Saturday, November 28th, 2009...11:09 AM

So, Skinny Trainer, What Do You Know About Being Fat?

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Obese From the Heart Cover

I have been thin, OK, skinny, all of my life. Other than wanting to go out to eat to celebrate or the random craving now and then, I don’t have “issues” with food. If anything, I don’t think about food, and I have been known to regularly let my blood sugar get too low because I forget to eat. As a personal trainer, I feel confident in my abilities to help people learn to make exercise a part of their daily routine. I am proud to know that I can help people feel stronger and more confident, but when it comes to dealing with people’s eating habits, sometimes I feel stuck. Sure, I can suggest a food journal or ways to cut hidden calories. I can recommend that people eat more fresh fruits and vegetables and less processed food, but at the end of the day I think, “Is that really getting to the root of the problem?”

So, when I heard about the book Obese From the Heart: A Fat Psychiatrist Discloses by Dr. Sara L. Stein, M.D., my interest was piqued. Hmmm . . . this seemed like a book I should read. So I did, in about two days.

What I loved about this book was its brutal honesty. Dr. Stein is a psychiatrist who works with bariatric (obese) patients, but she’s obese, too. How does that work? Why would someone want to get help with their weight problem from someone who obviously hasn’t quite figured it out themselves? I know why now: because she understands. She knows the struggle, the self-doubt, the fear, and everything else associated with food addiction. She gets it like no skinny person can.

The most humbling thing I realized in reading this book was that we are all really the same. We all turn to one tool (or vice) or another to soothe our anxiety or to try to get ourselves out of a funk or even a deep depression. We drink, we smoke, we do drugs, we exercise, we read, we watch TV, we stay up too late on the computer refreshing Facebook hoping that another friend is up late, or we eat. The underlying problems are the same. It’s just that the tools that we use to cope are different. Many of us are able to conquer our addictions, but the paradox of food, what makes food addiction so hard to manage, is that the over-eater can’t just give food up like cigarettes or alcohol or Facebook. They have to eat. So, the obese person must learn to deal with their food cravings while continuing to require calories to survive. What a nightmare. Stein lays it out in no uncertain terms: “So begins the brutal cycle of trying to control your addiction while still using.”

Sure, there are other factors that contribute to obesity: genetics, thyroid problems, culture, and chemical food additives in fast and processed foods designed to make foods taste irresistible. However, except for the rare few, there are deeper issues bubbling below the surface: depression, anxiety, anger, trauma, grief, suppressed emotions, multi-tasking, stress, exhaustion, boredom. Not only can a person become addicted to the substance that helps them deal with these problems, but they can get addicted to the problem itself. For example, a person can get addicted to the adrenaline rush that comes with productivity. Then, in response to their body’s signals to slow down, they may turn to food, alcohol, etc. to help them relax, creating another addiction. I clearly realized for the first time in reading this book that addictions come in layers and the repercussions, in turn, are complicated as well. In order to deal with any of it, you must treat the whole person and not just throw solutions at one part of the problem or the other. Dr. Stein doesn’t suggest that improved diet and exercise or bariatric surgery won’t help the obese person to lose weight, but she very clearly warns that failure is almost guaranteed if these approaches are seen as magic bullets.

I don’t have all the answers. Dr. Stein doesn’t either. I do know that my approach to helping my clients continue to make changes that improve their health will shift gears a little bit. Exercise is a good start. It helps the person feel like they are doing SOMETHING to deal with their problem, but they need more. A food journal or counting calories or boxing up half your lunch might work for those who are overweight simply because they are not paying attention, and I have those clients; but for the clients who struggle daily with what they eat, I need a different approach. Without playing dietitian or therapist, I will suggest. I will prod. I will offer ideas for small, realistic changes in eating like substituting fruit for processed sugar. I will encourage my clients to take time for themselves to relax and recharge. I will suggest that they get sunlight. I will recommend prayer, affirmation, meditation, gratitude. I will help my clients recognize negative thought patterns. I will honor my clients in the bodies they are in. I will encourage my clients to seek joy in everyday things. I will meditate on Namaste: “The divine in me honors the divine in you.” In so doing, I will remind my clients to honor the divine in themselves. When necessary, I will refer my clients to others who can help them better than I to deal with the underlying issues. I do a lot of this already. It’s in my nature. It is part of my mission. Now, I feel assured that it is the only way.

Maybe this is all just wishful thinking. Maybe the skinny trainer still doesn’t know what she’s talking about. Maybe. Dr. Stein calls obesity “the last unanswered prejudice. It is acceptable in society to ignore, demean, degrade, to be openly hostile toward, and to generally overlook obese individuals.” We allow ourselves to do this because we sometimes forget to see the obese as “individuals” at all. This is why looking at the whole person in trying to help makes so much more sense to me than a stupid food journal and calorie counting.

Thanks Dr. Stein for your insight and thanks to my clients who challenge me everyday to see a reflection of myself in them.


Update (01/12/2010): Just today I saw an interview with Dr. Stein on YouTube!

About the Author:

Chris Heidel is the owner and primary personal trainer with Libra Fitness in Austin, TX, a private, in-home studio. Chris focuses her business on developing mentoring relationships with her clients built on trust and meaningful support to help them set, achieve, and maintain realistic fitness goals. Chris truly believes that while getting in shape isn’t easy, it doesn’t have to be complicated. Chris is certified through the American Council on Exercise.



  • I’m obsese (duh). I struggle with it, but over the past year I’ve come to realize that I don’t dislike myself as often as I used to. I know that sounds weird. But I don’t see myself as being “the useless fat chick” as often, I never thought that all the time, but there were times when I felt that way and now I catch myself and realize I’m making progress in myself.

    Yeah, I’m overweight. That, honestly, probably won’t change without surgical intervention (which I am considering – after I figure out how to pay for it anyway). I can try, I can drop some pounds, but I have have hereditary issues (90% of my family is probably considered morbidly obese) and probably enough emotional baggage to keep any therapist busy.

    But this year, I’ve been trying to focus more on being healthy, exercising (even when I damn well don’t want to), eating the right foods (even if my portion control sucks). That’s big for me. I still eat too much and I still eat when I’m stressed (that’s probably my biggest trigger – stress) but if I can grab the watermelon instead of the cupcakes, that’s a win. And I find myself not grabbing the cupcakes at all sometimes too, which is always kind of shocking *laugh*

    For me, right now, seeing those bloodwork numbers come back really good (my doctor is always impressed actually) and feeling strong and working out and building muscle and feeling really good is more important than that number on the scale. In fact, I’ve stopped looking at that number for now. I want to concentrate right now on how I feel about myself and how I feel in the body I have. When I can accept that, perhaps I can move forward on what else I need to do. I’ve done all the diets and stuff. I refuse to set myself up for failure again, it will happen, not as fast as some people might want, but it will when I’m ready (mentally and physically and emotionally). I have considered a therapist, but besides the insurance issues, I don’t think I’m there yet.

    Back to your post… I read a book last year called Beautiful Boy. I cried a lot reading that book. It’s a memoir of a father who watches his son go down the path to drug abuse (meth, mostly). I realized that we all have our demons. I also realized that I can be harsh on people that get involved in drugs and can’t get out. I think it’s interesting to hear about others struggles like this because we all do have our issues. His struck home for me, not because I’m a drug addict or anything, but because I felt his pain. I felt the pain of watching some of my larger family members “eat themselves to death” and I wonder, is that really any different? I don’t want to pass that down to my own children, so I have to – I have no choice – I have to make changes. Those changes won’t happen in a year or even 2 years, but I think I’m on the right path, but I’m also open with my kids about my problems and what I’m doing to change it. I’ll never be perfect (if you find someone perfect, let me know, k?), but I can make positive slow changes. Changes that will hopefully stick.

    Further, since I’m over-sharing on your blog and probably out-writing you *laugh* It’s one reason I love you and how you handle your clients. You take it slow, but you push when needed, just little ones “just 2 more”. I think that had you pushed too hard and fast, I would have given up. But I haven’t. I’m showing up and doing it. And I give myself major points for that. This is the LONGEST I’ve EVER stuck with any type of exercise program. So, thank you, Chris. For accepting me for who I am, but also for keeping me on the path. You, my dear, are simply amazing.

  • This is a fantastic review. I must read this book.

    As an adult, my weight has ranged from anywhere from 130lbs to 218lbs. I have analyzed my emotions and behavior around food for years. Food can be used addictively as well as a tool against society and against self. I had conflict around how strangers reacted to me when I was thin. I felt unsafe. Ironically, being heavy has freed me in an important emotional way. When people tell me they think I’m beautiful or sexy, I believe them. And the reason is that I’m convinced it’s real and true, not attractiveness based on a societal standard.

    I think a glass of wine and about 5 hours of your time and I can finish this thread…

  • Candy, thanks for affirming that a trainer doesn’t have to be a drill instructor to get results, and I’m sticking to you like glue! Proud of ‘ya.

    Jenna, a few more months, and I’ll bring a bottle. :)

  • Chris, what a wonderful review. I want to go out and get it too. You are so right about everyone having their own issues. I have done so many good things with regards to my health in the last few years, but I can not, for some reason shake my Dr. Pepper addiction. It sounds crazy, but I’ve been drinking it since I was 9 and it is completely an emotional thing for me. I have tried so many times to quit and I just keep coming back. Personally, I think, like you mentioned, that it’s related to anger, pain, hurt feelings, SOMETHING that I haven’t dealt with and need to. I’ve been reading a lot recently about disease being caused by emotional issues and I am coming to firmly believe that. Thank you for an insightful review into the book and into you. Your clients are very lucky to have a trainer that takes such an interest in them.

  • Thank you for spreading the word about this incredible book. Even though I had weight loss surgery almost 9 years ago (and kept off all 130 pounds) this book has been an incredible resource. I had so hoped someone like you would just take the time to read it and relate to those of us that have lived the obese life…and the many misconceptions that exist. I’m going to take time to write a review on the book sites and I think you would do a great service to Dr. Stein if you submitted yours as well. I’ve been trying to talk “addiction” for years in the weight loss surgery community and I was thrilled the book addresses the subject in depth along with many others. Awesome post!

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  • How did I miss this amazing article? Thanks, Chris. You’ve helped me find the courage to face my demons. Plus you’ve added a book to my “to read” list. p.s. You are a gifted writer, by the way.

  • Thanks for writing about this topic. I’m obese, more than 100 pounds overweight and for years I have tried to explain to others how obesity is a totally different issue from being overweight. Yes, diet and exercise works, but somehow it doesn’t last for most obese people.

    Yes I have managed on my own to lose 120 lbs. I did it by myself. Then regained 100 of it. People who are obese have millions of fat cells on their bodies, so even when we lose weight we don’t lose those fat cells. They are just there waiting for just one cup of soda, and before you know it your back to point one.

    The fact is obese people can never eat like “regular people” ever again in their life, thats why gastric surgery works for most of us. We can never have a full plate, because in reality a full plate lead to another and eventual weight gain. Just a few ounces at a time. But truly who eats like that?

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