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Sandwiches

• Ask that spreads be served on the side.
• Use mustard, lettuce, tomatoes and toasted bread to improve sandwiches without adding extra calories.
• Choose lower calorie fillings such as lean beef, chicken, turkey and tuna. (Unless high in mayonnaise).
• Replace mayonnaise with low-fat yogurt in other kind of sandwiches, choose mustard over mayonnaise.
• Spread your bread or toast thinly with an all fruit presence or a paneer-based spread you can make at home, flavoring according to your choice.
• Go slow on greasy burgers, samosas, and chocolate, whatever.

Beverages

• Try having ice water or club soda with meals.
• Have coffee or tea without added cream or sugar.
• Exercise control over alcohol. In particular do not drunk on an empty stomach, alcohol brings your worst food cravings to the fore.

Oriental Restaurants

• Choose steamed dishes, stir fried dishes, vegetable-based dishes, vegetable based soups, steamed rice.
• Avoid deep-fried and/or batter dipped foods, fried rice, sauces and gravies.
• Ask that foods made in oil or butter be sautéed in wine instead.
• Avoid buffets for they leave you with no option to order food prepared.

Indian Restaurants

• Good appetizers are minestrone soup, clopping (seafood soup), or steamed mussel's ion red sauce.
• Choose lean veal, chicken or fish.
• Choose tomato-based marinara, masala and cacciatore sauces on pasta.
• Avoid sausages, meat ball and meat sauces, cream or butter sauces, breaded or fried meats & vegetables, butter sauces, breaded or fried meats & vegetables, buttery garlic bread.
• Go for pasta e fagioli or spaghetti with marinara . Avoid fettuccini Alfredo (pasta with cream sauce) & cannelloni (cheese filled pasta) other high-fat pitfalls are fried calamari and eggplant parmigiara.
• Few Indian restaurants offer salad bars where you can put together, your own salad from a range of ingredients. Just watch it with the dressings and with toppings like croutons and cheese.
• Cheese tandoori chicken and fish dishes as well as those using a low fat yogurt curry sauce.
• Choose vegetables prepared without ghee (clarified butter) lentils or seekh kababs.
• Restaurants offering all-you-can eat thalis & buffets tempt you to eats all too much.
• Mate cereals, lentils (dals) legumes (beans & peas) and vegetables the superstars of your meal.
• Mate cereals, lentils (dals) legumes (beans & peas) and vegetables the superstars of your meal.
• Steamed idlis are a good choice if eating at a South-Indian restaurant.

Mexican Restaurants

• Pick your way carefully through Mexican menu. Gazpacho, grilled meats, seafood, chicken fajitas, black bean soup, plain corn tortillas, with salsa dip soft chicken tacos or beans in a soft tortilla are among the wiser options.
• Avoid fried meat dishes, high-fat side dishes such as sour cream or guacamole, large amounts of cheese, smothered dishes, fried chips, refried beans, quesadilla crisp tacos, salted chips with salsa, beef burrito with cheese or sour cream
• Choose vegetable toppings for pizza instead of extra cheese.

Greek Restaurants

• Choose plaki (fish with tomatoes, onions & garlic), shish kebab, rice & pita bread.
• Grilled chicken salad is a healthy choice.

Japanese Restaurant

• If the cuisine is Japanese, Yakitori (meats grilled on a skewer) is a good choice as are summon (cucumber salad) and teriyaki.
• Avoid deep fried foods such as tempura other dishes kinder the heading of a gemono (which means deep fried), tonkatsu (fried pork) and tori katsu (fried chicken) need to be avoided.

Steak House

• Choose small portions of lean cuts of beef such as London broil, filet mignon, sirloin or round steak.
• Have visible fats removed before broiling.

Desserts

• If you have a choice, choose fruit-based creations-something like a fruit sorbet, or a fruit salad (minus the ice-cream) over cake, or torte or pie.
• If a fruit based desert typically comes with a fat rich topping sauces such as cream, crème fraiche or a chocolate sauce, request the topping to be on the side and spoon it on with a light touch.
• When you do eat ice creams, try regular varieties rather than rich, super prenum types, which are invariably high in fat.
• Other low fat options: Desserts that rely on egg whites, such as meringue or angel food cake, sherbets, ice milk or flavored ices also won't do you in.
• Face-to-face with a seductive or other rich desserts (sundaes, kulfi) tale a one-spoon or one fork helping.
• Fresh berries are excellent choices of dessert if you pass up the cream.
• Ask about special low-fat low calorie offerings: perhaps there's a gelatin & sugarless fruit based dessert choice for diabetes and that's good for weight watchers too
• Having made all those demands & having had them acceded to-don't forget to tip generously. Your server deserves an E (i.e. Extra) for effort.
• Never forget that the secret to successful weight-loss lies in working with your body, not against it. Without dumping healthy eating for the gourmet approach, there are always ways with which you can make life easier for yourself and for the rest of the company. WF will teach you ways to add nutritional heavyweights to your diet instead of giving them up.

Words to be Watched Out in Restaurants

Words Indicating Low-Fat Choices

The Ten Certainties of Successful Weight Management

1. Accept Your Body and Learn to Have a Positive Self Image

Because thin females are seen as the ideal in our society and because we have come to believe that body size and shape are totally under a person's control, most people enter diet and exercise programs with unrealistic goals and expectations. If you continually strive to achieve a socially imposed ideal, you will never be free of your insecurities or your self-consciousness. You must truly realize and then learn to accept that we are not all meant to be fashion-model size.

Our body size and structure reflects not only our eating and exercise habits but also our genetics. The role this latter factor plays in determining weight seems to vary greatly between individuals. We are all born with a certain body type inherited from our parents. Although hardly anyone is pure body type, there are three different applicable categories: ectomorphs, mesomorphs, and endomorphs.

Characteristically, ectomorphs have a light build with slight muscular development. They are usually tall and thin with small frames and narrow hips and shoulders.

Mesomorphs have a husky, muscular build. They often have broad shoulders, and their weight is concentrated in the upper body, making them look compact or stocky.

A heavy rounded build with shoulders usually narrower than their hips characterize endomorphs. They have a round, soft appearance and are more often overweight or obese.

When we understand and appreciate our bodies, we are able to work with them, not against them. Although many of us are a combination of two body types, we cannot become what we are not. However, everyone can improve their appearance and their health and performance levels by implementing the principles WF.

Even if you have a genetic predisposition to being overweight, the way you live is what ultimately determines whether you become fat. Genes clearly play a role, but they certainly don't determine what you're going to have for dinner or how often you exercise. Chances are if you're living an unhealthy lifestyle, you'll become fat and unhealthy.

All of us can't be thin. But every single one of us can be healthy. By focusing on what you're eating and how much you're exercising, you'll be able to achieve optimum health and fitness, even though you may not achieve society's ideal of thinness. Accepting yourself does not mean that you're hopeless and that it's okay to do nothing. It means that you feel good and care about yourself, and that you want to be the very best you can be, regardless of your genetics, regardless of society's standards.

To achieve this level of optimum wellness, you must have a positive self-image. This means that your feelings about your body are not influenced by events in your daily life. For many women, life's problems are projected onto their body. “If only I were thinner-or more muscular, I would have made the team, gotten the job, been chosen...If only I were thinner-or more muscular, I could meet more people, find the right guy be happy”. This self-defeating habit is reinforced by the image we see in advertising; your body becomes an easy target for everything wrong in your life.

When you have a positive self-image, you value and respect your body; you are also more likely to feel good about living healthy lifestyle.

No matter how much genetics predetermines how you store and lose fat, the body you've been given will still respond positively to being appreciated and treated well. Focusing on fun physical activity and eating healthy foods will help you feel good whatever your size. Developing a healthy, positive image of you is the first critical factor in your fitness success. Having a strong sense of self-worth provides the basis for making rational and affirming decisions about your health.

2. Avoid the Negative; Choose the Positive

Negative self-talk is a destructive habit and part of an essential defense mechanism that we often develop to protect ourselves. We are all strongly influenced by our feelings, often determining how and what action we ultimately take. If the feeling is uncomfortable, negative self-talk results; then we often decide not to take any action at all.

Many women assume that if a past experience produced a certain result, there is nothing they can do to change that experience in order to produce a different result. “You tried every diet there is. I know what I should do; I just can't do it”.

Please understand that you can make the choice not to repeat old patterns of eating, non-exercise, and negative thinking. You have the ability to choose the emotions you have. If you don't like feeling guilty, frustrated, or doubtful, you can choose not to. You, and no one else, must decide what is comfortable for you. In order to become successful at making healthy choices, you must avoid negative self-talk and start practicing positive thinking.

Positive or negative self-talk plays a big part in your decisions. It is very important to practice positive thinking and to remind yourself that you're a worthwhile person whatever you do. Try to consistently acknowledge that you are making positive changes to improve your health. You should be proud of yourself. Visualize yourself as capable, happy, and confident.

Remember that there are bound to be times when you're feeling frustrated or depressed. Positive thinkers know that these feelings are valid, and they don't try to ignore them. Positive thinkers acknowledge and try to understand them, but they don't blame themselves for the conditions that lead to these feelings.

3. Accept Change as a Positive Force in Your Life

In order to be successful at leading a healthier lifestyle, you need to have knowledge and a good understanding of the best, most effective ways to do that. WF will give you that. But we also want you to know that it's okay to be afraid and uncomfortable with this lifestyle change; that's natural. Changing old habits isn't easy. In general, women have a hard time adjusting to change. Change is made even more difficult when we're not certain we want the goals we have set out to achieve. Change is impossible when we set ourselves unrealistic goals.

But it truly is possible when we set realistic goals and when we make those changes gradually. If you have a willingness to work through initial emotional discomfort as you move step-by-step into this new lifestyle, you'll find the confidence, commitment, determination, and belief in your own self-worth that will ease the way.

Health living means making important lifestyle changes in the way you eat and exercise and, we hope you're coming to see, in the way you think. It may sound overwhelming at first, but it's really quite simple. Remember that these changes will be gradual. They'll also never be painful or hard to stick with. Many Americans have already successfully made the change to healthy lifestyle. You can too, once you understand how easy it is.

Making the change to a healthier lifestyle is a process you will enjoy and can be proud of. The easiest way to go about it is to take it one step at a time. If you try to hurry change, chances are that it won't be permanent. It's important to understand that once you put into effect the lifestyle habits we are going to teach you, they are yours forever and will make a substantial impact on your life.

Once you truly believe that you have the ability to find a comfortable balance of food, activity and life attitudes, you can break free from diets forever. Action creates motivation. Once you understand and implement the non-diet approach of WF you will become successful. Once you start achieving great results, the excitement and fun you experience will make the change well worth the effort. Enjoying the many great benefits of a healthy lifestyle will help provide the impetus to stay on the healthy road you've taken.

4. Theres no Such Thing as Cheating

There's no right or wrong way to eat. Healthy eating is all about motivation, balance, and flexibility. To achieve a healthy balance, WF's weight management program offers easy-to-understand and easy-to-follow recommendations. However, it will be up to you to adapt these recommendations to your life. There will be times when you eat a high-fat meal or eat beyond fullness, or when your schedule gets so busy that you miss a workout. This happens. It's normal. But it's very important that you don't get down on yourself and abandon your new healthy lifestyle when this happens.

An all-or-nothing attitude is why so many women have so success; we choose structured programs because they relieve us from making choices for ourselves. A properly designed program makes sense, but expecting to stick to a structured eating and exercise plan for an extended period of time without ever deviating makes no sense at all. In fact, this is so unrealistic as to be a set-up for failure. If you begin to change your habits with the assumption that any deviation from your plan will ruin it, you might as well not even begin. Life is full of unplanned obstacles, distractions, and temptations. Your best approach is to prepare for them, keeping an open mind and maintaining a positive attitude.

It's very important that you begin your healthier lifestyle with an understanding that there will be days when you will stray from healthy eating and exercising. Before you begin, tell yourself that no matter what happens, rather than abandoning your new lifestyle, you'll resume your healthy habits as soon as you can; it is equally important that you feel confident, not guilty, about doing so. Whatever the temptation or obstacle is, keep in mind that it's not wrong or bad to eat fattening foods once in a while or to miss a workout. Just remember to resume your healthy lifestyle. If you keep moving forward and you don't let guilt and discouragement stop your program all together; you'll eventually have improved eating and exercise habits.

With this approach, there is no such thing as cheating. When we feel we are cheating, we often punish ourselves; we make ourselves feel guilty, frustrated and defeated. Replacing the negative concept of “cheating' with the idea of 'straying from healthy habits' takes away the all-or-nothing emphasis on right and wrong. If you treat every deviation from your plan as a failure, you won't get very far.

Substituting the idea of a brief straying away from your plan instead of feeling guilty, and learning to return more and more quickly to healthier habits, is more realistic. It's also easier and more enjoyable.

5.There are no Good or Bad Foods.

In the WF non-diet approach, all foods are legal. There are no 'good' foods or 'bad' foods. You must believe this. Sudden changes and/or drastic restrictions of high-fat foods when you have a preference or craving for fat will result in feelings of deprivation. No one can or should go through life depriving himself or herself of food they really enjoy. You must learn how to make gradual healthy changes to the foods you love while experimenting with a learning to appreciate new flavors and textures.

A recent survey showed that more than 75 percent of people feel guilty about eating so-called 'bad' foods. The greatest obstacle to adopting healthy eating habits is guilt. Attaching a value to foods only makes you feel bad for eating them. When you do decide to eat a high-fat food, enjoy it. Don't beat yourself up over it. Just make a special effort to eat low fat the rest of the day. Remember that there is nothing wrong with splurging now and then. It can even be good for you if the satisfaction of a higher - fat meal that you've been craving helps you stick with a low-fat lifestyle the rest of the time.

6. Avoid Short-Term Thinking Successful Programs are for Life

The WF program is not a plan that you go on and start over when you've been 'bad'. You must become flexible enough to allow it to become a comfortable, enjoyable way of life. Then these healthier habit will work with you and for your than against you. As you experiment, you will discover what works best for you.

Diets teach us that changing our exercise and eating habits are short-term projects rather an improved lifestyle. Headlines and advertisements everywhere read 'Lose 30 pounds in 30 days', and most women believe them. They go on and off diets, start and stop exercise programs, and their weight-and self-esteem-go up and down. Unfortunately, most women don't realize that there is a real alternative to diets, so they jump back on the diet roller coaster when their weight goes back up or a new miracle diet comes on the market.

In order to break free from the diet mentality, you need to view these healthier changes you're making as part of a permanent lifestyle transformation. To gain the lasting benefits of this program, it is important to re-orient short-term thinking towards realistic goals.

Goal setting is a great way to stay motivated and achieve the results you deserve. Unfortunately, many women set goals simply to look better in the short run and not for the other many benefits a healthy lifestyle offers us in the long run.

Living a low-fat lifestyle and decreasing your body fat takes a long-term commitment. Trying to do it all at once, however, only makes you frustrated and discouraged. Instead, set a realistic long-term goal; then achieve it by reaching smaller, short-term goals. For example, if your goal is to decrease your body fat by 10 percent, shoot for modest goals, such as decreasing your body fat by one percent each month. Decreasing body fat slowly is not only the safest and most effective way; it is also the most realistic. Every goal, short - term or long - term, should be one that is truly attainable.

Every goal should also be one that you are in charge of. Setting a short-term goal where you are in charge, such as exercising four times a week, will help you achieve your long-term goal. Remember and remind yourself: each time you reach a short-term goal, you are one step closer to achieving what you really want healthier, more attractive body.

7. Live Your Program One Day at a Time

Focusing on how you're going to look and feel at some time in the future prevents your from enjoying the way you look and feel today. Focusing instead on the day-to-day process rather than the end result paradoxically brings about a better end result. Thinking only about the future reminds you of how far you still have to go rather than focusing on what you should do today.

If you happen to overeat, or eat a high-fat meal, or skip a workout, enjoy it; don't worry about it ruining your program or your future. Shift instead to living low fat and healthy the rest of the day. By taking it one day at a time, you can do a better job of concentrating on what's working for your and what's not, how you're feeling and what you're thinking.

For example, perhaps you've just enjoyed a low-fat version of your favorite pizza, using healthy cooking techniques you recently discovered. You can't believe that how great it tasted and how easy it was to prepare. Focusing on this present moment, when you're feeling satisfied, energized, and confident, helps you stay more balanced in your decision-making about food exercise.

Setting small goals and acknowledging all the small achievements on your path are essential to successful change. Remember to take it one day at a time.

8. Eating Should Always be a Pleasurable Experience

If you're having a special diet meal that's different from what the rest of your family or friends are eating, you'll feel as though you're being punished. In order to be successful in changing your eating habits, you must look forward to and enjoy each meal you eat. This doesn't mean that you have to learn to like rice cakes and celery. It means you must learn how to make simple changes in the foods you love.

Perhaps one of your favorite meals is fried chicken, a baked potato, and salad. Small changes in how the food is prepared can turn this traditionally high-fat meal into a low-fat well-balanced one. Simply marinating a skinless chicken breast in sweet and sour sauce, rolling it in breadcrumbs, and baking it makes the chicken a lot less fattening than if it's fried. Instead of butter or r regular sour cream on your potato, try low-fat or nonfat sour cream or a reduced fat dressing.

We will discuss how to make other small, yet very effective, changes later; for now, just realize that healthy eating patterns can only occur when you're enjoying all the foods you eat. If you're eating low-fat foods just to be healthy but without enjoying the flavors and textures or how they make you feel this most likely won't be a permanent change. However, if you begin enjoying healthy foods, you're far more likely to stick with healthy eating for life.

Many women also enjoy eating out but associate this with being 'bad' or eating 'illegal' foods. Fortunately, it is very possible to eat a healthy, low-fat meal in a restaurant. You don't need to forget your favorite foods or eat before you go out with friends or family. The same decision-making process that we teach occurs whether you eat at home or go out to a restaurant. Many women think that they have two options when eating, eating for taste and pleasure or eating for health. As you learn and practice the healthy eating techniques of the WF program, these two options will become one and the same.

9. Avoid Getting Stuck in the Weight Loss Obsession

For many women, the primary motivation for adopting healthy eating and activity habits is to lose weight. They think that first they'll lose weight, then they'll feel better about themselves.

Please understand that these are two separate issues. One is body image; how we feel about our bodies, The other is weight loss. Many women start exercising and eating healthier for the sole purpose of looking better; if they don't see immediate improvements in their appearance, they decide it's not worth the trouble and quit. They ignore all the other great benefits of adopting a healthier lifestyle and forget that success takes time and commitment.

Remember that we are not all meant to be slim, trim, or beautiful. If you implement the health and fitness principles of WF, you will see definite improvements in appearance, but exactly how much will be determined in part by your genetics. Pay attention to all the other improvements you are making: increasing your levels of confidence and energy, bettering your physical and psychological performance, and drastically reducing your risks for injury and disease. Our approach teaches you to revamp your goals of weight loss into goals of enjoying physical activity and healthy eating for their contributions to increased performance, energy, and well being.

10. Take Time to Measure your Progress

Success can be measured on a number of levels. It's important to measure your progress by the new healthy habits you're adopting as well as by your appearance. Long-term decreases in medical problems, injury, and other health risks and an improved quality of life, with or without weight loss, are the most important measures of success.

Short and medium-term changes can also be measured regularly during the process. These include obvious changes in health-related behavior patterns such as a decreased reliance on medications, increased ability to perform physical activity, a reduced intake of fat, and the increased intake or dietary fiber, vitamins, and minerals in your diet.

If you've started making slight changes in how your food is cooked or prepared, or if you're reading labels at the grocery store and are discovering new tastes and textures, you're making great improvements towards a healthier lifestyle. When you feel good about yourself and acknowledge the changes you're making along the way, you're more likely to keep moving forward on your path.

Physical indicators of progress towards a healthier body fat distribution include the waist circumference and waist-hip ration (WHR). Because abdominal obesity has consistently been associated with risk factors for diabetes and heart disease, any reduction in the waist circumference or in the WHR is a positive step towards a healthier body fat distribution, regardless of weight loss.

Another good way of determining physical progress is having your body fat measured by either hydrostatic weighing, electrical impedance, or simply by using body fat calipers. This latter is by far the cheapest and most accessible. Although it is not as accurate as the other two methods, it can at the very least give you a beginning point from which you can easily measure decreases in body fat.

However you decide to measure your physical progress, never use the scale as an indicator. Your weight does not reflect how healthy you are or the progress you've made. When you step on the scale, your weight reflects the combined total of both you're lean body weight (muscle, bone, organs, and fluids) and body fat weight. Two women with identical body weights do not have the same body composition; they could, indeed, have entirely different body types. For example a 170-pound woman might have 60 pounds of body fat and 110 pounds of lean body mass. A healthier, more muscular woman might only have 25 pounds of body fat and 145 pounds of lean body mass. Even though these two individuals weight the same, one is in much better shape than the other.

Using the scale to measure your progress gives you no information about the body composition (fat vs. Muscle) changes that are actually occurring. The scale may show that you've lost seven pounds, but it can't tell you that half of the weight was muscle and water, not fat. Similarly, people become discouraged when they haven't lost any weight, even though they have actually lost pounds of fat and replaced them with pounds of firm, fat-burning muscle.

Developing healthier eating and physical activity habits will most likely result in a loss of body fat even though the scale may indicate that you weight the same. Learn to use other methods of determining body composition and pay more attention to improvements in how you feel, in your self-esteem, and in your physical appearance.

Effect of Dieting on Metabolism

When a women suddenly stops taking in the amount of calories to which they are accustomed their body responds by slowing their metabolism. The body will act as if it is starving, which sometimes it is. Metabolism is the rate at which a women's body burns the calories needed to function normally. It is for this reason that rapid weight loss programs don't work in the long run. The body responds to the plunge in calorie intake by slowing the metabolism so that it can continue to operate on fewer calories. The dieter will hit a plateau in weight loss, which for some people stimulates a frustrating pattern of weight loss and gain, known as yo-yo dieting. Repeated attempts at rapid weight loss can permanently slow a person's metabolism, making weight loss harder with each diet. Generally, diet plans that are well balanced and do not fall below 1200 calories a day are manageable.

The Slowing of One's Metabolism

Several other things will slow a person's metabolism. The first is a lack of exercise. Exercise increases your metabolic rate both during and up to 48 hours after exercising. Muscle tissue is far more active than fat tissue and even when a women's muscles are at rest, they are actively consuming energy. A person's metabolism speeds up in order to provide muscle tissue with this energy. For this reason, we also need to make sure we provide our body with enough calories to fuel the consumption of energy. Changing the amount of muscle vs. fat in the body is the primary way in which a women can alter their metabolic rate. Our metabolism also slows as we age. The body needs fewer calories and more exercise to maintain a healthy weight. It has been found though that older women who exercise in combination with a balanced diet low in fat can counteract any decrease in their metabolic rate associated with aging.

Eating Disorders: Signs and Causes

The Signs

 

Although the reasons for eating disorders are diverse, the symptoms are quite common. Some of the symptoms of an eating disorder are obsessive exercise, calorie counting, fat gram counting, starvation or restriction, a compulsive interest in health and food issues, self-induced vomiting, and the use of diet pills, laxatives or diuretics. Another symptom is a persistently negative body image expressed constantly with statements like "I am so fat," "I hate my body," and "If I was thin everything would be better." People with eating disorders may express some of the above listed symptoms in patterns, fluctuating between what seems like healthy eating patterns and harmful ones.

The Causes:

Eating disorders are in fact distinguished more by the emotions that underlie them than by the eating habits that accompany them. A women who suffers from anorexia or bulimia may not even be abnormally thin; they may simply express an obsession with their weight rather than starve themselves or vomit after eating. Eating disorders also do not all have the same emotional source. For some women eating disorders are the result of an extreme need for control or a constant need for acceptance. For others it may be the result of sexual abuse and/or a sense that they do not deserve pleasure and so must deny themselves. For some anorexic women starving themselves serves as a test of their limits, a measure of how much control they have over themselves and their emotions. For others still it may be a combination of all the above with low self esteem.

Many of the symptoms of an eating disorder are also associated with a number of other psychiatric problems. Eating disorders are very frequently associated with many other psychiatric illnesses. We don't know exactly what causes eating disorders. Many of the things that are theorized to cause them are also thought to cause other psychological problems.

Are you at Risk for Eating Disorder?

Being female is the biggest risk factor in developing an eating disorder, as women suffer from either anorexia nervosa or bulimia nervosa with a frequency nine or ten times greater than men. Beyond that, the answer is more complicated. Eating disorders are a result of social, genetic, and environmental factors.

Social pressures are the reason women are afflicted with eating disorder more than men are. Data from studies that have tracked obese women against their healthier counterparts have shown that fat carries a definite stigma with it in our culture. The larger women in these studies were found to be more impoverished, to be less successful academically, and to have a lower chance of successful marriage than other women did. Thus, media and culture can create incredible pressure for a woman to be thin.

A woman's personal background may increase her chances of developing an eating disorder. In many cases, teenagers who feel that their families do not provide them with enough attention, or if the family is abusive, may turn to food as an aid to their problems. This establishes a complex relationship with food, where it can become both a source of stress alleviation as well as the source of anxiety. Presumably, if a young woman is raised in an environment where she feels nourished, she may be less likely to develop either anorexia or bulimia, since her family is supplying her with the emotional support she requires.

Recent research has indicated that some women are biologically predisposed to develop eating disorders, either through a chemical imbalance or through genetics. For example, it has been shown that low levels of serotonin, a neurotransmitter used in the brain, can disrupt normal eating patterns. As for the genetic factor, a few studies with twins indicate that at least a few cases of eating disorders may be attributed to inheritance. It is important to note, however, that neither one of these biological bases may be the sole determining factor in whether a woman develops an eating disorder. Instead, they can increase the likelihood that she may become sick, especially though the influences of either social or personal history.

Combating Binge Eating Disorder (BED)

Binge Eating Disorder (BED) has only recently been recognized in the eating disorder field as a distinct disorder with its own set of characteristics.

The criteria* for diagnosing BED are as follows:

A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

Eating, in a discrete period of time (e.g. within any two hour period), an amount of food that is definitely larger than most people would eat during a similar period of time in similar circumstances.

A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)

B. During most binge episodes, at least three of the following behavioral indicators of loss of control are present:

• Eating much more rapidly than usual
• Eating until feeling uncomfortably full
• Eating large amounts of food when not feeling physically hungry
• Eating alone because of being embarrassed by how much one is eating
• Feeling disgusted with oneself, depressed, or feeling very guilty after overeating.

C. The binge eating caused marked distress

D. The binge eating occurs, on average, at least two days a week for a six-month period

E. Does not currently meet the criteria for anorexia nervosa or bulimia nervosa, purging or non-purging type.

* from Diagnostic & Statistical Manual of Mental Disorders, American Psychiatric Assn., Fourth edition.

BED is different than bulimia nervosa in that there is no purging component, such as vomiting, laxative abuse, or excessive exercise. Most people with BED are obese. It is estimated that between 20% and 50% of all obese people suffer from BED. People with BED are more likely to have been obese as children, experienced frequent bouts of weight loss and regain, have significant body shape distortion, and have other psychiatric problems such as anxiety or depression

Causes of Binge Eating Disorder (BED)

Many factors likely contribute to the development of BED . Researchers are looking into the impact of chronic dieting, sexual abuse, depression, and obsessive-compulsive disorder have on the development of these disorders.

There is great social pressure in developed countries to be thin and physically fit beyond what is necessary for maintaining good health. The ideal body size of extreme thinness and/or well-defined "ripped" muscles is unattainable for the vast majority of women . Chronically fighting the body's natural weight by undereating (dieting) has been shown to result in rebound overeating and binge-eating. Some people rebel against society's ideal body shape by overeating and under exercising. Others become so discouraged about their inability to lose weight that they give up efforts to normalize eating behavior.

Eating is a soothing behavior that leads to a sense of calmness and relaxation. When food is introduced as a way to calm down or as a reward for good behavior, one learns to self-soothe with food regardless of physical need. Overeating becomes a learned response to all manner of physical and psychological stresses, whether they be positive or negative stresses. The habit of overeating becomes so automatic that one is often not consciously aware of the behavior.

Binge eating perpetuates the overeating behavior by increasing the stomach's capacity. This, in turn, decreases the signals to the body for satiety and encourages further binge eating.

No one knows for sure what causes binge eating disorder. As many as half of all women with binge eating disorder have been depressed in the past. Whether depression causes binge eating disorder or whether binge eating disorder causes depression is not known.

Many women who are binge eaters say that being angry, sad, bored, or worried can cause them to binge eat. Impulsive behavior (acting quickly without thinking) and certain other emotional problems can be more common in people with binge eating disorder.

It is also unclear if dieting and binge eating are related. Some studies show that about half of all people with binge eating disorder had binge episodes before they started to diet.

Researchers also are looking into how brain chemicals and metabolism (the way the body uses calories) affect binge eating disorder. This research is still in the early stages.

Medical and Psychological Consequences of Binge Eating Disorder (BED)

Chronic binge-eating or overeating can lead to obesity. Obesity is associated with an increased risk of developing diabetes, high cholesterol, and high blood pressure. Chronic overeating and rapid eating can cause digestive problems, sleepiness, and lethargy.

People with BED feel tremendous guilt about their eating behavior and shame about their body size. They tend to isolate themselves which furthers the feelings of inadequacy and the obsession with food and weight. Isolation also makes it easier to binge eat or over eat. They may have limited enjoyment and fulfillment in their lives.

The discrimination experienced by the obese is real. They suffer psychologically and financially as a result. Even obtaining good medical care may be difficult due to prejudice among physicians and other health-care providers.

Tips on Overcoming Binge Eating Disorders (BED)

It is important to recognize that overcoming any eating disorder is extremely difficult and can take months or years of treatment, depending on the disorder's severity. Knowing about nutrition and health is not enough. One has to learn to respond to life differently. The following tips can help you be supportive.

• Reinforce your love by being willing to listen to your loved one's struggle and give hugs when needed.
• Do not assume weight loss will solve the problem, even if the person says it will.
• Do not try to control the person's eating, even if you are asked to do so.
• Ask your loved one what you can do to be most supportive, but do not accept the role of policeman over his/her food intake.
• Let the person know you love him/her for reasons other than body size or looks.
• Do not try to "fix" the problem by offering to go on a diet with your loved one.
• Accept the struggle, even if you do not understand it.
• Educate yourself about the disorder. There are many books available in bookstores or the library (see Suggested Reading List below).
• Attend support group meetings or therapy sessions if asked to do so.
• Model healthy eating and exercise habits. Do this as a genuine concern for your own well-being, not as a way to try and get your loved one to change.
• Practice size acceptance of yourself, your loved one, and others. Focus on characteristics other than size or looks that you admire in yourself and others.
• Recognize that it is not your job to fix your loved one. It is your job to be supportive. Tell the person about your concerns in a loving way, and offer information on resources available in the community. Then leave the rest up to her/him.

Treatment

Different types of therapy can help treat this disorder. For example, family therapy and cognitive behavioral therapy teach people techniques to monitor and change their eating habits and the way they respond to stress. Counseling also helps patients look at relationships they have with others and work on areas that cause them anxiety. In some cases, doctors may prescribe antidepressant medication to be used in conjunction with therapy.

As with any eating disorder, there is no quick fix for binge eating. Treatment can take several months or longer while the person learns how to have a healthier approach to food.

Psychological Treatment of Binge Eating Disorder

While individuals with BED often feel helpless to make changes, several effective treatments are available.

Cognitive behavioral treatment of binge-eating disorder resembles treatments developed for bulimia nervosa. Typically, it involves keeping a diary of food eaten, binge episodes and moods to identify patterns of events, situations or moods that trigger the binge-eating episodes. Individuals are taught coping skills to help deal with stressors that contribute to binge eating.

Studies indicate that cognitive behavioral treatment can eliminate or greatly reduce binge eating in most people. Interpersonal psychotherapy, another short-term treatment handled individually or in groups, also has been used effectively to treat binge-eating disorder. Initial research indicates that such antidepressants as Prozac may also be helpful in treating BED.

Weight Loss Treatments of Binge Eating Disorders

Obesity, a common problem among people with BED, is associated with many health problems. On the other hand, dieting and weight dissatisfaction appear to contribute to binge eating, so most BED treatments prescribe no dieting. Indeed, many popular treatments for "compulsive eating" advise people to give up any goals to lose weight if they are to gain control over eating. Such treatments focus on helping individuals accept their current weight.

Regardless of the attitude about weight loss, it seems clear that treatment should address poor body image, which individuals with BED often have. The message that needs to be communicated is that it is possible to feel good about themselves and their bodies despite their weight.

About Weight Gain During Pregnancy

You may have counted calories before pregnancy, but now's the time to be extra smart about what you eat and put dieting aside until the baby arrives. You need to gain weight in order to prepare your body and nourish your developing baby properly. A newborn weighs only about seven or eight pounds, but you should gain more than that. Your body must increase blood volume by about 50 percent and add muscle, fluid and tissue so that your baby can grow and develop.

If you don't gain enough weight, your baby may weigh too little. Babies who weigh less than 5 1/2 pounds at birth are at greater risk for developmental difficulties and illnesses.

The current recommendation for most women is to gain 25 to 35 pounds during pregnancy. Teens or underweight women may need to gain 28 to 40 pounds. Overweight women may be advised to gain only 15 to 25 pounds. Women 5'2" or smaller should gain at the lower end of the recommended range. The target weight for a woman carrying twins is 35 to 45 pounds.

Body weight increases at different rates during pregnancy. In the first trimester, weight gain is slow at only two to four pounds. During the last six months, you will gain about one pound per week. It's important that your weight increase steadily. You should report any sudden weight changes to your healthcare provider.

When will the weight go? You will lose about 12 to 14 pounds within a week after childbirth. Increased activity and nursing your baby will help you to lose even more. Part of the weight gained during pregnancy is stored as a fat reserve for breastfeeding. Your body will use about 100 to150 calories per day from this stored energy in producing breast milk, enabling you to return to your pre-pregnancy weight more easily.

Components of Average Weight Gain (in Pounds)

Low-Calorie, Lower-Fat Alternative Foods

These low-calorie alternatives provide new ideas for old favorites. When making a food choice, remember to consider vitamins and minerals. Some foods provide most of their calories from sugar and fat but give you few, if any, vitamins and minerals.

This guide is not meant to be an exhaustive list. We stress reading labels to find out just how much calories are in the specific products you decide to buy.