Self Care for Weight Management

Let's start with basic emotional self care. What does it mean? In class they provided a "Self-Care Inventory" which was adapted from "Take Time for Your Life: A Personal Coach's 7-step Program for Creating the Life You Want" by Cheryl Richardson. Although it will take a little more work than going through a check list, I think it might be more useful to come up with your own inventory. Think hard about what in your life makes you happy or fulfilled or at peace, gives you energy or satisfaction or pleasure. Make a list of everything you can think of. Now--and this might be easier--list what drains you. Which list is longer?

What would it take to maximize the parts of your life that fulfill you and minimize those that drain you? Are there things you want to be doing to fulfill yourself that you are not doing? And what is keeping you from doing them? Or is it that you are just doing TOO MUCH and need to be doing less, even if what you're doing is satisfying on some level?

I am debating how much to go into this. I think it is so personal that it would almost undercut the spirit of this exploration to offer specific suggestions or examples. Just take some time to focus on it and see what comes up for you. Aha! There is the problem, huh? "Just take some time..." Just take some time to be mindful while you eat, and just take some time to exercise, and NOW WHAT? "Just" take some time to ponder self care, which, we can only assume, should lead to taking just a little more time to provide said self care? Ay yi yi.

Well, there it is. Whether the things in your life that you identify as "nourishing" are weekend hikes, volunteering, candlelit baths, or whatever else, they all require a little TIME. And ultimately, I think that's what self-care is: taking TIME for yourself to do your heart's desire...or, to do nothing at all.

I know a lot of my followers are working moms, and we may be among the worst at taking time for ourselves. It is a constant challenge. But you know the rap about putting on your own oxygen mask first, right? If you do not take care of yourself, how can you possibly keep up with taking care of everyone and everything else?

This is where the little inventory exercise comes in. Are there small ways you could begin to shift the fulfilling/draining balance? Like everything else we've been talking about, start small. Start experimenting with saying no to requests of your time. Find some little thing that has been nagging at you and address it. Find even a five minute block of time each day where you do only exactly what you want to do.

If the way you take care of yourself is by eating when you're not hungry, you really must spend some time with this issue. If you incorporate some kind of spiritual practice or ritual or body work into your day on a regular basis, say no easily, tend to feel radiant most of the time, have plenty of energy, sleep well and feel deeply in touch with your "true self," feel free to move on.

Part III: Can Weight Management Be a Spiritual Quest?

I have really been stalling with this last (or second to last?) section because I just can't fully wrap my brain around it. It's a little more nebulous than the approaches to food and exercise. I guess you'd have to say it's a SPIRITUAL approach to weight management. The thing is, ultimately I'm afraid it will lead to having to LET GO of the whole concept of "managing" one's weight. I can't be sure until I write it, but I can't help thinking I'm in over my head with this one.

It all started with the class I took having a "three-legged stool" approach, the third leg being self care. (The first two, I hope you got, were intuitive eating and exercise.) They always said that self care was just as important as the other two legs of weight management, but when I started thinking about writing this, I realized they never really explained why.

First, they taught stress management tools: progressive muscle relaxation, visualization, deep breathing and meditation. A lot of people over-eat when they're stressed, so this makes sense. Then they focused on emotional self care, which included doing a self-care inventory to identify "what's fueling you" and "what's draining you" and then writing a self care list to remind us of specific ways to care for ourselves. A lot of people eat for emotional reasons, so caring for our emotions makes sense too.

I will elaborate on all this later, but I want to take the whole concept a little further first. I just found the one paragraph in the class workbook that offers their explanation for encouraging self care:

"When we listen to and treat ourselves with respect, compassion and gentleness, it helps us remain committed or get back on track with our nutrition, fitness and stress management behavior goals. Self-Care is a way of living that helps us maintain personal balance, replenish energy and motivation, and grow as a person. It is not selfish to practice regular self-care."

This is getting closer.

In my field (social work), there is a lot of talk about self-care. It's something we are meant to practice ourselves as well as teach our clients. I get sick of hearing about it. It's a great idea, but it's beginning to sound trite and contrived to me. For example, one of the suggestion in our work book is: mail yourself cards of encouragement and appreciation. Oh please! That one just makes me want to cuss.

But, I tell myself, take a step back. It's not just about treating yourself to a pedicure once a month. It's not just taking deep breaths to avoid eating a bag of fried pork rinds. (What ARE those, anyway?) It is a way of living with deep self respect. If we can, as they recommended, "listen to and treat ourselves with respect, compassion and gentleness," won't it just come naturally to eat healthy food, listen to our bodies, be physically active?

I guess where I'm struggling is that this self-care idea is presented as a means to an end, a TOOL to use to help you lose weight. Sure, it can be helpful that way, but can't it be so much bigger than that?

Instead of thinking of self care as the third leg of the stool, think about what it would mean to fully and deeply respect your body and appreciate the life it gives you. What would it be like to mindfully inhabit your body in each moment? Would that change your whole relationship to food? To exercise? To the whole idea of "weight management"?

Working with all of these ideas has really taken on a life of its own. While I still wish for a thinner, more fit body, I also feel like I've sort of stumbled on to something much more important. This has become, in a sense, something of a spiritual quest for me.

So, I will go back and talk about some more specific ideas regarding self care. (I keep changing my mind about whether or not to hyphenate that. Sorry for the inconsistency.) I also have a lot to say about visualization in particular. Then there is a little Zen Buddhism to address. And I have to write a little something which I will entitle: Respect Your Butt. I might throw in a little neurobiology. And of course, everything always comes back to mindfulness. (Have you noticed that?)

There is so much fun still in store, so stay tuned! Right now, however, I'm going to go on a little run with with the dog before it rains again.

Take care.

Ways to Motivate Yourself

I've found a few things that have significantly increased my motivation to exercise regularly which I would like to share with you.

1. Buy a pedometer. This was the first thing that got me to really pay attention to my daily activity level. I have to thank Kaiser for this one. They sponsored a "Walk Across Italy" race at work. Last year they walked across Cancun and I thought the whole thing was pretty silly, but for some reason, this year I got into it. I was even a team captain! In teams of six, we all tracked how many steps we walked each day for six weeks with the goal of all our steps adding up to some huge number of miles which is the distance from the north to the south of Italy. Or something like that. Anyway, being accountable to my team members motivated me a lot, and I really enjoyed tracking my daily steps. I continued doing it for months on my own after the race was over. It really makes you very conscious of the level of activity you have built into your regular routine and makes you look for simple ways to increase it. It's fun to see what your average daily steps are and then see if you can increase that average by 10% each week. Or something like that.

2. Set goals. People scoff at the goal setting routine I proposed earlier, but it really worked well for me. What's your long term goal for your regular activity level? What would be a small, simple goal that could be achieved in the next week? What could you do in the next 24 hours to increase your regular activity? If I had set a specific goal for the week I was much more likely to actually get up and do some sit-ups or take a quick walk after lunch. It changed the conversations I had with myself when I was lying in bed in the morning. You can get up and meet your goal, or you can lie in bed and fail to meet your goal. Hmm. It was a matter of pride. It was a way to make myself accountable to myself. There's something about that proverbial gold star on the chart that still holds power. Like the pedometer, it's really fun and easy! Using a pedometer is a really easy way to set and track goals, too.

3. Sign up for a race/Exercise with friends. A week from today, I'm running my first 10K--my first race ever, really, and a trail race to boot! If you'd told me a year ago I'd run a 10K this year (or write a blog about weight management), I'd've called you crazy, but here I go. Ten women signed up together and we're renting a house for the weekend. It's something I'm really looking forward to. Four of us have been meeting once a week to train. I can't believe how much farther I can run with friends than by myself! And running on a trail is much more fun than on a treadmill. I've never been so motivated to exercise regularly in my entire life. It's actually fun! Plus it's a great excuse to spend an hour with my friends each week, which is as good for my health as the running is! I look for opportunities to run during the week and I'm disappointed when I don't find them. I actually miss running if I go for more than a few days without it. Don't get me wrong, I'm a naturally sedate person, and the actual running still feels like torture, but now I want to do it anyway! Agreeing to run a 10K with friends has changed my life! (Incidentally, it is this to which I attribute most of the gains on my self-assessment.)

4. Toys make it fun. We got a Wii Fit Plus for Christmas, and it is so much fun! It's not all cardio-driven, but any of it is better than sitting on the couch and watching TV. It's fun for the whole family! I also splurged and spend an extra $30 on a Nike-ipod set-up when I bought new trail running shoes for the race. There's a sensor in the shoe and a gadget you plug into your ipod when you run that tracks your time and distance. I haven't tried this yet, but I guess you can upload it to nike.com and track your training and do all kinds of fun things with it. I usually steer clear of things like this, but both of these have helped motivate me to MOVE MORE.

Do the Math

Even though I just suggested you don't embrace the idea that you "should" exercise to lose weight, I think it's important to know how it works. This is basic information that may be common knowledge, but I had to look it up.

A pound = 3500 calories, so if, for example, you wanted to lose a pound in a week, you'd have to burn 3500 calories or reduce your intake by 3500 calories, or some combination of the two. That's 500 calories a day. That's about 5 miles (about one hour) of running. (Running burns about 100 calories in 10 minutes; biking 80, brisk walking 50, regular walking 30.) Most of us are not going to start running 5 miles every day, but that's okay, because a pound a week is too ambitious. Try this idea instead: if you add 2000 steps (about one mile) to your daily routine, you'll burn 100 extra calories a day which is over 35,000 calories in a year which adds up to ten pounds.

I've also heard that weight training, while not burning as many calories as cardio, increases your average daily metabolic rate. Muscles burn more calories than fat, three times more according to one source I found on line. I also found a source that denied the whole idea, so who knows, but I like the idea that as I'm turning fat into muscle, I'm speeding up my metabolism.

Move Your Body

When I finally got some decent medical insurance, I went in for a check-up to confirm that I was perfectly healthy. The only advice my doctor gave me was, "Exercise, exercise, exercise!" At the time I was in my 20's and living in the City. I'd just sold my car because the only time I ever drove it was to look for a new parking space on street cleaning day. I walked everywhere. Even at work we would walk to visit our clients. The first time I went out with Matt we saw a play South of Market and ended up walking all the way home to Noe Valley, half way across the city. I was single and plenty of time to go to the gym after work. Exercise was built in to my life. I didn't even have to try.

Things are a little different now. I drive an hour to work. I drive to my patients' homes. I go back to the office and sit in front of a computer. I drive an hour home. By the time I finish with dinner, dishes, helping Quentin with homework, etc., I'm beat. When am I supposed to exercise? Sound familiar? I hear so many people say, "I know I need to exercise, but I just can't find the time." I've said it myself a million times. It's not as easy as it used to be to incorporate into the old routine.

Even writing about exercise is hard to fit in! I wrote this whole entry and a couple more in my head about two weeks ago and am just now finding a chance to sit down at the computer. Now I can't remember what I wanted to say!

Well I think it's just a choice we have to make. I can't tell you how many mornings I lay in bed arguing with myself about whether or not to get up and exercise. What a waste of my mind-time! You just have to decide it's something that is important to you.

I think the idea that we "should" exercise to help us lose weight carries a lot of the same dynamics as going on a diet. I think it's much more effective to choose to be more active for the joy of moving your body and for mental and physical health. And it just has to be a priority, a given, like brushing your teeth. Instead of trying to figure out how to fit exercise into your busy schedule, figure out how to fit your busy schedule around your exercise. (I have to give Judith Beck credit for that one.) Is everything else that fills up your day really that essential? Is it as important as maintaining your mental and physical health?

My fried Laurie says, "anything is better than nothing." Start where you are. See if you can add just a little bit more movement to your days. If you're not getting any exercise at all, start by stretching for five minutes once a week: certainly you can find five minutes. And if you can find five minutes on one day, you can probably find five minutes twice a week. And so on. Find something fun to do--it doesn't have to be drudgery. Dance in the kitchen while you're cooking. Put on some rocking music while you're cleaning the house. And the old stand-bys: take the stairs and park farther away. The more you move, the better you'll feel. Really: it's true!

Transitioning

I don't know about you, but I went on a Christmas tear! I ate all the chocolate I could get my hands on, and I did some excessive after-Christmas-sale on-line shopping: general over-consuming. Thank goodness for the New Year to put an end to all this holiday mania! With resolutions in place, I was ready to jump right back in to my new, healthy, balanced relationship with food and put an end to the grasping chocolate addiction and overall wantingness.

Along with eating mindfully and intuitively, I had decided to stop eating sugar altogether and cut down on the carbs. Hmm, that sounds suspiciously like a dieter's mentality, doesn't it? Stopping the binge in favor or restrictive eating? Can you guess how well that worked for me?

That first day back to work there was the goodbye potluck for one of my all time favorite co-workers--a sad occasion, worthy of a good meal--to which someone brought the most amazing donuts I have ever seen in my life. Then there was not one but two big boxes of those fabulous little hazelnut chocolate balls wrapped in gold foil. It would be no problem if I could eat just one or even two or three, but no! I took it upon myself to work through those boxes as quickly as possible so that we could all be done with them and move on! I was shocked when someone pointed out that they actually have whole hazelnuts in the middle: I had never noticed! I don't like hazelnuts! Boy was I relieved when they were all gone.

It was not the start to the new year I had pictured for myself.

Now, as I'm reminding myself of all the things I have learned in the last year, I am calming down and relaxing into a more normal eating pattern, and I'm noticing that since I started working with all of these ideas four months ago, I do eat very differently. I couldn't eat as much as I did 6 months ago if I tried! I get full quickly and actually feel satisfied. I appreciate my food more, and, excepting the chocolate binge, I want less of it. This is no crash diet, that's for sure! It is testing my patience as a weight loss tactic. But it is so much more than that.

OK, it was time to retake that self assessment. Remember that? It was four months after I had taken it the first time when I started the weight management class. On a scale of 1-10, my satisfaction with all the areas it addressed had averaged a 5 back in September. Now it's a 7. Wow! I am 20% more satisfied with basic and important aspects of my life and my health than I was 4 months ago! That's a 5% a month increase--a pretty good return.

So, I had my Christmas tear, but overall, I am on a good path and want to continue in that direction. It is, overall, very satisfying.

As we transition into a new year, I am also going to transition the focus of this blog from eating to exercising--part 2 of 3. (Part 3 is about self care, stress management, spirituality, that kind of thing, but we'll get to that later.) I have much less to say about exercising than I have about eating because, well, it's just not as complicated, but it is just as important.

One last little aside I have to include about mindful eating before I move on, though: I told my 7 year old daughter about the mindful eating exercise I described in my last post, and she proceeded to show me how it's done. She spent the next FORTY-FIVE minutes eating three small squares of a chocolate bar. She's my hero!

Mindful Eating

Have you noticed that mindfulness seems to be the panacea of our time? Well, it works for weight management, too. Eating when you're hungry, eating what your body wants, enjoying every bite, and stopping when you've had enough all require paying attention. Paying attention = being mindful. Mindful eating is eating with intention, with awareness and without judgment.

If you've never actually tried a mindful eating exercise, I highly recommend giving it a try. It'll only take five minutes.

Here's what you do:

1. Choose a bite sized bit of food. (You can do it with a whole meal, but it will take a lot longer!) In my class we had a choice of a chocolate chip or a grape. I've heard raisins recommended, but raisins are not a food I personally want to pay too much attention to.

2. Before you start eating, take a few deep breaths. Bring your attention to your food and the act of eating. (I think it's important that we always stop to acknowledge that we are about to eat. That in itself can be a big step!)

3. Think about what had to happen in the world to bring you this bite of food. (I found this part very profound!) Is it in its original form or has it been transformed into whatever it is now (eg, if you're eating a raisin, it was once a grape which was once part of a bunch which was once attached to a grape vine, etc.)? How many people might have been involved in making this piece of food what it is and getting to you? Were there factories involved, packaging, transportation, grocery stores?

4. Look at your food and notice what it looks like. Bring it up to your nose and notice what it smells like. Touch it to your lips and notice what it feels like.

5. NOW you can eat it! Notice how we're on step 5 before it even gets in your mouth? See how slowly you can eat it, how long you can make it last. Notice what it feels like in your mouth. Notice what it tastes like. Notice how different parts of your mouth respond to it. Be curious about it. If you find your mind wandering, gently remind yourself that you are eating and bring your attention back to your food and your body.

6. When you swallow, let your attention follow the food all the way down to your belly.

7. If you have any bites left (not likely if you chose the chocolate chip!), take a breath or two before taking the next one.

When I did this exercise in class with a chocolate chip, we were asked to spend five minutes eating that one thing. (One person in the class had finished his before we even started!) Now obviously our busy lives will not allow that kind of time spent on every bite we eat, but once you've done this exercise, you might be able to bring a little more mindfulness to each meal.

If we can also be mindful of our bodies while we eat, we can really experience eating for the sake of providing ourselves nutrition rather than for any other reason (what other reason could there be?).

I just got three new books about mindful eating so I might have more to say on this later! In the meantime, if you want more information, I got a hand out in my class called The Principles of Mindful Eating which came from The Center for Mindful Eating at www.tcme.org.

One final thought: Although I am an atheist and have never been one to say grace before a meal, there is something very relevant and compelling about the practice of acknowledging and appreciating every meal before you eat it. We are incredibly fortunate to even have the option of overeating, aren't we?