Disorders of eating are self-destructive habits, ways of eating that take on greater and greater centrality and importance in the mind and life of the sufferer.
Thus, as one progresses into a more active and severe eating disorder, one becomes more "restrictive" and/or "impulsive" in eating and exercise behaviour, and the more one's general emotional state is negatively affected.
The weight control attitude associated with an active eating disorder is characterized by varying degrees of restraint and disinhibition/binging, and more or less extreme weight loss goals. Different combinations of anorexic and bulimic behaviour patterns are possible.
As people recover from eating disorders they become more flexible and moderate in their eating intentions and behaviour. The recovered patient remains more concerned about her weight and more restrained in her eating compared to the non-eating disordered population, but there is significant increase in the level of moderation and in the integration of this behaviour change.
The changes in weight and eating attitudes with recovery are correlated with equally significant changes in mood, life satisfaction, coping and body esteem.
The amazing thing about someone with an eating disorder is that she pursues a course of action which she knows has negative consequences, and yet sticks to the disorder, much like an addict. That's why you can't treat eating disorders by prescribing diets, or even by hospitalization, without dealing with the essential irony of the problem. You help someone gain self-awareness and deal with emotional coping, and she finds her own motivation to change.
As Bruch and later Garner and Garfinkle point out, there is an overriding importance in the overall causality and maintenance of the disorder of a feeling of ineffectiveness, even defectiveness, and a desperate means of organizing oneself in the service of a goal, even if that goal has negative side effects. Unless a person can overcome the general negative feelings about herself, she will not be capable of motivating herself to recover from the eating disorder. The goal of recovery must become stronger than the attraction to the habit.
As the motivation for recovery grows and the change process proceeds, the restrictiveness and impulsiveness of eating thoughts and behaviours are normalized.
Finally, it's important to remember the recovery from eating disorders is a long-term process. Recovery should be measured over several years.
Stephen Stotland, Ph.D.
Friday, March 12, 2010
Understanding the stages of weight control
The stages of weight control is an idea that looks at the process of behaviour change as both continuous and discontinuous. In other words there is change within each stage and between stages.
For example, in the contemplation stage, a person will gradually become more sure of their intention and closer to implementing an action plan, the more reasons they find to make the effort, vs. the reasons not to.
As one progresses with the analysis of the pros and cons and likelihood of success of the behaviour change, the more sure one becomes of making the change, until such point as the decision is firmly made and an implementation plan has been created, at which point the person moves from contemplation into action.
Once beginning the action stage there is a long period of "apprenticeship" in which the person acquires the basic skills and knowledge - of course, there are some kinds of behaviour change (e.g. becoming a medical doctor or an architect) in which the action/learning stage is very long; the same can be said for "recovery from obesity" (otherwise known as "weight management").
In the early "novice stage", the person benefits from a clear structure and feedback. As new eating and exercise habits are established, resulting in the desired weight and body changes, the structure can be modified, allowing more flexibility, in the intermediate stage.
After 3 - 6 months of consistent eating and exercise behaviour changes the individual should have reached the "intermediate stage", with stable habits and adequate flexibility. At this stage the person is quite confident about weight control and not disturbed by situational variations in behaviour. Thus, if one eats more or less "nutritious" food on some occasion, there is still a degree of moderation and therefore no fear, frustration or guilt, but rather satisfaction and resilient confidence.
Eventually, with sufficient practice and experience one may attain the "mastery stage,"where the new habits are fully automatic and second-nature. Within this stage there is still room for development, to the "expert stage." The expert can develop new ideas and can teach others. Thus, the expert of weight control has both mastered his or her own weight, and can help others do the same. Many experts in weight control have overcome their own weight issue.
The stages of weight control include the unmotivated stage, the contemplation stage, the concerned but disengaged, the novice, intermediate, mastery and expert stages.
Treatment require a knowledge and understanding of the stages. Different treatment stategies are appropriate for different stages, but what is always required is regard for the degree that the individual has progressed in his or her "apprenticeship."
If the goal of treatment is to create "experts" then the treatment must go far beyond diets and exercise plans, as there is need for a deeper analysis of motivation, skills, attitudes and self-regulation processes.
Of course, one cannot become an expert without first being a novice, then intermediate and master. It's a process, even a journey.
The 7 stages of weight control are a guide for individual development.
To learn more about my research on the stages check out our webpage: Stage Survey Results
Stephen Stotland, Ph.D.
For example, in the contemplation stage, a person will gradually become more sure of their intention and closer to implementing an action plan, the more reasons they find to make the effort, vs. the reasons not to.
As one progresses with the analysis of the pros and cons and likelihood of success of the behaviour change, the more sure one becomes of making the change, until such point as the decision is firmly made and an implementation plan has been created, at which point the person moves from contemplation into action.
Once beginning the action stage there is a long period of "apprenticeship" in which the person acquires the basic skills and knowledge - of course, there are some kinds of behaviour change (e.g. becoming a medical doctor or an architect) in which the action/learning stage is very long; the same can be said for "recovery from obesity" (otherwise known as "weight management").
In the early "novice stage", the person benefits from a clear structure and feedback. As new eating and exercise habits are established, resulting in the desired weight and body changes, the structure can be modified, allowing more flexibility, in the intermediate stage.
After 3 - 6 months of consistent eating and exercise behaviour changes the individual should have reached the "intermediate stage", with stable habits and adequate flexibility. At this stage the person is quite confident about weight control and not disturbed by situational variations in behaviour. Thus, if one eats more or less "nutritious" food on some occasion, there is still a degree of moderation and therefore no fear, frustration or guilt, but rather satisfaction and resilient confidence.
Eventually, with sufficient practice and experience one may attain the "mastery stage,"where the new habits are fully automatic and second-nature. Within this stage there is still room for development, to the "expert stage." The expert can develop new ideas and can teach others. Thus, the expert of weight control has both mastered his or her own weight, and can help others do the same. Many experts in weight control have overcome their own weight issue.
The stages of weight control include the unmotivated stage, the contemplation stage, the concerned but disengaged, the novice, intermediate, mastery and expert stages.
Treatment require a knowledge and understanding of the stages. Different treatment stategies are appropriate for different stages, but what is always required is regard for the degree that the individual has progressed in his or her "apprenticeship."
If the goal of treatment is to create "experts" then the treatment must go far beyond diets and exercise plans, as there is need for a deeper analysis of motivation, skills, attitudes and self-regulation processes.
Of course, one cannot become an expert without first being a novice, then intermediate and master. It's a process, even a journey.
The 7 stages of weight control are a guide for individual development.
To learn more about my research on the stages check out our webpage: Stage Survey Results
Stephen Stotland, Ph.D.
Weight of the world
We all must learn to "carry our own weight" they say, which means to take responsibility for ourselves and not to expect others to "carry us". Some people have more to carry, as they have had the misfortune to come from difficult family circumstances, unhelpful environments and little opportunity for education or personal growth. And yet some who began in the most disadvantaged of situations have emerged, found ways to thrive and find happiness -- we say that such individuals have "resilience." These individuals have discovered how to unburden themselves of unnecessary weight, to keep only what is essential and valuable.
Why do so many of us appear "weighed down" by our emotions and problems, as if we are carrying the "weight of the world" on our shoulders? Why not just set down the heavy load, and allow ourselves to feel light and free? This is not merely a rhetorical question, but a central philosophical and psychological problem. Each of us must look deeply into our own eyes, into our soul, to our past, present and imagined future, to make sense of existence, to see ourself clearly, to finally say, "I understand why I do this," before we will be able to let go...
To understand ourselves we look within, but we can also learn by looking at the outside, seeing ourselves as another would, as an observer. In this sense, look at your physicality, at your body, your posture, your facial expression, your movements. Look at how you do things, your attitude. To take a simple but relevant example, look at how you eat. What is your attitude towards the food? Do you value the food? Respect it? Give it the proper attention? Use it sparingly, rather than greedily? Do you consume it slowly with mindful pleasure, or aggressively and quickly? Look at your attitude towards food and the act of eating as a reflection of your attitude towards yourself, other people and life itself. Perhaps this is a radical idea, but give it a chance...
When we carry too heavy an emotional burden it is bound to come out in many small but ultimately significant ways - in our eating, sleeping, moving, breathing. The central human dilemma is to gain self-awareness and to find philosophical meaning in our lives. This is not merely an intellectual, academic exercise, but the key to health and happiness!
Stephen Stotland, Ph.D.
Why do so many of us appear "weighed down" by our emotions and problems, as if we are carrying the "weight of the world" on our shoulders? Why not just set down the heavy load, and allow ourselves to feel light and free? This is not merely a rhetorical question, but a central philosophical and psychological problem. Each of us must look deeply into our own eyes, into our soul, to our past, present and imagined future, to make sense of existence, to see ourself clearly, to finally say, "I understand why I do this," before we will be able to let go...
To understand ourselves we look within, but we can also learn by looking at the outside, seeing ourselves as another would, as an observer. In this sense, look at your physicality, at your body, your posture, your facial expression, your movements. Look at how you do things, your attitude. To take a simple but relevant example, look at how you eat. What is your attitude towards the food? Do you value the food? Respect it? Give it the proper attention? Use it sparingly, rather than greedily? Do you consume it slowly with mindful pleasure, or aggressively and quickly? Look at your attitude towards food and the act of eating as a reflection of your attitude towards yourself, other people and life itself. Perhaps this is a radical idea, but give it a chance...
When we carry too heavy an emotional burden it is bound to come out in many small but ultimately significant ways - in our eating, sleeping, moving, breathing. The central human dilemma is to gain self-awareness and to find philosophical meaning in our lives. This is not merely an intellectual, academic exercise, but the key to health and happiness!
Stephen Stotland, Ph.D.
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