The benefits of intentional weight loss can be very significant. In addition to the directly physiological changes, improvements in disease risk markers, there is also an improvement in comorbid disease control and, not to be forgotten, the very profound psychological benefits that can follow.In 1997, Jung published estimates of the benefits of intentional weight loss. He estimated the effects of 10% body weight loss that being an average of 10-kg weight loss in subjects averaging 100-kg in weight. Jung’s study also recognized that a 10% loss of bodyweight produced a >50% decrease in the risk of developing type 2 diabetes, a fall in fasting glucose levels of between 30 and 50%, and a 15% decrease in HbA1c. Clinical experience shows that even a 5% bodyweight loss can produce quite profound benefits and many patients will express subjective improvements of decreased breathlessness’, less weight-bearing joint pain, more energy and a more positive outlook.To achieve these long-term health benefits, initial weight loss has to be maintained. In developing any weight-loss programme the emphasis must be on long-term weight management, and this has proven to be the greater challenge over early weight-loss success. The long-term prospects for those who are able to maintain their weight loss can be very significant. Hypertensive patients might be able to manage their hypertension and find they no longer require a prescription of antihypertensive agents. Type 1 diabetics might be able to reduce their insulin dosage levels, type 2 diabetics might decrease and even remove their need for hypoglycaemic agents. Additionally, they are highly likely to delay the onset of cardiovascular disease and to improve their life expectancy.However, many experts would emphasize that the improvements are best seen as a means of delaying disease and long-term monitoring of those at risk is essential. Recent research would suggest that those who are obese at the age of 40, despite long-term weight loss, do carry a decrease in life expectancy of approximately 3 years.*63/312/5*

How often in a day do you compliment people? How often do you acknowledge them? We often forget that what’s important is the bond between people and that acknowledgment of others is the basis of communication. It makes relationships intimate and personal.
If you’ve got a dog, did you ever notice how when you come home, it immediately runs over and starts licking you? Ten minutes later, if you come in again, it’s the same thing. What if you had someone in your life who gave you the same kind of love and attention? What if every time when that person saw you he or she said warmly, “Gee, it’s good to see you.”
Learn to acknowledge others. Always look for something good that you can say. Genuine compliments are important because they’re a form of acknowledgment—they let us love and be loved by others.
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Asked to imagine group therapy, most people probably picture the “Bob Newhart” variety, in which a handful of colorful characters sit in a room and interact with each other. That’s called interpersonal group therapy, and is one valid method. But group therapy comes in many forms, and groups operate in different ways. Some, for example, don’t focus on eating behavior at all; others focus on eating exclusively.

Psychodynamic therapy helps the patient gain insight into her situation and works to bring about changes in her personality. This type of group offers patients the chance to express themselves and interact with others in a safe, supportive environment. Therapists in eating disorder groups often take a more active role than they do in other types of group therapy.

One goal of treatment is usually to help the patient identify and trust her feelings. Another goal is to improve her close relationships with other people. Conversation often focuses on family issues, such as problems with parents or siblings, responsibilities at home, and so on. Other common themes include:

• The sense of ineffectiveness

• Low self-esteem

• Anxiety

• Misperception of feelings

• Mistrust of others and of oneself

• Disturbances in body image

• Avoiding maturity

• Behavior that reinforces symptoms of the illness

Dr. Irving Yalom, a psychiatrist at Stanford University and a noted group-therapy expert, has shown that group therapy works partly because the issues that concern patients aren’t just talked about as abstract theories, as may happen in individual therapy. Instead the issues are experienced firsthand, in the “here and now” of the therapeutic process itself.

Let me give an example. A seventeen-year-old anorexic named Terri had trouble keeping friends because, as a certified perfectionist, she couldn’t tolerate the slightest personal shortcoming. She was always correcting other people’s grammar or brushing lint off their clothes. Once, in a group session, she told a patient named Gail, “You can’t say ‘irregardless.’ There’s no such word.”

“What’s it to you?” Gail fired back. “Why does it bother you if I make a mistake?” Picking up on this exchange, we were then able to examine Terri’s perfectionist attitude and how it affected her relationships-not in the outside world, but in that very room at that very moment.

One drawback to the psychodynamic method is that discussions may not give enough focus to symptomatic behavior. Poor eating habits that contribute to the illness may go unaddressed.

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To keep your weight-loss program on the right track, dangling motivational carrots in front of your nose can help. Just ask Bevan Brooks, a legislative aide living in Washington, D.C., and a successful weight-loss champion.

Right out of college, at age 22, Bevan found herself heavier than she’d ever been. Not one to let such problems go unattended, she decided to make some lifestyle changes to help herself slim down and stay healthy. “I knew that it would be easier to do while I was still in my early twenties than when I got older,” she says.

Without forcing herself into a rigid diet or exercise plan, she began eating better and working out regularly. She took up jogging and cut out addictive pepperoni pizzas.

Over the course of a year, Bevan lost 20 pounds without counting fat grams, calories, or even stepping on a scale very often. How, then, did she keep motivated?

“I would remind myself of activities and special events that were on my calendar in the weeks or months ahead,” Bevan says. She liked the idea of looking her best and being in good enough shape for whatever was coming her way. Parties, trips, sporting events, visitors from out of town, and other occasions in the not-too-distant future were fuel for her commitment.

She knew that she wanted to look good for her best friend’s beach wedding, for example. Every time she thought about bagging a workout or eating too much pepperoni pizza, Bevan would remind herself about the wedding. She rarely strayed. “How I looked meant more to me than a pepperoni pizza,” she says.

Today, if her schedule looks jam-packed one week, Bevan makes sure that she doesn’t miss any workouts or healthy meals the week before. That way, during her busy week she can skip a run or eat something a bit richer than normal during a stressful day without beating herself up about it.

“Knowing what’s on my calendar also helps me get up to workout in the morning, especially if I know that I might go out with friends after work,” she adds.

WINNING ACTION

Check your calendar for weight-loss “carrots.” Instead of just focusing on reaching a certain size or shape, keep your motivational focus fresh. Use an upcoming occasion as incentive to work out and eat right. Then, once it has passed, check your date book for the next big event.

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• TYPES OF GROUP THERAPY FOR EATING DISORDERS TREATMENT: PSYCHODYNAMIC GROUP THERAPY