake and their activity every day have the best chance of losing and keeping it off. Even health professionals can underestimate their dietary intake by 30% or more. Research shows that most weight is lost within the first six months before reaching a plateau. It is easy to give up at this stage, but keep in mind that the longer you have been overweight, the longer it will take to lose it and keep it off. Setpoint theory suggests that you will have be patient and diligent to ride out the plateau as your body adjusts and you may have to live at the plateau weight for months before you can begin to lose again.
Professionally Supported Strategies
The second level of help enlists the support of peers whereby those with similar issues come together either in person (groups) or online to garner helpful hints, compare trial and error methods, and enlist motivational support.
The third level of help involves seeking the advice of allied health professionals who possess specific training in the biology or psychology of weight management such as dieticians, nutritionists, occupational therapists, and health psychologists.
The highest level of help is when medical advice is sought and the outcome may be that diet pills are prescribed or bariatric surgery performed. Increasingly, research shows that the best chance of success is from a multidisciplinary team of allied health service providers who have specific bariatric training and this now seems to be the safest method and most effective method to chose.
There are problems inherent in each level of help. Self help books may be written using too much professional or scientific jargon or may contain only a few chapters of information with over half the book full of recipes. And while there is much research evidence to support the use of peer support programs for a variety of health conditions; anecdotal evidence of weight loss programs describe how some tyrannical programs mandate humiliation to control behaviour as they forced people to weigh in front of their peers, and berated members for failing to lose. In one group the person who did not lose had to wear a pig mask. This practice is unconscionable, and there is no place for such degrading treatment in a civilized society.
Even professional led treatment has its limitations. The old way of thinking was just to consult a dietician with the underlying assumption that all you need to do is tell someone the correct way to eat and ‘voila’ – problem solved. Unfortunately, many seek the quick fix and turn to diet pills as a first strategy thereby artificially altering their feeling of hunger. There are two major problems with this: it assumes that people overeat because they are hungry and if you take away hunger you take away the impetus to eat.
Choosing your Help
Every weight management strategy must begin with a psychosocial assessment to explore the cause of your body size and weight – be it genetic, medical, or lifestyle; include a weight management history of what worked, when, and why and what didn’t and why; and identify problem areas which would lead you to use food as a coping strategy. The key to success is finding a way of living which allows you to find balance in matching your food intake to your natural activity levels in relation to your genetics, your health status, and your lifestyle.
There are many reasons to eat, and self soothing with comfort foods, habit, celebration, or duty surely rank as high as hunger – even more so I believe. Secondly, it appears more likely that many people misinterpret anxiety as
hunger, and so it follows that the best treatment should address reducing stress and anxiety. This is best achieved through individual counselling as drugs used to treat anxiety have their own weight gain side effects and exacerbate weight conditions. Research results show that dieters claim they are sabotaged by “emotional eating” so it certainly appears that individuals need to learn how to recognize and deal with the issues which are triggers for eating.
Choose your help according to your perceived cause, and your most troublesome symptoms. If you are suffering from anxiety, depression, lowered self esteem, poor body image, and feel stigmatized at work or at home, then seek the guidance of a psychologist. If your girth is such that you cannot manage public transit to work, or find it difficult to dress or perform basic hygiene, then consult an occupational therapist. If your problem is not knowing how to get the required nutrients given your finances and cultural food choices, then contact a dietician.
Certainly if the weight loss goal is significant (more than 10%) of your body weight, then I recommend, in fact I insist, that your health status is monitored medically in terms of blood pressure, blood chemistry, liver function, kidney function etc. Consult your family physician and state that you are planning a lifestyle-based weight loss program and ask for baseline tests and your GP will decide according to your history if these parameters should be monitored monthly, quarterly, or annually.
The ideal weight management strategy must be tailored to address your complex emotional and physiological needs and wants which govern lifestyle choices. For true happiness in reaching your weight goals, you must acknowledge the role of ‘good enough’ or realistic body size vs some ideal. Recognize that for most body shapes, we gain one to two pounds a year after age 20 just in naturally aging, so do not set yourself up for failure and aspire to return to your high-school prom image. Accept that if you are a grandmother it is acceptable to look matronly, if you are a mother, you can look maternal and so on…..Do not judge yourself on magazine models where a fourteen year old is presented as bride and a sixteen year old boy presents as sex god. Besides, a community of women looking like Robert Palmer’s ‘Simply Irresistible’ dancers or men as Chippendale dancers would be a hilarious if not scary sight indeed.
Accept that if you are an insulin dependent diabetic injecting insulin seven times a day that you may never override the fat storage mechanisms of insulin and may have to contend with a larger build than you would prefer- I know I do.
Research is focusing now on whether it is possible to have health at every body size. Begin by deciding which symptoms or consequences are causing you the most distress now or have the potential to in the future and choose your help accordingly.
Alvy Newman is a Clinical Therapist and PhD Candidate in Health Psychology with doctoral research in the psychology of eating behaviours. She provides advocacy and education in obesity and its management. The next article will address seeking help for emotional eating.
Did you know…
→Appointments are scheduled at a time that is convenient for you and usually within two to three days?
→No one at your place of employment will know that you have used your EAP unless you tell them?
→Counselling is provided for a broad range of services, including marital and relationship; parenting; stress; separation/divorce trauma; workplace; and personal issues?
→Counsellors can help you access community resources and support groups?
→A comprehensive description of the services provided through your EAP is available through your EAP brochure
or on our website at www.qxplore.com?
QUINTE COUNSELLING SERVICES INC.
***PSYCHOEDUCATIONAL ASSESSMENT SERVICES***
Are you a worried parent whose child or adolescent is experiencing difficulty with:
*not achieving at the expected level?
*Mathematics, Reading, Spelling, or Writing skills?
*paying attention and/or concentrating?
*managing emotions and getting along with others?
A Psychoeducational Assessment by Quinte Assessment and Treatment Group Inc. can identify causes of your child’s problems and recommend what can help.
Sara Kapler, M.A., C.Psych. Assoc., Brian Kong, Psy.D., C.Psych.,
Eva Mourelatos, M.A., Carl Sordoni, Ph.D., C.Psych.,
Shannon Mossip M.A., C.Psych., Mohammad Nikkhou, Ph.D., C.Psych.
Quinte Counselling Services Inc.
208 John Street
Belleville, Ontario, K8N 3G1
Toll Free: 1-800-527-7793
QUINTE COUNSELLING SERVICES INC.