MANAGING WEIGHT WITH MINDFULNESS

Where is your attention when you eat?  Do you love the pleasure of eating so much that you overeat from sheer enjoyment rather than from physiologic hunger cues? Do you overeat as a self-soothing antidote for emotional stress, anxiety or depression?  Or do you consider eating a necessary but boring interruption in your busy day at home and work and overeat while reading, watching TV, driving or talking?  If any of these eating patterns describes you, the power of your attention is being used unskillfully.

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BEFRIENDING YOUR BODY WITH MINDFULNESS

Being disconnected from or being self-critical of your body can have serious health consequences. An 18-year-old woman had bilateral breast implants at an out-of-state clinic. Since her early teens, she had wanted this surgery because she thought her breasts were too small and unattractive. When she saw me the week after her surgery, her breasts were painful, tender, red and obviously infected. She was now ashamed and deeply regretted her decision to alter her body based on social pressure and images....

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MINDFULLY MANAGING ANGER

Anger can be a healthy emotional response or a serious health risk.  Managing anger appropriately does not require that we deny it, repress it or get completely rid of it. Brief, mild-to-moderate episodes of anger and righteous indignation can be a useful stimulus to positive and constructive action on both the personal and societal levels. However, severe, repeated or uncontrolled anger can lead to serious harm to oneself or others.  The body’s stress (“fight or flight”) response is triggered by anger.

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BEFRIENDING YOUR BODY WITH MINDFULNESS

Being disconnected from or being self-critical of your body can have serious health consequences. An 18-year-old woman had bilateral breast implants at an out-of-state clinic. Since her early teens, she had wanted this surgery because she thought her breasts were too small and unattractive. When she saw me the week after her surgery, her breasts were painful, tender, red and obviously infected. She was now ashamed and deeply regretted her decision to alter her body based on social pressure and images from media and advertising. After we controlled her infection, she required another surgery to remove the implants.


A 55-year-old woman’s cardiologist referred her to me for mindfulness training and stress reduction to help her manage her multiple chronic medical problems. She had been compulsively eating for years and confessed to regularly eating as much as 4,000 calories in a single meal. Her facial expression and body language spoke of her hopelessness and exhaustion. In a telling example of the crucial importance of body awareness, she consistently expressed difficulty feeling any physical sensations in her body during body-scan meditation. She was literally out of touch with herself. Tragically, soon after our second meeting, she died from organ failure of both her heart and lungs.


These stories illustrate how being disconnected from and criticizing your body can put your health at risk. Increasingly, mind-body

research shows you can transform self-criticism of your body into self-acceptance and self-compassion. Mindfulness practice is fundamentally about training the mind to pay attention, and it begins by paying attention to your body. Mindfulness also emphasizes present-moment awareness, in contrast to our frequent habit of thinking about and living in the past and the future. The body is a perfect place to begin this practice since it is our constant companion and is always in the present moment – always in the here and now.


Body-scan meditation is one of the foundational practices of Mindfulness-Based Stress Reduction (MBSR). This practice invites a compassionate self-regard for your physical body as you direct your attention to one area of your body at a time. Attention is focused sequentially on each part of the body in turn. Moving your attention through the entire body, you are encouraged to focus on the tactile sensations in your body, befriending, welcoming and accepting non-judgmentally whatever sensations are present. When you are aware your attention has wandered to thinking, judging, hearing sounds or feeling emotions, you simply bring your attention back to the physical sensations in the body.

Some people find body-scan meditation feels like “coming home.” One of my students said, “I feel like I am in my own skin for the first time in my life. ” Those with physical pain may experience their pain in a new way, sometimes finding they are less distracted by the unpleasant sensations as they learn to attend to the simultaneous pleasant sensations in other parts of the body. Even those with significant physical discomfort often report their relationship to the pain changes over time. While the actual pain level may either diminish or remain the same, there may be less suffering caused by the emotional reactivity often associated with chronic pain. The vicious cycle of pain/ emotional reactivity/muscle tension/ increasing pain is often interrupted. As pain and discomfort are experienced in the context of compassionate self-regard and non-judgment, one’s overall quality of life may be enhanced even without an overall reduction in the perception of pain.


A core principle of mindfulness training is that “there is more right with you than there is wrong with you, regardless of your condition.” Another core principle is that all conditions are workable. These can be new and revelatory concepts for people who don’t like their body or have long-standing chronic physical or emotional pain and suffering. The body scan and other mindfulness practices give people an opportunity to directly experience the truth of these principles right in their own bodies and in the growing calmness, hopefulness and equanimity experienced during formal practice sessions and informally in their daily lives.


Two other fundamental practices of MBSR are also based on body awareness: mindful hatha yoga and sitting meditation with awareness of breathing. Just as in body-scan meditation, the instruction in mindful hatha yoga is to pay close attention to the physical body, thoughts and emotions during movement and in static postures. Even sitting meditation is based primarily on attending to the physical sensations of breathing. You may feel the breath most clearly as it enters and leaves the nostrils. You may feel it most clearly as the belly expands and contracts with each breath. The invitation is to avoid postures or movements that cause pain while simply attending fully to physical sensations in the body or the breath.


A critical moment in all these practices is when you notice your attention has wandered off to thinking, sounds or emotional reactivity. At these moments, you are reminded to be gentle with yourself, bringing deep kindness to the so-called “distraction” and simply returning your attention to the practice, whether it’s body scan, hatha yoga or awareness of breathing. Training the mind to pay attention takes time, patience, selfcompassion and a commitment to regular practice.


After only a few sessions of body scan, you may begin to spontaneously bring awareness to the body during everyday activity at home or work, alone or with other people. You may more readily pick up on early warning signs such as self-judgment or muscle tension. You may notice you are more relaxed in meetings and conversations. You may notice you are listening more and listening with kindness. You may use the wait in the grocery line or at the traffic light to bring kind attention to the breath, a body area that deserves your attention, the body as a whole or to a growing sense that your life is OK.


Over time, the formal practice of body-scan meditation and other mindfulness practices may change your relationship to your body, mind, emotions – and your life. Your health may benefit as well.


Sources and Resources

Body-scan meditation. I have recorded two versions (5 minute and 40 minute) available at http://www.mindbodystudio.org/?page_id=1594

DR. JOHN PATTERSON

Dr. John Patterson is past president of the Kentucky Academy of Family Physicians and is board certified in family medicine and integrative holistic medicine. He is on the family practice faculty at the University of Kentucky College of Medicine and the University of Louisville School of Medicine, Saybrook University’s School of Mind Body Medicine (San Francisco) and the Center for Mind Body Medicine (Washington, D.C.). He operates the Mind Body Studio in Lexington, where he offers integrative medicine consultations

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