The Thin You Within You: Winning the Weight Game with Self-Esteem

By Abraham J. Twerski, M.D.

Diets don't work. The pounds may slide off, but for too many dieters, once the food scales and calorie counters have been put away, the weight returns. Dr. Abraham Twerski, a specialist in addictive behavior, shows that it is not lack of willpower that leads to overeating but an absence of self-esteem. To develop healthy eating habits, a person must first develop a strong sense of self.
With his characteristic upbeat style, Dr. Twerski explains:

-The seemingly illogical compulsion of overeating and its connection to low self-esteem
-The origins and evolutions of low self-esteem and how to identify common problems of a negative self-image
-How to rely on yourself, instead of food, in times of stress, anger, and fear
-How to deal with friends and family members who may contribute to and unhealthy self-image and eating habits
-How to find the courage to change the life-long habits and where to get outside help in the form of therapy and support groups

With Dr. Twerski's straightforward and honest approach, losing weight is redefined as gaining a sense of self and banishing diets forever.

• Language: English
• Publisher: Macmillan Publishers
• Release date: Nov 15, 1998
• ISBN: 9781429954174

Abraham J. Twerski, M.D.

Dr. Abraham J. Twerski is a psychiatrist, an ordained rabbi, and founder and medical director of Gateway Rehabilitation Center in Pennsylvania. His books include When Do the Good Things Start? and Waking Up Just in Time, both inspired by Charles M. Schulz’s Peanut comic strips; and Life’s Too Short!, The Thin You Within You, and I'd Like To Call For Help But I Don't Know the Number.

Book preview

Part One

Understanding Overeating

Chapter One

Why Do We Let People Insult Our Intelligence?

Every month, without fail, someone advertises a miracle diet guaranteed to reduce your weight quickly and dramatically and, as an added bonus, without starving yourself.

Let’s think for a moment. If any of these phenomenal diets really worked, why would there constantly be a need for new and different ones? Why not just stick with the one that works? You might argue that people don’t know which one is really effective, and that might be a valid argument—if the notion of dieting was recent. You could say the right diet hadn’t been developed yet. However, dieting has been going on for years, month in and month out: diets, pills, exercises. Hundreds of gimmicks have been advanced over the years, and if any of these was really good, certainly it would have persisted.

It is not really accurate to say that these diets don’t work. In fact, they do work, and that’s part of the problem. Almost any diet will cause you to take off weight fairly quickly, but as most people have sadly found out, it is only a matter of time before the weight returns, and then some. The result is a yo-yo syndrome, and as some people have said, they have lost more than a thousand pounds over the years—and are still overweight.

If we were honest with ourselves, we would understand that these quick, surefire methods work for the short term, but none results in a long-term weight reduction.

Of course, if you are marooned on an island with nothing to eat but fish, you could indeed lose all the weight you wanted. But as soon as you returned to civilization, the weight would come right back. This is equally true of pills, diets, spas, surgery, and other gimmicks. None of these is sustainable over the long haul, and consequently the weight loss is short-lived.

Hope lives eternal, and each time a new promise of some magical method appears, we are vulnerable. This time things will be different! The effects of the previous seventy-four diets didn’t work, but this time I’ll take the weight off and keep it off.

We know why we allow our intelligence to be insulted. We wish to deceive ourselves.

The only way to maintain a reduced weight is by a lifestyle change. We are always reluctant to make long-term changes because they can be uncomfortable. We are essentially creatures of habit. We do things a certain way, and our habits become integrated into our behavior. If you have any question about this, just transfer your wristwatch to the other hand. Even though it should not make the slightest difference on which hand it is worn, you will soon find that you are very aware of the change, and it may even feel cumbersome or awkward. Returning the watch to its usual place brings back a feeling of comfort. If feelings of discomfort accompany so minor an alteration, how much more so with significant behavior changes? It’s easy to imagine why some people consider change virtually intolerable.

Another factor in our resistance to change is an intolerance for delay. Thanks to technological advances, most tasks can be accomplished with unprecedented speed. Distances that required weeks if not months of travel can now be traversed in hours. Cooking that used to take hours can be done in minutes. Written communications that took days to arrive at a destination appear in seconds, and calculations that required laborious, time-consuming effort can be done in a fraction of a second. We have come to expect things to happen fast. However, a lifestyle cannot change at a rapid rate; it may take years. Little wonder that people who are accustomed to microwaves, fax machines, and computers are impatient with a process that takes years and are susceptible to promises of methods that take only a few weeks.

If you are one of those who have tried umpteen diets and have come to the realization that your next diet is not likely to produce any more durable results than its predecessors, this book is for you.

Much of my work as a psychiatrist has involved treatment of alcoholism. When I began working with alcoholics, a very wise and seasoned therapist told me that the only word I should avoid using with my patients was alcohol. Recovery from alcoholism requires a lifestyle change, and as long as the focus remains on alcohol, the real problem will remain unattended. This is equally true of food, and this is one reason why preoccupation with food and diet is counterproductive: It evades the real problem.

You will therefore not find in this book much mention of foods to eat or not to eat. Also, there is still no universal agreement on which foods to avoid or to emphasize: fat, proteins, carbohydrates. Each one has been championed or vilified throughout the years. Indeed, new and sometimes conflicting ideas about nutrition appear in the news every few weeks. How can we avoid being confused?

Obviously, we can use only the information we have, since we have no access to discoveries of the future. Furthermore, it is important to take a reasonable approach toward nutrition and not go overboard. For example, a recent finding that broccoli and spinach contain a cancer retardant does not mean that you must eat huge amounts of broccoli and spinach at every meal, but rather that these should have a place in the menu. Similarly, if it is found that a certain food may be harmful, this does not mean that it must be totally avoided. Usually the findings are based on foods fed to laboratory animals in amounts much larger than any sane person would eat.

There will always be people who champion dietary extremes, and there are many anecdotal claims for certain diets. Medical research has not confirmed any of these claims, and the reasonable approach is to have a well-balanced diet, based on the most reliable scientific information. The appendix at the end of this book contains current nutritional guidelines.

Eating problems involve two components: the person and the food. The various diets that have been unsuccessful in the long term have sought changes in the food. My approach is to deemphasize the food by avoiding fads and adhering to the general guidelines in the appendix and focusing instead on the necessary changes in the person. Let us now look at what some of these are.

Chapter Two

Just What Is an Eating Problem?

When does eating become an eating problem?

The primary function of eating is to provide the body with its necessary nutrients. This function, in its purest form, is best observed in animals in their natural habitat. Animals in the wild are not obese or bulimic. When their nutritional needs are satisfied, they stop eating.

This situation in human beings is not as simple. Over and above its nutrient value, food has social and ritual values. Various religious services include eating or drinking, and many social activities center around food. Breaking bread together has symbolized friendship since ancient times. Although we may have met all our daily nutrition requirements, partaking of hors d’oeuvres at an evening reception can hardly be considered an eating problem.

Eating that results in overweight can be both a physical and emotional problem. Ideal body weight cannot be calculated to the ounce. If the normal range for a person is 140-145 pounds, we hardly consider her obese if she weighs, say, 147 pounds. Although there is no precise demarcation between healthy and unhealthy weight, bear in mind that the heart was designed to serve the ideal weight efficiently, and that each additional pound adds almost a mile of blood vessels, which places an additional workload on the heart. It is also known that overweight contributes to high blood pressure and to metabolic diseases, such as diabetes. From a health perspective, maintaining the ideal weight is desirable, and if eating results in excess weight, it may be considered a problem.

Eating can be an emotional problem when it is compulsive, when you feel compelled to eat even though you intellectually understand that you should not be eating and aren’t even hungry. You may think you are hungry, but you know that this desire for food is not in your body’s best interest and yet you feel driven to eat.

Bulimia is a compulsive condition in which one feels compelled to eat and then compelled to lose weight. Some people consider being slender as attractive and think themselves overweight even though they are well within or even below the normal range. Their preoccupation with food, in quest of an idealized image rather than the physiologically ideal weight, results in their eating habits becoming a problem.

Elsie is a thirty-year-old woman who is representative of many others. At 5’3, and given her frame, her ideal weight should be plus or minus 116 pounds. However, at 115 pounds Elsie considered herself to be fat. She periodically dieted and exercised to lose weight and fluctuated between 110 and 118 pounds. Her moods varied with her weight, but it was difficult to determine which was cause and which was effect. Much of her waking time was occupied with ruminating about food, about her weight, and about her wardrobe. This preoccupation had far more to do with her self-image than with health considerations. While there was nothing grossly abnormal about Elsie’s behavior, she was generally unhappy, except for those days when she weighed 110 pounds, and her unhappiness could certainly be considered to be a problem."

Some people have an average ideal weight if calculated over an extended period of time, but the average is a result of a yo-yo pattern, alternately gaining and losing weight. This apparently healthy average is misleading. For example, a room at a steady seventy-degree temperature is comfortable. Wide temperature fluctuations between sixty degrees and eighty degrees yield an average of seventy degrees, but we would hardly say that the room was generally comfortable.

There are several studies that demonstrate that compulsive eating and especially bulimia are more prevalent among women than men, and that there has been a significant increase in bulimia since the 1980s. It cannot be mere coincidence that this period coincides with some fairly radical changes to the female role in society.

Several writers have pointed out that for all the gains achieved by the feminist movement, there have also been some severe stresses. Stereotyping has its limitations and may indeed be oppressive, but broadening horizons and increasing one’s options is not without cost.

In 1968 I was asked to develop a counseling service for Catholic nuns, some of whom were thrown into turmoil by the liberal changes of Vatican II. One thirty-five-year-old nun who had served as a teacher since entering the convent came for a psychiatric consultation, bringing with her a questionnaire she had received that asked about her interests and what she would like to do in the next several years. In addition to the traditional roles of the nuns as teachers or nurses, there were now opportunities for a variety of positions in community services. The nun threw the questionnaire on my desk and stated angrily, If I wanted to have a choice of careers, I would not have entered the convent. I used to receive a little card telling me where I was assigned to do the Lord’s work. I don’t want to make choices.

To some people, being dictated to may appear tyrannical, but to someone who does not want the responsibilities of decision making, this is a desirable arrangement.

The traditional female roles of homemaker, teacher, secretary, nurse, or social worker may indeed have been stifling to women whose creativity was suppressed, but there was relatively little stress in choosing a lifestyle. A woman who chose the role of wife and mother had no reason to feel that she was performing a less than optimum role. Today, however, with the opening of professions and business opportunities to women, the choices are much wider, and the demands of some of the available roles are much greater. To add to this, women in the workplace often feel that they have to prove that they are equal to or superior to their male counterparts. A woman may feel that she has to choose between being a wife and mother or being a doctor, lawyer, or executive. Choosing the former may result in her feeling that she is not fulfilling herself and that resigning herself to the traditional role is a regression, whereas choosing the latter frustrates her maternal instincts. She may therefore decide to do both, which results in what Dr. Harriett Braiker has termed the type E woman, the E meaning "everything to