Author: Shrein

What are the Signs of an Eating Disorder?

There is never one sure sign that someone you care about is struggling with an eating disorder. Eating disorders are complicated, so it is important to know what to look for. Physical symptoms of significant weight loss or gain, compulsive exercising, and vomiting are strong evidence but are not the only indicators. Below are other possible signs that may indicate they are struggling and are in need of support.sad6

  • Constant thoughts about his/her weight
  • Enjoys cooking for others, but not for themselves
  • Frequent weighing of self
  • Weight  determines their mood for the day
  • Avoids eating with family and friends
  • Feels guilty after eating
  • Frequently compares their body to others
  • Preoccupation with the eating behaviors of others
  • Eating to relieve stress or depression
  • Constant concerns about being fat
  • Difficulty concentrating
  • Increased isolation
  • Frequent participation in diet fads
  • Eats the same rigid foods all the time
  • Declines social engagements because they must work out
  • Quick exit after meals
  • Laxative/diuretic abuse

 

 

Support for Family & Friends

“What Therapists Do That Is Helpful To My Recovery”

Below are a few responses made by clients in regards to positive support:holding_hands

v They allow all feelings

v They speak in the moment

v They tell the truth without judgment

v They ask specific questions and draw out information

v They don’t assume things

v They acknowledge our fear and our ambivalence regarding getting better

v They know that it takes time

v They validate and acknowledge our experience

v They are not emotionally connected to our behaviors

Examples of specific questions and statements you can ask or make:

v “Is your eating disorder self giving you a hard time right now?”

v “I know part of you sees it that way, but is there another part of you also?”

v “Is your eating disorder voice saying something?”

v “Maybe I can help you not listen to that part.”

v “What would your healthy self say?”

Possible statements made by someone with an eating disorder and suggested responses:

v “I am a vegetarian.”

Instead of: “Being a vegetarian is a form of food restriction that serves your eating disorder,”

Try: “That is your choice.  I would like to help you learn to be a healthy vegetarian.”

v “I don’t want to talk about my binge.”

Instead of: “It is important for you to talk to me about it if I am going to help you.”

Try: “I will accept that, can you tell me why you don’t want to talk about it?”

v “I don’t want to gain weight.”

Instead of: “You have to gain weight to get better.”

Try: “I would like to understand what that would that mean for you, gaining weight.”

(this can help the person discuss the purpose of the low weight and its pros and cons)

 

Taken from The Eating Disorder Sourcebook

Common Stages of Recovery

Once a person begins the recovery process from an eating disorder, expectations around the duration may often hinder the  recovery work and keep the person stuck in using their eating disorder behaviors to handle their anxiety. Further, the education around the timeline of recovery is important for all involved.  Clients have often stated their fears of burdening their family and loved ones during this process is their main concern. When all members of the support system are aware of the different stages of recovery, they can model for their loved one non-judgment and patience, which may ultimately lead to a swifter recovery.sad2

The stages below were published by Carolyn Costin in her book, The Eating Disorder Sourcebook.   

∞     Presence of behaviors with no sense of a separate eating disorder self.  At this stage clients often do not even accept that they actually have an eating disorder, much less an eating disorder self. The behaviors are seen as being something they are either willfully or uncontrollably doing.

∞     Denial of seriousness.  When clients do admit they have an eating disorder, they are almost always in denial of how serious it is or can be.

∞     Beginning awareness of a split self.  Continuing their behaviors, in spite of wanting to get better and their own ambivalence about recovery, helps clients begin to see that they have both a healthy self and an eating disorder self.

∞     Active engagement with the eating disorder self and the healthy self.  Clients journal from and dialogue with the two selves. This helps to discover the function of the eating disorder self.

∞     Need for behaviors while developing the healthy self.  The eating disorder self will still be acting out through behaviors, while the client is strengthening the healthy self.

∞     Decrease in behaviors but thoughts/desire for behaviors, strong.  The healthy self gets stronger and can fight off some of the eating disorder urges. The habitual nature of the symptoms begins to diminish, but the eating disorder self is often still in control.

∞     General symptom control with reduced thoughts/desire.  The healthy self is in control most of the time, but clients still battle eating disorder thoughts and act on them occasionally.

∞     Control of symptoms by healthy self but remaining thoughts/desire.  At this point the healthy self is in control of the symptoms, but clients are at risk for returning to the behaviors, because the need for the behaviors has not been resolved and eating disorder thoughts are still present. Treatment should continue until the need for behaviors is significantly diminished. It is common for clients, significant others and insurance companies to think that at this point clients are recovered or well enough to stop treatment. This is not the case and often leads to relapse.

∞     Integration of eating disorder self and healthy self (recovered).  Clients do not have to work at abstaining from eating disorder behaviors because there is no desire to engage in them. The need for the eating disorder is gone.  Clients turn to people or to their inner self to regulate emotions or otherwise get needs met. There is no separate eating disorder self; it has been integrated so there is one whole self. The person has a normal, healthy relationship with food and weight and does not need to use eating disorder behaviors to deal with problems. At this point, they are now ‘recovered’.

 

 

Making Is-ness (& Recovery) Your Business

I just finished reading a very fun yet meaningful book written by Marie Forleo, a business, relationship and self-acceptance guru for women.  Her book, ‘Make Every Man Want You’, provides more than just guidance on how to meet someone.  It offers wonderful insight into how you can be present in your life and to enjoy it!  Forleo calls it making is-ness your business and many of the tips and self-reflection exercise can also be applied to the recovery process.

In the chapter titled, Irresistibility 101, she states that to foster your irresistibility, you must take personal responsibility for your life.  Honing this responsibility will allow you to acknowledge the fact that you have the ability to respond to your life instead of automatically reacting to it.  She states that “many of us behave like robots, mechanically acting out habitual thought patterns of self-pity, overwhelming resentment.  Rather than discovering who we are now or who we are with now, we re-act, or act again, based on how we reacted to similar events in our past.”

Many of my clients sought therapy because they realized that their way of reacting to life’s stressors or challenges with the ‘support’ of their eating disorder no longer worked for them or was not working as well as it had in the past.  By acknowledging that the eating disorder thoughts and behaviors were actually getting in the way of allowing them to be present in their relationships or attracting new relationships, they were ready to begin the journey of recovery.

Per Forleo, “Being personally resinspirational-quotes-large-msg-133224814478ponsible allows you to dissolve old programming and start responding to your life appropriately rather than mechanically re-acting like you did in the past.  This is an incredibly exciting place to live.  With personal responsibility, you gain a tremendous amount of control in your life.  You can free yourself from cyclical life patterns and proactively impact the quality and existence of your relationships.”

Often, eating disorder behaviors are about gaining a sense of control.  Unfortunately the control is unrelated to what the stressor is actually about and instead turns it into a problem with your body image or weight.  Therefore, the ‘responsible’ actions are instead around food and exercise versus handling the stress or conflict in a productive and healthy way.

So how do we stop these patterns?  Forleo believes that the first step in personal responsibility is by facing the reality of how you operate in your life.   But this does not mean you should beat yourself up about it! “When you judge, berate, criticize, complain, or otherwise add commentary to your self-observations, you actually cement undesirable behaviors in place.  The challenge, of course, is that our minds are automatic judgment machines.  They instantly evaluate everything we do as either good or bad, right or wrong.  Thankfully this isn’t a problem.  The trick is to simply notice the judgment and then not judge yourself for judging yourself and if that doesn’t work, take one step out and don’t judge yourself for judging yourself for judging yourself.  At some point, you’ll reach a state of neutrality.  There’s a law in physics that states that for every action, there is an equal and opposite reaction.  In other words, what we resist persists.  Judging, berating, criticizing and complaining are all forms of resisting.”

Here is your assignment:

For the next 24-hours, make is-ness your total business.  No matter what happens- your printer breaks, your date cancels, or the plane is delayed for two hours- pretend that you wanted it to happen.  You can even say, “And this is what I want!” after any circumstance that your mind wants to resist.  While this may feel odd, it will help you become aware of all the ways you resist your is-ness and unwittingly create misery, frustration and upset in your life.

 

Shrein Bahrami, MFT  |  2146 Union Street, San Francisco, CA 94123  |  415.595.8963

Is Food Addiction Real?

intuitiveeatingI will often hear from clients that what gets in the way of following a meal plan or eating in a non-dieting way is the fear that they cannot control themselves around food or are addicted to food.  The book, Intuitive Eating, addressed the debate around food addiction and below is their research explaining many of the compulsive and impulsive behaviors around food.

Survival of the Species

This brain-reward system is believed to be necessary in order to ensure human survival.  This involves the brain chemical dopamine, which triggers both a pleasurable feeling and motivation behavior.  Engaging in activities necessary to survival (such as eating and procreating) triggers a rewarding feel-good experience.

Hunger Enhances Reward Value

Hunger by itself enhances the reward value of food, through triggering more dopamine-related activity.  For example, if you discover you are hungry, you might find yourself suddenly interested and motivated to cook a meal.  Dieting (which can be a form of chronic hunger) also has this effect.

Pavlovian Conditioning

The dopamine effect could be attributed to Pavlovian conditioning (recall the classic study, in which Pavlov’s dog salivated at the mere ringing of a bell.  This anticipatory salivation occurred because the dogs were conditioned to receiving a treat each time, after a bell rang).  This is not addiction.

Dopamine Deprivation

Many pleasurable activities trigger dopamine, including socializing, hiking a nd playing games. The great majority of people we see in our practices, who binge eat, are often leading very unbalanced lives.  These unbalanced lives “deprive” them of the dopamine benefits.  When needs are not being met, food becomes even more enticing,  more  rewarding.

Music Lights up Dopamine Brain Centers

Recently, a new study showed that when people listen to music, it lights up the same region of the brain which has been implicated in the euphoric component of psychostimulants, such as cocaine (Salimpoor 2011).  Just the anticipation of hearing the music lit up the dopamine brain centers. (Yet, we really don’t think you can make the case for ‘music addiction’!)

Food Addiction Studies are Limited and Flawed

The research on “food addiction” is too much in its infancy to be drawing any conclusions.  In addition, the great majority of studies have been on animals.  The limited research on humans has only been focused on brain-imaging studies with a very small amount of people and not much exclusion criteria (Benson 2010).

Yale Food Addiction Questionnaire

This has generated a lot of headline news.  Yet, upon a closer look the questionnaire seems to actually be measuring compulsive eating or rebound eating from chronic dieting (Gearhardt 2009).  Here is a sampling of questions:
– I find myself consuming certain foods even though I am no longer hungry.  (Classic compulsive eating or distracted eating can cause this.)
– I worry about cutting down on certain foods (Classic compulsive eating or distracted eating can cause this.)
– I have spent time dealing with negative feelings from overheating certain foods, instead of spending time in important activities such as time with friends, family, work or recreation.  (Classic compulsive eating or distracted eating can cause this.)

Studies Show Eating ‘Forbidden Food” Decreases Binge Eating

Finally, there are three studies to date, in which binge eaters eat their forbidden foods as part of the treatment process (Kristeller 2011, Smitham,  2008).  Binge eating decreased significantly in all of these studies.  If food addiction were an issue, you would not expect these types of results.  Food addiction theory would predict increased binge eating, triggered by eating ‘addicting food,’ yet the opposite happened.

 

Shrein Bahrami, MFT  |  2146 Union Street, San Francisco, CA 94123  |  415.595.8963

The Real Issues Beneath an Eating Disorder

sad2For someone who is struggling with an eating disorder(ED), it can be very difficult to understand or explain to others why your ED developed.  This is a question that will continue to show up in individual therapy sessions and especially family sessions where parents or significant others are desperately trying to understand the reason for the ED and why their loved one cannot just let it go.  The list below is taken from the book, “Your Dieting Daughter: Is She Dying for Attention?” by Carolyn Costin.  It provides a very thorough list of the issues someone with an ED struggles with and will use their ED to cope.   Until these issues are acknowledged and addressed, the need for the ‘support’ from the ED will remain.  Often with my clients, I will give them this list in session and go through each bullet point, exploring if or how each issue resonates with them.  By doing so, significant clarity can be gained and then alternative and healthy ways to cope can be implemented.  Read my post on Self-Full versus Self-Less for ideas on healthy ways to cope.

Poor self-esteem/self-worth

I’m afraid of myself and of being out of control.

I’m not very worthy.

People don’t like me.

I’m no good.

I can’t trust my own judgments or make decisions.

Belief in a myth

I will be happy and successful if I am thin.

Eating helps me to forget my problems.

Thinner people are happy.

Being thin will make me attractive.

Need for distraction

When I’m bingeing or throwing up, I don’t think about anything else.

Eating takes my mind off things.

Worrying about my weight keeps me from worrying about other things. 

Need to fill up an emptiness

Something is missing in my life.

I feel empty inside, starving makes it better.

Eating fills up my emptiness.

Need for perfection and black/white thinking

I have to be the best at anything I do.

I will be the best dieter.

I will have the best body.

Black/White thinking:

     I’m either fat or thin.

     I either binge or starve.

     I’m perfect or a failure.

     If I can’t win, I won’t try.

Need to be special/unique

I get a lot of attention.

Who will I be without this?

I get to be taken care of, worried about.

Nobody is like me.

It is the only special thing I have.

Need to be in control

My family is too involved in my life.

I have to be in control of something.

I’m always in control of everything else, so this is my way not to be.

The eating disorder behaviors fill unstructured time.

I’m proud of the willpower it takes.

This is the one thing no one has control over but me.

Need for power

I base my feelings of self on how others treat me.

I feel powerless.

This gives me power over myself and others.

It’s powerful to be able to give up food, like a saint or a monk.

I can really get at my parents this way.

Need for respect and admiration

Everyone respects me when I lose weight.

People admire you if you are thin and/or if you don’t eat.

Society perpetuates respect and admiration for thinness:

     Obtains it through weight loss (restricting).

     Tries hard to get it through weight loss, but can’t do it (restricting and bingeing).

     Rebels against it (bingeing).

Has hard time expressing feelings

Very difficult time with anger, rebellion, resentment.

Symbolically swallows, denies or rejects feelings.

Can’t deal with conflict or confrontation.

Denies feelings or expresses them in destructive ways.

I don’t know what I’m feeling, even if I do, I can’t express it.

Safe place to go – doesn’t have coping skills

It’s a special world created to keep all the ‘bad’ out.

If I follow my own imposed rules, I know what to expect, how to ‘win’.

Lack of trust in self and others

I don’t trust myself emotionally.

I never know if someone really likes me.

I don’t trust anybody.

I can never make a decision.

It’s easier just to follow rules.

Terrified of not measuring up

I can’t compete, so this way I take myself out of the running.

What are my good qualities?

I won’t have anything if I don’t have this.

I’m constantly comparing myself to everyone.

Terrified of being fat.

Terrified of being deprived.

Terrified of being deprived and of being fat.

 

Shrein Bahrami, MFT  |  2146 Union Street, San Francisco, CA 94123  |  415.595.8963

RecoverED Vs. RecoverING

My dear friend and colleague, Dr. Linda McCabe, graciously accepted my request to share her beautifully written and thought-provoking blog article on recovery.  In it, she shares her own recovery experience and beliefs on the differences between being recovered from an eating disorder versus being on a path of recovery or ‘recovering’.  Enjoy!

RecoverED vs. RecoverINGrite-of-passage

             Recently, I had a respectfully spirited discussion with a colleague of mine. Together, we have 39 years of professional experience (25 for her; 14 for me) in treating eating disorders. And together, we have over 50 of personal recovery experience, both of us having solidified our own eating disorder recovery and being led into helping others as a way to give back what we had been given/worked for ourselves. We were debating the terms “recovered” vs. “recovering.”

Carolyn Costin, a well-known expert in the field of eating disorder treatment is adamant about the position of being “recovered.” She states:

Being recovered to me is when the person can accept his or her natural body size and shape and no longer has a self destructive or unnatural relationship with food or exercise. When you are recovered, food and weight take a proper perspective in your life and what you weigh is not more important than who you are; in fact, actual numbers are of little or no importance at all. When recovered, you will not compromise your health or betray your soul to look a certain way, wear a certain size or reach a certain number on a scale.

http://montenido.com/to_the_client/recovered_recovering

This makes sense to me and I agree. However, I ALSO think of recovery for myself as a larger picture. I don’t see recovery from an eating disorder limited to food, exercise, and weight. I see these aspects of recovery as doorways into an ongoing journey of life-long growth. Losing weight and over-exercising to the point of becoming anorexic in my college years long ago and discovering this was a misplaced way to journey through a rite of passage into adulthood was my entryway into self discovery and recovery.  And, in the early phase of my recovery, when I struggled with bingeing and purging, I was entering another phase of the journey. Though I was still struggling with eating disorder behaviors, I was also doing the difficult work of looking at family of origin dynamics, cultivating a food plan and spirituality that worked for me, developing tools to “tolerate distress” and “regulate emotion” in ways other than using food, navigating how to keep myself and share myself in relationships, and finding a whole new identity of who am I without an eating disorder; who am I as a woman; who am I as a human being on this planet?

Owning the Shadow and Dis-identifying from an Overdeveloped Superego

I worked a 12-step program for the first ten years of my eating disorder recovery. In this program, one identifies as a “bulimic/anorexic/compulsive overeater” whether one has 1 day of abstinence from eating disordered behaviors or 20 years. The thought behind this, as I understand it, is that owning this part of one’s self (shadow) gives one the choice to be free of it and integrate its wisdom without “acting it out.” It is a practice of beginning to dis-identify from this aspect of the self enough to allow other parts of the self (the “Healthy self/Recovery Self,” Wise Mind, Playful self, Embodied self, Self that experiences sadness, anger, joy) to be discovered/re-covered.

I don’t engage in bingeing, restricting, over-exercising, or purging behaviors. I haven’t in a decade and a half. However, I do still see very clearly these parts of myself, of my brain, of my multifaceted Self.  As I say to clients, you have to give that part of yourself a voice: you don’t have to act on it and you certainly don’t have to believe what it is saying. I use the metaphor of what 12 steps call “the itty bitty committee” in your head.  Each member needs to be able to share. But that doesn’t mean that certain members get to run the show or be the dictator. The voice of an Eating Disorder, “ED” as some call it, can be very dictatorial. It is an extremely overdeveloped Superego, Critical voice. Giving it a voice is important, but dis-identifying from it enough to see that there are many, many, MANY other aspects of the self that need an opportunity to speak as well is crucial. I love how Eating Disorders Anonymous (EDA) holds the position that “People can and do fully recover from having an eating disorder.” And “In EDA, we help one another identify and claim milestones of recovery” that celebrate a newly growing recovery self. http://www.eatingdisordersanonymous.org/about.html

The Importance of Humility vs. Allowing yourself to be “big,” visible and have a self

In the history of 12 step Program, and in my clinical experience working with people recovering from substance use/dependence I see there is a necessary “ego deflation” aspect to recovery. The founders of Alcoholics Anonymous (AA), Bill W and Dr. Bob, had years of narcissistic denial and grandiosity in their capacity to pause from acting out on “self-will run riot” in their alcoholism and how it was causing damage. Their philosophy of recovery stresses the importance of pausing and reflecting on how their actions would potentially hurt themselves and others before taking action. This is a necessary and essential skill for people recovering from impulsivity mixed with a lack of ability to empathically imagine how their actions will affect others. However, I see a temperamental difference in people recovering from substance use and people recovering from eating disorders. (Please excuse that this is a generalization that is not always true and that many people have both, one or neither of these tendencies.) People recovering from eating disorders have been called the “silent screamers” that are “starving for attention.” In other words, people with disordered eating often care-take others in their family system and relationships at the expense of themselves. They often have overdeveloped empathy for others and their eating disorder has prevented them from attending to the importance of caring for and developing the self. In this sense, eating disorder recovery is more about developing an ego rather than deflating it.

In this self-discovery, there is a necessary aspect of breaking through denial that both substance use and eating disorder recovery require. Both require “rigorous honesty” with challenging old beliefs. In eating disorder recovery, though, there is a necessity of the process of recovering that is less black and white than substance use recovery. You can abstain from alcohol and drugs. You can’t abstain from food. And you can’t abstain from your body and the beliefs you have around your body. In eating disorder recovery: “it is about the food and it’s not about the food,”  “it’s about the food until it’s not about the food,” and “it’s about the body and it’s not at all about your body.”  In the words of Geneen Roth, who has been travelling the path of recovery and teaching others for decades, “You begin by understanding that your relationship to food is a doorway, not a wall, an opening, not a closing,” she said. “That itself, just that, is a leap because most people don’t want to hear that. Most people want to fix it and be done with it. They want to wake up at their natural weight tomorrow.  But until you work on the unseen level first, no amount of change in your eating is going to last. The very beliefs you have are going to drive you to doing the same things over again. What I say…is the body obeys the shape of your beliefs. If you want to change the shape of your body, you must first change what is shaping it.”

Ending the harmful behaviors of an eating disorder is essential to recovery and completely possible to end.  As Jenny Schaefer, author of the books Life Without ED and Goodbye ED, Hello, Me, says, “I am recoverED. Period.”  However, inquiring into the underlying beliefs that led to these behaviors is a life-long process of recovering. I welcome this process, again and again.

 

To read more inspiring blog posts or to learn more about Dr. Linda, visit her website here

 Originally published on PsychedinSF.com

Guided Meditation Videos

Meditation is an amazing tool to help you find grounding and cultivate a sense of peace and clarity.  It is a great way to start or end your day as well as a great refresher during the afternoon.  Although it seems quite simple, it takes practice and patience.  Wherever you are in your practice, guided meditation videos can help you find or deepen your zen.  Below are a few videos I recommend, enjoy!

Three Minute Mindfulness Meditationzen

Sitting With Breath — A Guided Meditation with Lori Granger, LMFT (15 mins)

Free Healing Meditation from Deepak Chopra by NPowerYourMind.com (16 mins)

Healing Spirit: Guided Meditation for Relaxation, Anxiety, Depression and Self Acceptance (21 mins)

Healing the Body, Mind & Spirit (40 mins)

 

 

Inspirational TED Talks

I love TED talks!  Whenever I am in need of some inspiration or relaxation, I can always find something thought-provoking, funny or heart-warming.  Below are a few of my favorite videos.

And, below are the 20 most popular talks thus far.

  1. Sir Ken Robinson says schools kill creativity (2006): 23,510,221 views
  2. Jill Bolte Taylor‘s stroke of insight (2008): 14,343,197
  3. Simon Sinek on how great leaders inspire action (2010): 14,228,854
  4. Brene Brown talks about the power of vulnerability (2010): 12,703,623
  5. Amy Cuddy on how your body language shapes who you are (2012): 12,682,694
  6. Pranav Mistry on the thrilling potential of SixthSense (2009): 12,068,105
  7. Tony Robbins asks why we do what we do (2006): 10,425,014
  8. David Gallo‘s underwater astonishments (2007): 10,266,221
  9. Mary Roach on 10 things you didn’t know about orgasm (2009): 9,435,954
  10. Daniel Pink on the surprising science of motivation (2009): 9.176,053
  11. Pattie Maes and Pranav Mistry demo SixthSense (2009): 8, 363,339
  12. Dan Gilbert asks: Why are we happy? (2004): 7,788,151
  13. Hans Rosling shows the best stats you’ve ever seen (2006): 7,685,726
  14. Elizabeth Gilbert on nurturing your creative genius (2009): 7,593,076
  15. Steve Jobs on how to live before you die (2005): 7,223,258
  16. Susan Cain shares the power of introverts (2012): 6,807,240
  17. Keith Barry does brain magic (2004): 6,371,778
  18. David Blaine reveals how he held his breath for 17 minutes (2010): 6,359,084
  19. Pamela Meyer on how to spot a liar (2010): 6,256,589
  20. Arthur Benjamin does mathemagic (2005): 4,951,918

 ted

 

 

 

 

Reject the Diet Mentality

Often, in our very “ditch-the-diet-mentalityhealth conscious, foodie, fit” society, it can be quite difficult to determine what of our food beliefs are actually health based and what are created from years and years of being exposed to a very diet focused culture.  Below is a chart taken from the book “Intuitive Eating”.  It very clearly illustrates common thoughts that are often behind the decisions we make around food and exercise and whether they are coming from a restrictive diet mentality or are truly healthy and intuitive to our bodies.  

 The Diet Mentality Versus the Non-Diet Mentality

ISSUE DIETING MENTALITY NON-DIET MENTALITY
Eating/Food Choices Do I deserve it?If I eat a heavy food, I try to find a way to make up for it.I feel guilty when I eat heavy foods.I usually describe a day of eating as either good or bad.

I view food as the enemy.

Am I hungry?Do I want it?Will I be deprived if I don’t eat it?Will it be satisfying?

Does it taste good?

I deserve to enjoy eating without guilt.

Exercise Benefits I focus primarily on the calories burned.I feel guilty if I miss a designated exercise day. I focus primarily on how exercise makes me feel, especially the   energizing and stress-relieving factors.
Progress is viewed as: How many pounds did I lose?How do I look?What do other people think of my weight?I have good willpower. Rather than being concerned with my weight, I trust that my weight   will normalize when I am attuned to my internal eating signals.  My weight is not my primary goal or an   indicator of my progress.I have increased trust with myself and food.I am able to let go of “eating indiscretions.”I recognize inner body cues.

 -Taken from Intuitive Eating, Tribole and Resch

Shrein Bahrami, MFT  |  2146 Union Street, San Francisco, CA 94123  |  415.595.8963