Jean-Philippe Zermati: “learn to be hungry when sitting down for a meal”

You remember, last summer Doctor Zermatti answered many of your/my questions about his method and its implementation through the web site Linecoaching, created by him and Doctor Apfledorfer. A few questions were left and he promised he would come back to enlighten me/you. I’ve listed what I find comes on a regular basis, keeping in mind that it is impossible to deal with each case and to go into details of all eating disorders. But, I think, there is something in it for everyone. We have planned to reiterate this exercise in a few weeks with a theme worth its own interview: “how to deal with impulsivity, mother of all eating vices”. In the meantime, I’ll leave you to this long article which I hope you will like.

Furthermore, Doctor Zermati asked me let you know that he and Doctor Apfeldorfer are putting together a group therapy which will be “live” (not online) and places are still available, in case some of you might be interested. For more info, click here.

Lastly, and that will be all, I am keen to say once again, even if it seems obvious to me – but my Internet experience has taught me that NOTHING is obvious – that I am not a stakeholder of Linecoaching. I maintain a trust relation with mister Zermati and I keep mentioning his method very simply because I have been able to observe it bearing fruit with me. In a totally selfless way thus.

I’m handing over to Doctor Z.

Is your method compatible with family or office life? Because, eating when you are hungry, by definition, can’t be scheduled, can it? What happen if appetite comes at 4 p.m.?

Jean-Philippe Zermati: It is true that family or social meals are here for everyone to eat together at the same time. Meals are indeed organized according to social, even physio-social, conventions. Proof is in Spain they make sure they are hungry around 10p.m. when in the US it will be much earlier and around 8p.m. in France. The definition of meal could be this one: the moment you decide to share your hunger. But people suffering from eating disorders don’t know how to be hungry when it suits them. That is why this skill has to be taught to them: to control their provisional appetite. It requires practice and a transitory phase which can imply not matching other people’s schedule. But the objective really is for this phase to be transitory, and not living with a different pace from your kin’s! The goal is to learn to be hungry when sitting down for a meal

But then how can we control our hunger so that it matches the one commonly accepted in our society?

Jean-Philippe Zermati: the guiding principle, is to first give priority to your hunger and not to meals. Knowing that initially, indeed, hunger can appear outside lunchtime for example. Then you have several options. First, it’s to decide to have lunch at 11 a.m. because you can’t wait, you are too famished and don’t know how to deal with it. Some people will pick this option at the beginning of their therapy. Secondly, you can decide to wait, telling yourself you won’t faint and you are able to wait. But some people simply can’t do it because it makes them too anxious. The third option left is the snack. Namely, eating something small enough for hunger to come back an hour later. There too  it can be complicated with eating disorders. Some people can’t stop once they’ve started and are unable to eat a small piece of bread, chocolate or any food without reaching satiety. That is why the process takes time and requires parallel work on a lot of difficulties explaining this bad management of hunger: fear of starving, emotion you can’t deal with, etc. Practicing savouring will also help to be satisfied with a small snack which won’t threaten the social organization of meals.

But the final objective is to be able to control your provisional appetite and to manage to sometimes eat just enough not to be too uncomfortable and start your meal without feeling full already.

In short, it’s a bit as if we had a hunger wallet and decided to “invest” in shares on some times during the day?

Jean-Philippe Zermati: Yes, a bit! You will choose the moment when you want to be hungry. But wait, this control is not be used to lose weight!

Is it possible to follow an online therapy when you suffer from specific pathologies like thyroid disorder, imbalance linked to menopause or even diabetes?

Jean-Philippe Zermati: I will answer for each of these examples, knowing that one of them is not a pathology but a normal physiological evolution!

But let’s talk first about the thyroid. For a start, I would like to highlight that, contrary to common belief, you don’t put on that much weight because of thyroid disorders. Actually, once it is balanced with medicines, you don’t lose that much weight either. In any case, once the thyroid disorder is balanced, there is absolutely no contraindication to follow our method.

With regards to menopause, which is, I insist, not a disease, you want to know one thing: menopause theoretically does not imply physiological weight gain but rather a shift of fat from the lower to the upper part of the body. This process is triggered by hormones, you can’t fight it and there is no miracle solution against it. But, truly, it can be hard to go through this period. Because of these changes in your body, of course, but also because a whole lot of things that happen at the same time (children leaving home, end of activities, etc). Inevitably, it can worsen or trigger eating disorders. Our method is thus fitted for this phase of life, since it just focus on how to deal with emotions. But you must keep in mind that there is nothing we can do against natural transformations caused by this hormonal disruption.

And finally, diabetes. Now, it’s a bit more complex. We indeed specify in the contraindications of Linecoaching registration process that diabetes requiring a treatment is a contraindication. In reality, the only contraindication is for people whose diabetes is treated with sulfa drugs. Because in that case, experimentations with hunger are impossible, these people could indeed lapse into a diabetic coma. But for other diabetes cases, the care they receive has evolved a lot. A few years ago, indeed, diabetics were given very strict diets, with no quick-sugar food at all. Little by little, they have been reintroduced and today some doctors decide not to prescribe such a strict food diet and to adapt insulin intake to eating habits rather than the other way round. Why? Because they realized, just like us, that diabetic patients used to develop very strong eating disorders because of too many interdictions. These disorders could put them in danger physically. It thus brought them to change the way they were treating patients. Not because of their ideology but because of pragmatism. For a nutritionist, if the given diet fails, the patient will gain weight again. For a diabetes specialist, if the treatment is not fitted, the patient dies. Obviously, it forces you to question yourself!

Experiments are thus done currently consisting in checking on diabetics who are allowed to eat according to their hunger sensations. Results seems very positive. The blood sugar level reduces just like with a low calories diet and it comes with a weight loss we hope is more lasting than with restriction techniques.

You now understand than diabetes in itself is not an obstacle for this therapy. Except when diabetes is treated with sulfa drugs. Thus if some people want to register but suffer from this pathology, they can write to us so that we can assess their situation.

What about people suffering from massive obesity? What hope can they harbor with your method?

Jean-Philippe Zermati: As a preamble, may I remind you that massive obesity is diagnosed for BMI over 40. These people can’t hope to come back to a “normal” BMI of 25. It doesn’t mean there is nothing we can do. First, we can help them to stop gaining weight. Because even when you’ve reached such an obesity level, the process doesn’t stop. If nothing is done, you keep putting on weight and even in an exponential manner, because after a while fat cells have multiplied (see the article in which I explained it). First step, thus, stop weight gain. Then, some of these people are still above their set point. We can thus help them get it back. This set point, I insist, surely has evolved at the whim of all the diets the person has been on during his or her life. Their set point can thus be very high, which can still be incapacitating. They can then rightfully hold claim to gastric surgery. But then too, we can help them, because this operation must be prepared. It is better to get there with a normal eating behavior. After surgery, there is always a euphoric phase coming with weight loss. Compulsions disappear because the person is driven by his or her weight loss, exactly like at the beginning of a diet that makes you lose weight quickly.  But when weight loss stops, if you haven’t worked on your eating behavior before, disorders come back and threaten the gastric surgery. That is why it is interesting to get ready and that is what we do.


To read the first episode of this interview, click here.

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