Saturday, Aug. 02, 2008

Forget dieting rules and listen to your intuition, counselor says

Modesto woman to join Stanford in a study

When people come to Signe Darpinian desperate to lose weight, they usually have tried the popular diets -- Atkins, South Beach or the calorie-counting plans.

Darpinian is one of a growing number of health professionals who urge clients to forget dieting rules. Her therapy includes simple messages like "eat when you are hungry." Clients trust their bodies to tell them when to eat, what foods they are craving and when to stop.

The process called intuitive eating, which involves homing in on the internal feelings of hunger and fullness, has been around for decades. Its champions include Geneen Roth, the author of "Feeding the Hungry Heart" and a well-known teacher in the field of eating disorders.

Although intuitive eaters seem to have a healthy outlook, there is little scientific proof it works better than the latest diet.

Darpinian, a marriage and family counselor in Modesto, is joining with researchers in the Eating Disorders Program at Lucile Packard Children's Hospital at Stanford in an intuitive eating study involving adolescents. The 16-month study, which could start in January, will track the young people for weight loss, but also determine whether they keep the pounds off and have healthier bodies and minds.

Darpinian runs the Meghan's Place Eating Disorder Center in Modesto, which counsels young people struggling with anorexia and bulimia. She said she's had success teaching intuitive eating to adults, and her work caught the attention of the Stanford researchers.

Dr. Rebecka Peebles, an instructor in adolescent medicine at Stanford School of Medicine, will conduct the study and Dr. James Lock, director of the eating disorder program at Lucile Packard, will oversee it.

Peebles said she works with obese children who need to control their weight for health reasons but can't seem to stay on a diet.

"We are trying to get them to use more intuitive approaches," Peebles said. "These kids want to lose weight and have tried all kinds of desperate measures or diets they found on the Internet. ... I really want to see how this works in a research setting."

With obesity at epidemic levels in the United States, the stakes are high in finding an effective approach to healthy eating. The relapse rates and sense of failure created by dieting have spurred interest in nondieting approaches.

The general idea is that humans are born with instincts to regulate food intake. But cultural obsessions with body image, food, dieting and a fast lifestyle cause people to lose touch with their physical hunger.

Must deal with emotions

People sometimes eat in response to emotions. They dig into that quart of ice cream because they're upset, sad, lonely, bored or they need to celebrate.

Darpinian said dieting manuals teach people to ignore the sensations of hunger. Dieters lose weight and then put it back on because they are not dealing with the emotional issues behind food, she said.

"People are so used to having someone else tell them how to eat, they are not used to responding to their inner bodies," she said.

When clients begin the therapy, she asks them not to eat at regular meal times for a few days, so they get in touch with their hunger. Clients learn to eat when they are hungry and to listen to their appetites, which tell them what foods their bodies need. Do they want something creamy, chewy, crunchy, sweet, salty, cold or hot?

A second guideline is eating what appeals to you. Intuitive eating has no list of forbidden foods. People can trust their bodies to want a balance of protein, carbohydrates and other nutrients, she said.