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Patients, Facebook friends, and friends of friends contacted me in horror after reading the NY Times article on the Biggest Loser. Weight re-gain is inevitable. Most if not all of it.  And metabolic rate is screwed too. The control you believed you had? Doomed to dissolve. The hope you were given that you'd finally made it to your goal size or weight—or were getting closer—shattered. Overweight, obese, underweight or average size—the feelings knew no size boundaries. Fear. Anxiety. Hopelessness. Panic. The pain of regain extended well beyond the 14 Biggest Loser contestants studied and their loved ones. It was felt by those of you who shared their struggle and their joy and sought inspiration from this outrageous, extremist show.  The NY Times summarized the research: by 6 years after the show’s end, all but one participant studied had either regained some weight or gained beyond their starting weight; 4 contestants are now heavier than before they tortured themselves w...

Against all odds She's not someone you'd expect to recovery. Decades living with an eating disorder, endless barriers to jump over.  But seeing the progress that my patient (I'll refer to as) Amy has made should provide hope to anyone who has long given up. Yes, recovery is possible. Not easy. Not quick. But possible. Please read through the end and share your thoughts with "Amy".  In the last 50+ years, I cannot remember a time in which I was satisfied (even slightly) with my body.   As a matter of fact, I view it as disgusting and embarrassing.   Even at my sickest state, I was convinced I was the fattest one in the room.    In this point of my recovery, I deem it important to reflect on how far I’ve come.   Below is my life’s journey thus far. It is uncertain to me why I have suffered from Eating Disorders for most of my life.    However, in my past, could lay the meaning for all of this.   My mom had EDs always.   My ED could be...

Got 30 minutes? Check out this podcast I was interviewed on yesterday on Heritage Radio's Feast Yr Ears. http://heritageradionetwork.org/podcast/lori-lieberman/ Topics discussed include: Why I love working with people with eating disorders--the most challenging of all my patients More nutrition pet peeves, what simple step pediatricians can take to catch an eating disorder What to say and not say to someone who has lost weight The me and Cate story of Food to Eat and Drop the Diet aka why I adore Cate Sangster My major food obsession. You mean you don't already know? If you like it, please share it. And thanks for your recent comments which I promise to respond to!

1) Recovery is about weight gain. Period. The simple answer?  It just might not be going the way you planned.  False.  Now don't let your eating disorder get all excited, saying "See! I told you so!" Weight restoration is surely a must for those who have fallen from their usual weight or in the case of kids, their weight for age and BMI curves. That is, their expected pattern of gain based on their age and their weight history. For kids, falling off their usual growth curve suggests a problem. It shouldn't be praised or rewarded, but evaluated. (Pediatricians, did you read that?!) But if someone's weight was high due to unhealthy behaviors such as binging, emotional overeating, or general disregard for satiety, and weight dropped with improved eating and coping, weight gain is likely unnecessary. Simply reaching a healthy range based on the charts also isn't enough. Perhaps your restrictive eating and suppressed weight began as a young teen, and you've liv...

You may have no idea how they're suffering. Your wife, or mother, or partner or son. It's about shame. And fear. That's why they can't tell you. That's why it's so hard for her to ask for help. I'm not placing blame, but I'm asking you to start to listen like you never have before. Because it's hard for those living with anorexia, bulimia and binge eating disorder to say what needs to be said. Don't be fooled by his size or his weight. People with eating disorders come in all sizes. And don't be fooled by how well she had been doing. Slips happen. That's normal. But recovery requires acknowledgement that things are amiss, and that support is available. Right there. In person. Not just virtually through this blog, or a virtual support group or a friend across the world. Yes, they need to know that you are there for them, unconditionally. Even if you really don't understand. Even though you wish they'd just 'get over it'. St...

Everyone is so happy. And doing so well, always having a great time. They’re all eating amazing food and managing their weight. They all look so healthy, too. And their kids are always smiling—they have the perfect families. Everyone else is so good at exercising—Map My Ride/Run and other apps prove they’re doing so much better than you running and cycling and walking. Yes, by comparison you hardly rate. Hardly his happiest or his best mug shot. Posted with permission. Or so it seems. It was quite timely that my patient whom I’ll call Beth, described her frustration having spent too many hours on Facebook. (Imagine that. Spending too much time on social media.)  She saw far too many ‘friends’’ photos displaying beach-bound bodies with a confidence she doesn’t possess. Like those ‘before and afters’ from diet ads from Diet Center and Weight Watchers (where the print too small to read confesses that these images are of rarely occurring weight loss that normal people don’t usually exp...

Kristen knew to avoid fats—except for those in nuts (which she included in very limited amounts) and certainly those in dairy and oils. Fats are bad. Period. She loves fat free yogurts, but those she omits because of the sugar. Same with milk, which she truly used to enjoy. Now she uses fortified water aka lite almond milk. Seasonal fruits, even the organic stuff—completely stricken from her diet, you know, because of the sugar.  Whole grains—well those have those god-awful carbs so those are out too. Yup, that leaves… lean poultry and fish and non starchy vegetables. No wonder meal planning is a challenge. No wonder she struggles to not binge following a day of deprivation. No wonder her energy level is low, and her thoughts are preoccupied with food and eating. Why can’t I decide what to eat? If you're like Kristen, you get so over-focused on what you shouldn't eat that you're challenged to figure out what to eat.   Your endless food rules about nutrition, weight and hea...