Category: Intuitive eating

I had planned to write an open letter to mister Dukan who has managed to create a buzz around himself cheaply by including a phoney and dangerous proposal in his to be published book. Some might point out the naturally gregarious media that take less than five minute to jump at the first nonsense uttered by a man whom we don’t really know where his gets his grand nutritionist title from. At the same time, it’s hard to keep your mouth shut in front of so much stupidity and I’m falling for it, of course. But as I don’t wish to stoop so low as to explain why I find incredibly stupid this proposal of giving extra points at the Bac[1] to pupils who would have a proper BMI, I will rather tell you a story.

(a bit long, I’m warning the ones who are in a rush, don’t click on ‘more’)

A story of a little girl who, around 13 years old, started to put on weight. She had never been very slim but, with the help of hormones and several other factors she managed to identify only years later, kilos started piling up at an age when the last thing you wish is to be called fatty. At the occasion of a consultation with her paediatrician, the latter, a stickler for these things – a precursor probably – sharply lectured her. It wasn’t possible, it had to be taken in hand, stop eating so much, come on madam, watch her, and you young lady, a bit of WILLPOWER, come on.

On her way out, she cried, she remembers. And the same evening, she started fasting, applying literally the diet that was in at the time and was named after a chef, Mister Olivier. With the passing of time, she now realises that she should have known better. Nevertheless, by dint of scrupulously eating plain yogurt, her mum watching her, slightly worried, she started to lose weight. A lot and fast. When you’re 13, it doesn’t take that long to slim down. Issue: she was tired. Very. So tired she fainted at school. The paediatrician, seeing her slimmer and staggering, yelled at her again. You didn’t get me, he explained, eating less doesn’t mean going on a hunger strike, and this diet was dumb, you just need to watch what you eat. How, why, this he preferred her finding out by herself. But it hung on one word the FAMOUS willpower. In the meantime, time for carelessness was over, bye bye Mister Olivier.

Except that it was too late. The rot had already set in. The little girl, with, so she thought, her censor’s blessings, gorged on all the cakes she had cut out for the past weeks. And even a bit more, just in case. It’s this just in case probably that she couldn’t get rid of later on. Just in case another doctor would order her to slim down again, just in case war would break out, just in case she would get dizzy again.

As the years went by, the little girl grew up, gained a lot of weight, and slimmed down sometimes. She, of course, didn’t stop after this first diet, one after the other with enthusiasm and foolish hopes.  Some diets worked, others less. One year, when she was finishing her studies, she straight out stopped eating or almost. Minus twenty kilos and the weird and stimulating impression that she was going to disappear. Ten month later she had gained 25 kilos and so on. In the 90’s, she discovered protein packets. Ahhh, packets. Pancakes powder with a metallic taste, plaster like and laxative vanilla “pudding”.  And the sta-bi-li-sa-tion phase. That was so alike Dukan diet, you couldn’t tell them apart, with meat and animal protein at every level and huge control over sweet veggies like carrots and green beans. Bad carrots. Again, jackpot, minus 15 kilos. And the appearance of the obsession. Of weight, of prominent hips, of the protein snack you’ll eat in two hours, fuck it’s long two hours. And no, I don’t want to go to hers, she will make lasagna again, I hate it. Well, I love it, but it’s the same, you get me. I smoke two packs of cigarettes a day but go on try to eat only a quarter of an apple for dessert and tell me how you feel. I’m happy, I fit in a size 10, but I think only of it and my breath stinks acetone from 20 km away. I’m brilliant at the same time, do you know anybody else with such a willpower? I’m just a shit, right, I gave up, I ate a carrot. I couldn’t stand peppers anymore. I’m not crazy you know? Do you still love me? How do you do this? No I’m not pulling my sweater down. It’s my tummy that I pull in reality but it’s still there, bloody hell.

And this impossible to chase impression that anyway there will always be kilos to shed, more, better. And controls from that doctor, well-established on place de la Madeleine, 120 euros a consultation to step on the scale, vaguely check her tension and sight that she should be below 55 now. He hardly bat an eyelid when she told him she wanted a child.

A desire that probably saved, if not her life, at least her couple and her reason, she now realises. Because in this body which, she thought, couldn’t welcome anyone as she hated it so much, two babies decided on an autumn day to settle and grow up. Babies who were in need, so her wonderful gynaecologist assured her, of carrots, green beans but also rice pudding, chocolate and any food she felt like. And she felt like a lot of stuff.  So much so that she never knew how many kilos she had gained during those seven months being pregnant. She stopped counting at 30.

After that, the little girl, as a mum, never again gave in to packets or other diets praised in the magazines. She even though erred for a long while from nutritionist to nutritionist, hoping to find out one who would find the words and explain her how to end up all this. Slimming down, she didn’t believe in it anymore, to stop gaining would already be good. But it was out of question to start starving herself again, out of question to weight all her food or to accept even once that an hysterical old bag measure her thighs to check if they are full of water. Never hear again that in Auschwitz there were no fat people.

On a fine day, just before her 40th birthday, she finally managed to knock on the door of the one who will never weight her, never promise any loss and never forbid anything, but who, cherry on the cake, will manage to make her loose more weight than all ever tried diets. By talking to her about hunger, emotions, satiety, the necessity to be fully aware of what she eats, when she eats it. Two years later, she has spent one week with friends eating a bit more than is sensible. Pretending that she didn’t tell herself once or twice that she was going to pay a high price would be a lie. Saying that she’s not afraid that it starts all over again, that kilos come back overnight would too be dishonest. But day after day, month after month, she finds herself believing in it. Maybe she’s out of this infernal circle. Maybe she will never go through this again.

There you go Mister Dukan. You and all your disciples, you and your inept precepts almost had me fall over to the other side. The side from where you never come back as one day the body can’t back-pedal. Because I believed, from very young, that being slim was the alpha and omega of happiness. Because believing in your dream, I ended up forgetting myself. Trying to correlate being slim and succeeding at the Bac1 is the last step of a long undermining started years ago consisting in making people think that fat persons are worms without willpower, unworthy of our so successful society. And with this, we create, day after day, more and more obese people, so anxious from the idea that they embody these values contrary to growth that they can’t stop eating to comfort themselves.

I’m convinced that we shouldn’t cultivate this disgust for fat, for obesity to lose ground. But this theory is not helping sales. It’s complicated, slightly far-fetched, almost shady. However, what I’ve kept in mind from doctor Zermati, with whom I’ve reach equilibrium, is something he told me during one of my last sessions with him: “You will be really fine when you will look kindly at overweight people you pass every day”. I try to do so because those people are my sisters and brothers. I am them forever, I have been them and will be them maybe again, because sometimes, life is so. It won’t take anything away from the fact that I’m human. I think it’s probably this that should give extra point for Bac1. Alas, we’re far from there.

Last time, I told you doctor Zermati would come back here to talk about this delicate question of impulsivity. Not the one that sometimes makes us do inconsiderate things but nevertheless positive like French kissing that simpleton of a boy who’s been looking at you for three months in the social rights class without daring to approach you.

No, the bad impulsivity. The one that presses you to empty your food cupboard because that bastard of a simpleton didn’t call you back since you French kissed him. Or because the last one didn’t sleep for the whole night and you’re exhausted. Or because your big boss is putting pressure for tomorrow’s meeting. Or… or… simply because you don’t know what to do, what can I do?

Doctor Zermati, it has been bothering him for a while, this question. Because it’s after all at the heart of his patients’ almost every difficulties. It’s bothering him all the more since he created with Gérard Apfeldorfer the site Linecoaching. Because members seems overwhelmed by emotions which drive them to compulsions. And from a distance, helping them is complicated. In short, Mister Z has thought long and hard and, a few days ago, he left me a slightly weird and inevitably very puzzling message: “Caroline, I’ve found something. It called it the chocolate pump. If you want me to tell you what it is, call me.”

You can guess that with such a name, the system could only excite my curiosity. Here are, thus, Jean-Philippe Zermati’s explanations. That, I think, are perfectly timed, right before Christmas and its trail of hard to control cravings. Without mentioning family which is certainly a softness cocoon but also a good ball-breaker sometimes and then, not other solution than raiding chocolates.

Let me give the floor to the expert.  

Why did you look into this issue of impulsivity?

Jean-Philippe Zermati: Since I’ve treated patients with eating disorders or weight issues, this question is central. But clearly, the experiment we conduct currently with Linecoaching drove me further into this thought. Why? Because a lot of members of this program suffer from compulsions and stumble over this issue of impulsivity. An appropriate answer to their questions had to be found and they had to be helped in handling this impulsivity. Food impulsivity is a reflex desire to eat, triggered by a situation of emotional discomfort.

How to handle these drives that press us to eat in a highly emotional state?

Jean-Philippe Zermati: It’s THE biggest question. The idea is not to fight against these emotions or try to suppress them. Life is made of positive or negative emotions and it’s a delusion to think you can get rid of them. On the contrary you must learn how to bear emotional discomfort and make sure it doesn’t trigger an immediate desire to eat. Or at least not a desire to eat that overrides everything else. With this purpose in mind, I’ve tried to re-orientate mindfulness exercises, which were not initially designed to address this specific issue. In a first step, I used them a lot in my office to identify and accept hunger sensations. Indeed, for some, hunger sensation can trigger true panic states. While practicing mindfulness within the office when the patient is hungry, I’ve noticed spectacular results in two or three sessions. That’s how I’ve decided to apply these exercises to emotions handling. Because after all, an emotion is not physically more painful than hunger or many other troubles we go through during our daily life.

How does the « chocolate pump » work?

Jean-Philippe Zermati: The initial principle, thus, is to observe your emotions right when you feel like eating when you’re objectively not hungry. You observe without judging the thoughts and physical sensations that go with them. Without trying to chase them away. Then, if you can, you put words on what you’re feeling: is it boredom, anxiety, joy, fear, tiredness? Once this emotion is identified, the patient has two possibilities: either she comforts herself with the desired treat. It implies having worked beforehand on how to enjoy your treat and on restriction behavior. In order to allow yourself to eat any sort of food without lurking negative ideas. In order for that comfort expectation not to turn into a compulsion. Or: maintain yourself for a few moments in that emotional discomfort to improve your tolerance to this type of discomfort and observe how it evolves with time. After this observation, again two possibilities ending the emotional exposure and choose food comfort, or again, wait a little, still observing your emotions. In the case of the option consisting in choosing to eat, if the savouring proves to be uncomforting, the principle is the same: observe again your emotion and possibly eat again, a small quantity of the same food, twenty minutes later.

Why this wording « chocolate pump »?

Jean-Philippe Zermati: because I was inspired by the morphine pump. Initially, when morphine pump was introduced, it gave rise to much criticism and many fears. Some were convinced that patients were going to give themselves much more painkiller than what they were given by nurses. Yet quickly it was noticed that the exact opposite was in fact happening and the sick were waiting for much longer between two takes, simply because they could control their decision and the length of their exposure to pain. Here, it’s finally a similar principle. At any moment, you can decide to stop bearing the uncomfortable emotion by enjoying a piece of chocolate, of cheese or any food synonymous with relief.

And it works?

Jean-Philippe Zermati: Yes it does. Mind that you must be able to observe an emotion without being overwhelmed, which implies training on mindfulness exercises. It must also be kept in mind that the experience doesn’t aim to prevent you from eating. It’s there to provide a choice between truly relieving food comfort or work on uncomfortable emotions tolerance. The outcome is usually a greater psychological flexibility and an access to a wide number of efficient answers to your emotions. This experience doesn’t aim either at calming the emotion, but at learning how to better bear it. So you shouldn’t expect to “feel better”. As such, I add that, from the accounts we gather on Linecoaching, emotions that most often trigger eating compulsions are rarely very painful. The most listed is thus… boredom. Yet in general, a bored person, who’s anxious about it, is being told: “occupy yourself”. That is totally useless. Getting busy all the time to “forget” the desire to eat amounts to an avoidance or emotional bypass strategy. A life without boredom doesn’t exist and at one point or the other, the inactivity will come back. So you must learn to accept boredom moments, even if it means comforting yourself with food, but because you’ve chosen it, and provided it is not a compulsion.

Edit: If you want a diagram that sums up this “chocolate pump”. It’s there.

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.

For the past weeks, I’ve received several emails in which some of you ask me about my experience with doctor Zermati.

I confess I haven’t answered to everyone, I spend a lot of time on my computer and handle, for work purpose, a high number of emails. Thus, I’m falling behind.

So I told myself that rather than answering ten times the same thing – you in general ask about similar stuff – I will create a sort of FAQ here. I actually already posted one sometime ago, which you can read here. But inevitably I evolve, my feelings and my impressions too, so this article is probably not useless.

Here is, thus, a compilation of the messages I’ve received and the answers I can give.

– You never mention how much you’ve lost, how much you weight today, what’s your exact clothing size, in short, give us numbers please!

Indeed, I’ve never given numbers here. Why? Because doctor Zermati advised me against it, right from the first sessions. You can read the explanation here. I want to keep that position, because I’m obsessed enough with my weight and if I start revealing it here, as well as exactly how much I’ve lost, it will only intensify. If I put on weight again and you realize it, there will inevitably be people asking how much I’ve gained. Yet it’s this pressure that, in general, makes you put on what you’ve lost. And anyway, Zermati’s method is far from perpetual “-3 kilos in three months” and promise no numbered loss. Giving you the amount of gone kilos for me might mislead you, make you think that what has been possible for me is so for everyone, or, on the contrary, make you fear not to lose more. Each organism reacts in its own way. Some will slim down more than me, and some less. In short, I’ve lost, it’s indisputable, more than I hoped, less than what I could have dreamed of at a certain period of time. All I can tell you, is that my current weight suits me perfectly, I don’t wish to continue slimming down and I’m not trying to. And the fact is that actually my scale has been fluctuating plus or minus two kilos for months.

– Was it easy to slim down from the beginning? Because for me it doesn’t work like for you and I’m wondering if you didn’t hide stuffs from us.

No, I haven’t “hidden” anything, neither medicine intake, nor intensive sport, nor any kind of privations. No, it wasn’t easy, as any total questioning of your eating system and of the way you grasp the very fact of feeding is still complicated. But it’s true on the other hand that compared to various experiences of all kind of diets and specifically the mother fucker protein diet, my Zermati journey was a true walk in the park. No food weighting, no calories counting, no forbidding… paradise for a sweet tooth like me! It’s true that I’ve lost rapidly. Maybe because from the beginning I was in a state of mind of complete trust towards this doctor. I had decided not to listen to my doubts and to lower my guard. I followed the exercise instructions literally, eating a chocolate slab for lunch during four days, then cashew nuts for my evening meal or trying to follow some rules like doing nothing else while eating. Maybe I’ve lost quickly because this therapy came at the right moment, when I was particularly receptive, I don’t know, I couldn’t explain it better than that, but I haven’t hidden anything, I promise.

– Do you still practice mindfulness exercises, do you reach it better than at the beginning?

It’s clearly one of the most difficult aspects of that therapy for me. Because you must take time to do it, you must find moments when it’s possible. Especially as I have to admit experiencing some difficulty in reaching mindfulness the same way I practiced it in Zermati’s office, with him in front of me patiently guiding me. But lately, I try hard to use these moments of mindfulness, because of the post-holiday stress, long lonely moment of my free lance life sometimes threaten to take me back into compulsion agony. And it’s true that when I reach it, before eating or during the first bites, I focus on what I’m doing and the temptation of wolfing down at 200 per hour my meal tend to disappear. I add that I also used mindfulness before leading a colloquium in June, with the satisfaction of feeling my panic calming down.

-Do you succeed not to weight yourself, do you feel freed from your anxiety towards food and weight?

No, I don’t manage not to weight myself. I weight myself everyday and I know it’s against Zermati’s recommendations, for the good reason that this weight obsession create such a fear to gain weight again that, often, you eat to calm that fear. Vicious circle, you see. But it’s like that, for now at least, I’m unable to get rid of this bad habit. Maybe because when I was gaining a lot of weight, I wasn’t weighting myself, refusing to face reality. Thus to imagining that I can lower my guard and not put on my kilos again, for now, I just can’t. You might guess that the answer is also “no” to the second part of the question.

No, I’m not freed from my anxiety. How to get rid of an anxiety that is part of me since I’m old enough to check myself in a mirror? When I was young, I would go to sleep every night kneading my tummy and repeating this prayer: “Make me slim down”. Today, I implore Mother Nature and all her henchman not to make me gain again. I haven’t reached yet this wisdom consisting of telling yourself that even if you put on weight again, you are not a looser and life is worth it anyway.

That said, I’m nonetheless a lot more zen than I was before. I’m not watching myself all the time, I’m capable of feasting without feeling guilty, telling myself I’ll wait until I’m hungry to eat again and that it shouldn’t be end of the world. When I put on one or two kilos, I don’t feel worry sick all day long with the idea that I could be on a wrong slope again. Most of all, I very rarely feel like emptying my biscuits cupboard, like it was the case before. And when it gets me, I sit down with the food I want and enjoy it, slowly. In general, it’s enough to calm me down.

– Does it take time for the method to be compatible with family life?

No, not really. I quickly found a pace compatible with my family’s. But on the other hand, I generally leave the table before my children or the Churros. Because I’m not hungry anymore. I sit a bit further on an armchair and continue our discussion with them or go about my business. I have to admit I’ve found the moment I reach satiety but I’m still struggling with not eating unconsciously without being hungry.  That explains me going awy when I feel I’ve had my fill. As a result, everyone does the same, when he or she thinks he or she is done, he or she asks to leave the table. I really have the impression that everyone is aware that it’s stupid to force yourself to eat or to finish your plate on the pretext of wasting. And there are no more crisis based on “you’re eating nothing” or on the contrary “stop stuffing yourself”. I’m not saying it’s full time serenity but better than before that is for sure.

Here you go, I believe I’ve covered it all. I’ve tried to be very honest in my answers. No, not everything is sorted for me and I believe it will never be the case. For the last couple of days, in the comments, I’ve been criticised in veiled terms for presenting my life only with its most positive aspects. Some of you thus are under the impression that I succeed in everything I do and that my life is smooth and perfect. If it’s the case, I’m sorry, because it is of course totally wrong. I’m trying hard here to spare you from my various existential anxieties. I also don’t want this blog is be my shrink. I thought it was obvious that what I don’t mention exist anyway. And if there is one worry that doesn’t leave me is the fear to put on weight again one day. Amongst others. Then, you can call it modesty, pride, arrogance, you name it but no, indeed, I don’t want to write EVERYTHING here and it won’t change.

Edit: And yes, I check myself a lot in the mirror. Probably to check that it’s not a dream and that yes, my body has changed.

I thus interviewed Jean-Philippe Zermati at the occasion of the Web site Linecoaching launch. Let me point out right now that our exchange focused on this website and not on the method this nutritionist has put together. Even if, of course, he mentions, in some of his answers, the basic principles of the method in question.

That said, I thank mister Zermati, alias doctor Z on this blog, for his answers which, I think, should enlighten you.

Before leaving the floor to the results of this interview, a few more words: I believe that mister Zermati and I have brought down one by one the barriers of a patient/doctor relationship. Mainly because of me. To have told on my blog our sessions with sometimes an informal tone has necessarily moved the initial lines. Now, here I am interviewing him, with my journalist cap, while not being able to disregard that I was talking to my doctor. Or I should write my former doctor, we indeed haven’t seen each other for a while.

This specific relationship has necessarily had an impact on our discussion and makes my objectivity rather relative. It doesn’t mean I’m claiming to be Linecoaching’s standard bearer. But I trust this practitioner, I’ve been in a position to assess his ethic and reliability during two years. I’m actually still surprised every day by the way his method has turned my life upside down. I’m not saying he deserves all the credit for my professional orientation change or my capacity to now speak in public without fainting. But, as I was telling him recently, “It goes beyond slimming down”.

After these few soppy sentences (yes thanks, my transfer is going very well), here comes doctor Zermati.

Why have you decided to create this website, Linecoaching, on top of your consultations and of the books you’ve written to explain your method?

Jean-Philippe Zermati: For me the question is rather “how could we manage without such a tool?” Linecaoching is indeed truly in line with what Doctor Gérard Apfeldorfer and I have been working on for years. I’ve been fighting for our voice to be heard for fifteen years. I was a president of the association GROS in which I participate voluntarily, give training, write books… But with this website we have a 1000 time bigger lever. We are, Gérard Apfeldorfer, myself and all the supporters of our method not very known. The apostles of all kinds of diets are much more known than us. And without being on the web we felt like we were fighting with a penknife against nuclear bomb assaults from some well-established nutritionists! Linecoaching must be primarily seen as a tool enabling us to reach a lot of people.

It’s thus not a mean to “make money” or to become a star on the web?

Jean-Philippe Zermati: Honestly, if I’d wanted to, as you say, “make cash”, I would have changed job or I would have practiced it differently. This site currently employs ten persons and it’s only a beginning, the personalized support we propose requires indeed a high number of experts being able to answer quickly to members’ questions. In an ideal world, of course, you could dream it was for free. Reimbursement of the fees by the department of health would be the only way to make it free. From the last news, it’s out of question…

What can be surprising, knowing your method or your views, it’s the promise of Linecoaching: “slimming down without a diet”. Yet, during your consultations or in your book you always stress the necessity to accept your set point and the fact that weight loss must not be an objective in itself. Why then place the emphasis on slimming down?

Jean-Philippe Zermati: You are right, I always insist with patients on the fact that weight loss is not a direct objective but a consequence of recovering a normal eating behavior. A happy consequence in general and which obviously makes me happy when my patients share it with me. But we shouldn’t bury our head in the sand. People come to me hoping to slim down. I rarely face overweight people who first of all wish to regulate their eating behavior. Generally suffering comes from weight, less often from compulsion. If we could eat more than is sensible permanently without putting on weight, much less people would consult. As a consequence, we indeed mention slimming down as we know what overweight people expect. However, you’ll find nowhere on the website a promise with numbers. And the question of set point comes very quickly, as well as the acceptation of this set point, even if it doesn’t match the one you’d wish. Acceptation is a difficult concept often confused with resignation. It is though a very powerful psychological tool which enables you to access change. You accept yourself in order to become different. Once again, Linecoaching is fully in line with our work and convictions.

Can people who will follow this online program slim down?  

Jean-Philippe Zermati: Indeed, not everyone will be able to slim down as much as they’d like. What we can do for each person suffering from overweight is to try to bring him or her back to his or her set point, keeping in mind that we don’t know, at the beginning, what it is. We can also help him or her to accept that weight. Because our theory is based on the idea that the more you stress about your weight and a slimness ideal, the more, at the end, you are likely not to slim down or even put on weight. We propose, for that purpose, that people work both on eating sensations which enable feeding when you’re hungry and stopping when you’re full as well as on impulsiveness that drives you to eat when feeling emotional. It’s a huge bet to motivate people on that promise that differs totally from the ones made by many nutritionists.

Don’t you think that with latest studies proving that a high percentage of people put on weight again after restrictive diet and especially the one recommended by Dukan, there is henceforth suspicion towards promises like “lose ten kilos in three months”?

Jean-Philippe Zermati: It’s true that, at last, it is officially said that diets make you fat. But what is rather disturbing, it’s that in general, all these people who have put on weight again after a diet say they want to do it again. Why? Because they blame themselves for this failure, not the method or the doctor. It’s a vicious circle which can last for long.

Does this individualized care via internet equals the one you propose in your office?

Jean-Philippe Zermati: No. We can’t guaranty the same customization than for face to face. Tools don’t have the same impact. I would say that the site is better than books but less individualized surely than a consultation. It’s certainly less efficient than a follow-up by a seasoned therapist but a lot better than resorting to a therapist who is not trained on eating behavior work… Besides, a lot of people, for several reasons, don’t have the possibility to resort to these therapists.

That said we are not the first ones to try the adventure of an online therapy tool. And some studies show that for some people it can be as efficient as seeing a therapist. We have worked two years to put in place this system and have used artificial intelligence software. We propose feedback on experience, regular analysis of results, regular assessments. A mutual assistance group has been put in place. It’s virtual but it’s not objectified, far from it. We try permanently to improve the system, for each person to be taken into account with his or her difficulties and to adapt their care program consequently.

Paradoxically maybe, the lack of relation with a therapist is tremendously compensated by solidarity between members and the support they bring to each other. I find a big human wealth in the exchanges. Writing within a group furthers expression. On a personal note, I’m living a very nice experience.

Who are the “coachs” who follow-up members?

Jean-Philippe Zermati: “Method” coachs – they are four at the moment but should be more numerous soon – are psychotherapists trained on cognitive behavioral therapy and whom we have trained on our method. They can be reached by mail every day.

Do you have in mind adapting this tool so that it can be used by GPs too?

Jean-Philippe Zermati: Yes one of our objective is to develop the site so that it can be used by GPs, in order to help them elaborate care programs for their patients. I also add that we train GPs, around sixty per year. But don’t have control on how they practice afterwards. With Linecoaching, we are sure our method won’t be misinterpreted or diverted from its objective.

The proposed membership is for six months, why?

Jean-Philippe Zermati: I sincerely think that you can’t obtain anything, whether through a face to face or online therapy, in less than six months. There is a possibility however for people to register for three months, to test the method.

What is surprising is that the free assessment proposed on the site doesn’t eliminate any candidate. Namely a person not suffering from overweight can be accepted in the program. Why?

 Jean-Philippe Zermati: I have never refused a patient, whether he or she suffers from overweight or not. I have more and more people who come to see me not because they are fat but because they can’t stand controlling everything they eat anymore. Knowing that one day or the other, this excessive restriction can lead to weight gain. Everyone is thus “accepted” in the program. We even hope to reach people who are not yet “damaged” by diets or issues with their eating behavior. They have a chance to obtain a weight loss that will satisfy them and which will spare them the fall in the vicious circle of restrictions. Besides, for the same size, between a BMI of 20 and one of 25, there are 15 kilos difference. A young woman who has put on fifteen kilos in a short period of time and who still has a normal BMI is not for all that free from a risk of a eating disorders. 16% of the French population suffers from obesity, but 70% of people say they have been on a diet at one point. It shows that the care can’t concern only obese people. Because once again, being on diets will make you fat in the long run. Rather take the problem at its roots.

And for people suffering from massive obesity, what can Linecoaching do?

Jean-Philippe Zermati: Unfortunately, results for these people are often not as high as their expectations. But we can of course help them. We can also propose a preparation to surgery when such an operation is programmed. Our method can also help them after surgery, when they need to learn to eat differently anyway.

Last question, I’ve often heard you saying that sport can trigger a bigger intake of food, in “anticipation” of the effort. Yet Linecoaching proposes a physical training program. Why?

Jean-Philippe Zermati: The fitness program, as we propose it, is a way to be reconciled with your body, to galvanize it and improve your eating behavior (emotional regulation and better perception of physical sensations, thus eating sensation too). We are rather surprised by the success of this part of the program. Feedbacks are very positive. And people have understood that it’s not about calories spending but about working in a different way on your eating behavior. The physical activity program stays optional as it must be in line with a desire to move.

Edit: yeah the picture, slightly cheesy. But I didn’t have one of the doctor with me and I’m telling myself that there’s a long way and blah-blah…

It is often said that when you lose weight it takes time to make yours your new image, to see yourself as you’ve become. It’s not wrong, it took me one year to first try on size 12 trousers, And six more months not to take with me in the fitting room a size 14 and 16, “just in case”.

But what is less said, it’s that others look at us the same way we do. You don’t change easily in people’s mind.

Yesterday evening, I was invited to a rout by my former boss. The occasion to meet a few colleagues from my old life. Not so old, I left only six months ago.

Six months during which I didn’t lose one gram, I believe I’ve stabilized, fluctuating plus or minus two kilos around my set point.

But it is not the question.

I thus saw again some colleagues and they were numerous – I mean it was not an isolated remark – to exclaim that I had slimmed down. Even that I was truly blooming – there was even one who though never had a nice word for me during the five years I spent under his responsibility who said the word “stunning”.

I will not lie, it was very nice, compliments, you should always accept them without nitpicking.

But still I wondered.

How come they had this reaction, when my figure was the same as today long before I left? And this dress I was wearing, my relentless black wrap dress from Monop, 2006 crop more or less, they must have seen it on me dozens of times. I wasn’t wearing more make up than other days, it didn’t take me more time to get ready, and I had terrible migraine, one that shrinks your eyes and give you a grey complexion.

I mean, I was not especially looking bad, but no more no less the same than six months ago. Of course, you can object that this new life turns out well for me, that serenity within yourself shows outside. But although I’m now sure I’ve made the good choice – or in any case a choice I must live with – I’m not unfazed at all, in the grip of questionings and daily doubts. That’s how I am and I fear I’ll have to deal with it until I reach the grave.

In short, I wish I were ‘Eat, Pray, Love’ heroine, but left with my cigarettes, my beta blocker and my hassles.

All this to say that I think the only reason for their ‘surprise’ lies in the fact they didn’t see me for a long while. And thus, they had gotten rid of their retinal persistence (I’ve been looking for a way to use that expression for three days, I find it sounds very serious) which was making them see me like I was “before”. Maybe also very simply, they weren’t looking at me before, I was part of the furniture, a work place is not a catwalk anyway, right.

The fact remains that I think it explains also why yourself you can’t look differently at a body that might have changed. You see yourself a lot through the prism of what others send back to you.

I would add that if these compliments moved me, they also slightly called to mind. The link between my weight loss and my supposed “spiritual fullness” was visibly obvious. The “you’ve lost weight”, I was hearing it as a “You’re happy, it shows”.

I believe I’ve more than ever understood doctor Zermati, when he was talking about danger of over promoting weight loss. It is such pressure, I believe, this link between well being and a slim body. If I had arrived yesterday, smiling and gussied up, but with ten more kilos, would my formers colleagues have concluded that I had made a big mistake and I was a loser? If I were to put on weight again, would I have to bear, besides annoyances linked to weight gain – be it only my ward robe renewal – sorry looks from my kin, who would deduct I’m not feeling good, even that I’m outcast?

I’m not setting the world on fire by writing these words. But obesity is more and more and irreparably assimilated to a whole lot of negative trait of character: slackness, laziness, depression, etc. It’s all the more so unfair that I don’t know anybody more full of willpower than someone on a diet.

I went slightly in several directions, this article has been written at a late hour. Don’t be mistaken, I wasn’t angry at these persons who were full of good intentions. I even confess having enjoyed the moment, who doesn’t dream of being a hit when coming back on the crime scene? But at the end, what I keep in mind, it’s that I’m worth – and this ‘I’ must be taken as a ‘we’ – more than a few lost kilos. And what moved me the most, it’s A., with whom I didn’t often speak during those years working with her and who told me she reads me and laughs, often.

Have a nice day…

The picture? No, nothing to do with the subject, it’s just ‘our’ small restaurant to which we go systematically on the first evening of our holidays, And I confess I really wish I were there…

So, what about Zermati? Let’s say I’m having a break. The truth being that I let an appointment pass and that, deadly ashamed, I don’t dare call his assistant back (she terrorizes me).

I’m an example of courage when it comes to facing my fears. I deplore, besides, other than doctor Z, the loss of my dentist whom I can’t contact again since I’ve made him believe I now live in Qatar (he called me on my cell phone during my press trip to Doha, being surprised that I had missed an appointment for the second time. Instead of admitting I had completely forgotten, I pretended I had been sent in a rush to the Emirates. Problem: he seemed to have understood I now live there permanently). Technically I didn’t lie, I simply didn’t clear the misunderstanding. I hold on to the fact that my previous temporary tooth lasted ten years. I count on the quality of the current one to last until 2015. By then he might have forgotten me and I’ll be able to plan a come back for my crown. That he ordered in November.

AHHHHHH I CAN’T THINK OF THIS, LEAVE ME ALOOOOONE[1]

I thus haven’t seen this good mister Z for three months. But I’m fine.

More or less.

I only weight myself every week.

Or almost.

Okayyyyyyyyy, Jimminy Cricket has decided to be a pain today.

Every day. But only once though.

Better. I was scared stiff last week-end when I noticed that I indeed had gained 1.5 kilo. I see no link between this nonevent and my morose mood during the whole of Sunday.

I’m kidding, I’m kidding, but I have to admit I’m not completely out of the wood yet. And that I’m, to tell the truth, terrorized by the idea of my kilos coming back. One year and a half of therapy haven’t changed anything. And though I’m aware, in a very acute way, that it’s this fear of gaining again that takes me to very soapy slopes.

That and the emotional rollercoaster I’m going through currently, alternating between particularly maniac phases –“I was right to chuck the whole thing in and say a big fuck to job security as well as to luncheon vouchers, because with liberty it’s champagne and finger food at any time” and openly depressed ones – “I can’t believe I deliberately decided to put an end to a monthly salary. Liberty is a cage with no bars and two-way mirrors, I want my badge and my vouchers back.”

On the days I’m feeling down, I’m rather poetic, if your think about it.

That tends to confirm there’s no creation without suffering. And this, it sucks big time. Because masochism has never been my strong point.

Says the one who voluntarily committed socially suicide.

Apart from that, you can call me joy.

And otherwise have you seen? I’ve been knitted. Class isn’t it?

I’m not telling who did it but if she wants to pride herself on it she’ll do it herself in the comments. I’m crazy about that doll and Rose asks for one very loudly.

I don’t know if it shows but its knees are inwards. She’s awsome1.

Edit: I’m slightly exaggerating, right, to make the joke. I’m fine don’t worry (Don’t feel sorry for me, I’m ok)1 (I’m thinking about a translation of the blog, so I start with small touches)

Who says festive season, says for me and for 99% of the feminine population, weight stress at its highest level. It was, as far as I’m concerned, my second Zermatian Christmas. I’d be lying if I said it was an example of zen attitude, but it seems however to me that on the long trap paved path to food serenity, I’ve moved forward.

First of all, I have understood that I was going to put on weight. Without this thought making me immediately feel like eating twelve chocolates to reduce my anxiety. Then I haughtily ignored all stupid advises that proliferate in magazines – even the most honorable ones- when festive season is approaching. The dumbest of all being the one that consist in eating an apple, an egg (assured bad breath for new year’s eve), or, squarely, a good old spoonful of oil before agapes. With which purpose? Well, logical: to get there without being hungry.

Except that this calculation is stupid. Firstly, it’s the best way to offend your host: “no, you can forget about the capon you worked on for twelve hours because personally I just had three eggs without yolk and thus I’ll just eat air while watching you guys enjoy the dinner”.  Assured conviviality.

Secondly, it doesn’t work. Well not as far as I’m concerned. Personally, I’m totally capable of honoring the turkey, apple or not around 18h. Result: not only do you eat like everybody else but you also ate before. Double penalty, in short. With, on top of that, a less intense pleasure than if the turkey had been enjoyed while being famished.

Especially, may I remind you, the mantra of all Zermatian is the following: what you eat with hunger doesn’t make you gain weight.

In short, no subterfuge consisting in reducing your hunger before the dinner. Furthermore, thus, I’ve accepted to continue eating while my satiety was doing arm twirls like: “hey tart, I’m there, huh, may I point out that we have not even started the main dish and you are not hungry at all anymore? So you leave the table, now.”

“Shut up, hyena”, I answered her, remembering this discussion with Dr. Z., during which he reassured me: yes, during festive season or any other special occasions, every normal human being goes beyond his/her hunger. No one has a stomach big enough to reach dessert, having tasted everything and still being hungry.

Basically, for Christmas, you are sentenced to eat.

Thanks Zermati, but it doesn’t help much, you could say.

Indeed, except that this good doctor also taught me, and it’s essential in case of food marathon, that you must trust regulation fairy.

The latter is the key for everything, as it’s thanks to that mechanism that normally, the next day, the day after next, even the week following the overindulgence, you are naturally less hungry. The older you get, the longer it takes for regulation fairy to show up, that said. Like when you’re a kid the evening after a blowout, you fast without even noticing it. At my age, almost venerable, it can spread over several days. But she ends up showing up, madam regulation. And instinctively, you take smaller portions, you even skip a meal, simply because you body says no, it’s fine, stop it, I’m completely full.

I didn’t believe it, to say the truth. Especially when my regulation fairy had been nowhere to be found for the last twenty years. Not because of bitch mother nature as I thought then. If this tart fairy was taking it easy on an island somewhere, it’s for a simple and good reason: I was so busy feeling guilty for what I ate and regretting what had deprived myself of that I had upset everything and poor miss regul was totally jetlagged.

This year, thus, I made sure I started the meal with a big hunger. In order to enjoy it. Then, I tried to sa-v-our, enjoy each bite of foie gras (I’ll say twelve Our Father for my sin) or Bresse chicken. I ate slowly, which prevented me from taking several helpings. I took some dessert, a little bit, when I was full. But telling myself that the worst that could happen would be to gain one kilo. Or two. And that it wouldn’t change my life (this, still, is the hardest part and I can’t swear that today I totally don’t care about putting on weight).

Nevertheless the miracle happened. My fairy appeared in the following days. Without telling myself I had to pay attention, I did Lent in advance. Then I went to Istanbul where I had a firm intention to enjoy local dish without worrying. Hotel pancakes and double choc brownies, here I come, bring on the mezzes. All this without a scale, which theoretically makes me as nervous as Brian Joubert before a triple flip.

And then, same, regulation fairy showed up again. With the help, I have to admit, of Istanbul’s crazy hills which have awoken some organs which I thought were gone.  Like my hamstrings. And that have probably contributed to get rid of meat balls eaten every day.

Outcome of the whole thing: after two weeks of holidays, one extra kilo. Which, taking into consideration my free-style eating during those two weeks, seems to be a miracle close to the immaculate conception.

There you go, I don’t know if this rather long tale will help some of you but I found important to start the year on this positive note.

Apart from this, thanks for your wishes, I wish you a good and sweet one too. On our side, after dream like holidays, despite a fucking flu, we’ve started 2011 with stomach bug. Three children out of three on the ground, one of them, Darling, vomiting the smallest drop of water and on the verge of collapsing for any food evocation. I suspect we’ll get there too from Tuesday onwards. Happy new year, they said.

That week in Doha, apart from the fact that it was a source of anxiety for several already discussed reasons, was for me a sort of initiatory trip in my long quest of food serenity. Since a bit more than one year Zermating on a daily basis, it was, with my stay at my step-mother’s, one of the biggest challenge I’ve had to face.

Why?

Because all you can eat buffet.

The all you can eat buffet, for any person having suffered in her life of hyperphagia, it’s devil, it opens the door to every window, it means assured stuffing, going wild from starters already. And thus there, it was food open bar, morning, midday and evening. During the rest of the day as well, the press room being supplied with delicious junk food all day long. To fill you, Qataris are flat out.

Fucking sense of hospitality.

Especially that those guys, they know how to cook. I confirm by the way that there was no semolina, however for humus, aubergine caviar, warm pita bread, double cream tzatziki and kebab, it was oil abundance. Same for dessert, series of Lebanese cakes AND western treats which had no reason to be jealous of best pastries from around here. I especially had a strawberry cheesecake that was a killer.

And I’m not talking about freshly squeezed oranges – they had a priori wiped out a dozen of Moroccan orangery for the occasion – served all the time, when it was not natural melon, pineapple, guava or mango juice.

In short, you’ve understood, land of plenty and abundance, all this.

The anxiety of the keeper in front of his goal is nothing compared to what I felt during the first breakfast when I caught the eye of the Hyatt employee in charge of making pancakes on demand.

Last week was thus my all inclusive baptism of fire. It must be said that I remember week-ends after which I succeeded in coming back with 4 or 5 extra kilos. I’m not talking about my luggage unfortunately. And this time, I couldn’t really explain, nothing, nada, not one gram.

Well, I’m not saying I don’t have the start of an explanation.

Squeezed oranges.

No more details.

But even. The fact is that I’ve tasted everything that was tempting me without gorging. For breakfast, I managed not to eat twelve pancakes, three brioches and four omelets. Without mentioning the bowl of Oreos which I didn’t even touch. I didn’t deprive myself, I didn’t dream of what I didn’t taste. And I did – almost – not feel guilty for what I’d swallowed. Wait, I’m not saying my food diary – which I didn’t write but you get me – would have given a hard on to Dukon, right. One evening, to go with my Cosmopolitan at Dunes bar, I think I compulsively munched 278 puffed cashew nuts (awesome, I still dream about it). But afterwards, at the buffet, the famous one, I settled for a few grams of humus to go with the flow. Without even thinking about it.

I’m not crowing over a victory, just like I’ll always be a smoker – especially currently as I’m on top of that subject – I believe I’ll always be likely to drawn my ill-being, my anxieties and even my happiness in any food containing chocolate, butter or sugar. But until now, everything is going rather well, my satiety, I found it and I won’t let it go.

Next, Christmas and its thousand and one temptations is fast approaching…