Eating Disorder Group Sessions Group Session 1 Obesity:

Hello, My name is Nancy and I am a counselor and a registered dietitian and I specialize in working with people who are seeking help for eating disorders. First when we talk about why people eat and why they do or do not gain weight we must talk about the balance between activity and calorie intake. In general when you eat more calories than your body needs to maintain your body and expend energy in movement the calories not needed for maintenance will be used by the body to build more tissue. Though weight does level off after time any temporary increase in calories over time will create a higher weight and the only way to lose this weight is to increase the amount of energy you use while decreasing the number of calories you eat, and this must be maintained even after weight goals have been achieved. "Therefore, additional weight loss can only be achieved by a more severe diet or a more arduous physical activity routine. Most individuals do the opposite: after having achieved some weight loss, they resume their original diet and exercise habits. Consequently, weight gain recurs rapidly." (Katan, & Ludwig, 2010, p. 65) Most people eat because they are hungry, while others, some who experience obesity eat when they are bored, lonely, sad or in some way in need of feeling better emotionally and this is fine if it only happens occasionally but if the feeling of the need to eat overshadows the bodies real needs over long periods weight gain usually occurs and can be detrimental to health. Hunger is an important cue by the body that you need energy and yet at the same time most nutritionists believe that waiting until one is very hungry to eat is also not a good idea as when one eats he or she is then subject to the body's natural tendency to store excess calories to maintain oneself in a feast or famine scenario. So the importance of eating regularly is essential, especially when one is trying to lose weight because it is important to remind the body that food is always available and that it needs to use the energy given it through food as soon as you consume it. It is also important to eat the right things, as some foods simply have more calories than others and have less nutritional value. One good cue for weight loss is to balance foods, eating a majority of fresh fruits and vegetables and lean meat to fill oneself up and then eating fat and sweets in much smaller quantities after one has already achieved satiety or the feeling of satisfaction one has when they have eaten enough. It is also important to eat smaller portions more frequently to keep the body feeling energized and to keep the metabolism active. To lose weight the most important issue is balancing activity and eating so that the body does not get more or less than it needs to help it rebalance itself. It may also be important to seek medical advice about nutrients or other chemical imbalances that you have that cause your body to link emotions to eating or that cause your blood sugar to go up and down rapidly and result in storing energy as fat rather than using it when you consume it. (Jones, 2010) I would now like to open the audience to questions.

Lindsey asked: "My parents were both obese, is that why I am?"

There is a genetic link to obesity, and it may be that your body is specifically tuned to be more likely to keep weight on because of some physical imbalance in nutrients, there is a great deal that goes in to how a body uses energy and...

Yet, there is also a good deal of evidence that obesity is perpetuated by the kinds of foods we eat and how much activity we expend, and this can be a pattern that is part of your everyday life that has been offered as a learning example as you were growing up. The answer is then yes and no, as the physiology of eating and weight plays a part but so does the pattern in which you live your life, the example you live by.
Robert asked: "My girlfriend and I eat together all of the time, so we eat the same food and amounts of food, but she never gains weight like I do. Why is that?"

One of the issues that is important in this question is the deceptive nature of convenience food. If you eat out often and you both order value meals at a fast food place, but you order a bacon cheeseburger and she orders a hamburger with no cheese and no bacon you may be eating as much as 500 calories more than her at one meal. It may also be that your girlfriend simply has a completely different metabolism than you and that her body simply demands more calories than yours does or that like we have talked about before you have a metabolic imbalance that predisposes you to gain weight, while she does not.

Group Session 2 Anorexia:

Hello, My name is Nancy and I am a counselor and a registered dietitian and I specialize in working with people who are seeking help for eating disorders. First when we talk about why people eat and why they do or do not gain weight we must talk about the balance between activity and calorie intake. When you eat far less than your body needs to maintain its natural weight or when your activity level is so high that it saps all your natural stores of first body fat and then muscle you are in a position where you might be at risk for anorexia. The reasons for developing anorexia can be very complex and can be related to physiological as well as psychological factors. The prevailing idea about anorexia has been that one thing that might drive it is first the drive to be thin, thinner that is healthy for the human body to be in some cases which is indeed the ideal in our culture. It may begin as an issue of image but it is likely that it also has a lot to do with emotions and a desire for control over one's body that you might not have in other areas of your life. In reality once the cycle of not eating or purging everything you do eat begins there is a clear sense that your body and mind are out of balance and this will eventually result in simply not wanting to eat, to the point where your ability to think is challenged and you might even get so sick that you no longer even feel hungry or crave food at all. (Abraham, Boyd, Lal, Luscombe & Taylor, 2009, p. 90) I would now like to open the audience to questions.

Nancy asked: "My mom says that I became anorexic because I've been reading too many Cosmo magazines and want to look like those girls. Maybe I did, but I really just don't crave food. What do you think it is?"

Part of the answer to your question has already been answered by my discussion but the reality is that your body is now at the point, no matter how it started that it no longer craves food, because you are ill and it is working as hard as it can to help you heal. Unfortunately this is a position that your body does not no how to heal from because you need energy to heal and without energy you cannot repair the damage that has been done by not eating. Your body needs to become rebalanced by…