Confessions of a Fat Dietitian
By Sharon B. Salomon, MS, RD
Today’s Dietitian
Vol. 7 No. 9 P. 66

She’s a dietitian, she’s overweight, and she’s tired of excuses. Sharon Salomon is going on a weight-loss journey, and she’s seeking counsel from the best weight-loss expert she knows: herself!

I am a weight-loss expert—not because of my degrees and training (I have a certificate of training in adult weight management) but because I am intimately acquainted with all the major weight-loss programs. I have eaten protein and excluded carbohydrates. I have weighed, measured, and counted. I have shunned meat and fat and feasted on grains, beans, and veggies. The pounds have melted away. Nevertheless, the pounds always return with a vengeance, more tenacious than before, as soon as I liberalize my eating. In all fairness, I define “liberalize” as adding back all the goodies I banished when I started the diet. For a dietitian, I have a perverse eating style not borne of education and knowledge but based on a love of eating lots of good food. When it comes to dieting and losing weight, I am not a dietitian. I am just one of the girls.

I have written public health messages on how to eat for weight loss, lower cholesterol, and reduce disease risk. I write the messages with skill praised by my colleagues, but the messages do not speak to me. Judging by America’s expanding waistlines, the messages do not speak to most people.

The mirror and the scale lie to me. The mirror is my friend because I am looking at myself through my eyes. I focus my gaze on my face, hair, shoulders, and legs. I avoid my middle. I do not turn sideways. The scale tells a different lie. It declares me fatter than I am, neglecting to factor out my dense bones (which I thankfully have) and my heavy muscle (true, I promise). I know I am fat. Not chubby or pleasantly plump or overweight. I am fat. I have too much fat on my otherwise sturdy frame.

Big Beginnings
I started life as a roly-poly cutie. My parents proudly delighted in my soft folds of pudginess. Early photos show me happily unaware of my heavy frame. I slimmed down during my late teens (puberty arrived behind schedule) and managed to hold onto my new lithe figure until a few years after my wedding. Marital bliss—and maybe shopping for and cooking all the meals—resulted in the alteration of my slender shape to extra-wide. The change was insidious. A pound or two per month, hardly enough to notice at first. I remember thinking that the dry cleaner must have done something to my clothes because they were getting tight. The clothes I washed by hand also seemed to be shrinking. Then summer arrived. Buying a bathing suit is a chore, even for those with the slimmest figures. But for those with less-than-perfect derrieres, the ritual is intolerable. It was in the dressing room—with a tri-fold mirror and really good lighting—when I knew my indulgences and not the dry cleaner were to blame for my snug pants.

It was a revelation then and it continues to be today. To have gained this much weight since my teens means I have eaten uncountable extra calories. Most of them have been enjoyable. I do not regret having treated myself to extra helpings of fried foods and desserts. I do, however, find it hard to believe that I am as overweight as I am.

Is (Body) Image Everything?
I was at the gym the other day pedaling furiously on the stationery bike as the new personal trainer walked by. He is a very slight man—short and without much definition to his body. The woman on the bike next to me whispered, “I wouldn’t hire him to train me. He’s too scrawny.” I had to agree with her. My trainer is a lean young man with well-defined muscles. He inspires confidence because he looks the part.

At the time, I made no connection to my own physical appearance and how it might influence someone’s perception of me as a competent dietitian. I had not spent much time thinking about how my weight might affect my professional credibility. I am an expert, after all. I have all kinds of degrees and certificates that attest to my knowledge. Do I also have to look like I know what I am talking about?

The credibility of overweight dietitians was recently discussed on a dietetic practice group listserv. The consensus opinion was that anyone doing diet counseling should be a model of health and vigor. I bristled at some of the remarks. The disdainful comments made me wonder: Are many dietitians too removed from the suffering of the populations we serve to truly understand the obstacles to long-term weight-loss maintenance? As a client, I might wonder why an overweight dietitian did not just take her own advice, but I think I might also be comforted to know that she struggles as much as I do.

Dietitian Sharon, Meet Patient Sharon
It is time to make some changes. Regardless of my ability to look past my physical size, there are other signs of my weight I cannot ignore. My protruding belly is interfering with Pilates exercises. I can no longer pull up my jeans past my knees (even when I lie flat on the bed), and shirts I bought last summer in a grotesquely large size are now too tight. I am past due for a wake-up call. My waist is the same size as my 30-year-old daughter’s hips and part of my anatomy squeezes into the airplane seat next to mine. It is all too terrible to think about.

I have decided to take myself on as a patient. I will do an assessment. I will be honest. I will be forthright with my treatment recommendations. I will break down the barriers to change that I have had in place for a long time.

Where do I go wrong? Portions at home and choices when eating out. My choices at home are very good: fruits, vegetables, dairy, whole grains, and lean protein. I know the solution is simple: Eat at home more often and eat less all the time. That sounds like deprivation to me. But Dietitian Sharon knows better than that, so I will forge ahead.

Dietitian Sharon has developed a plan for Patient Sharon. Patient Sharon will first tackle the excuses she uses so skillfully to avoid diet change with the help of Dietitian Sharon.

• Excuse 1: I have a life. Eating on the run is part of it. Planning takes time. I cannot always eat wisely.

Response to self: I do not have to plan. There is always a smarter choice on every menu and I do not have to eat everything I am served. Every meal does not have to be a gem. I will strive for balance.

• Excuse 2: I do not eat numbers. I eat food. Weighing, measuring, counting—I do not want to be bothered.

Response to self: If I eat until I am “satisfied” instead of “full,” I can forgo the measuring and weighing for a while. I will stop eating before I have to open the top button on my pants. I will serve myself less than I want to serve myself.

• Excuse 3: I do not want to feel deprived. I do not want to give up my favorite foods.

Response to self: I will not give up my favorite foods but I will eat less of them. I will put my favorites on a pedestal where they belong. I will worship them and treat them with the respect they deserve. One fried chicken wing is a lot better than none. This is not an all or nothing experience. This is a compromise.

• Excuse 4: I should start today. I should and I would, but I will wait. I will follow the dieter’s ritual of eating everything that I will miss while I am dieting, as though the food will disappear from the face of the Earth and I will never again have the chance to eat it.

Response to self: I will start today because I am not giving up anything but large quantities. Since I am not giving up any of my favorite foods, I do not have to eat a large pizza and drink a gallon of soda before I start my new eating plan.

• Excuse 5: Brownies made with prune puree? Not for me. Salad dressing made with fat-free mayonnaise? That is ersatz food. Never. I have a sensitive palate cultivated in childhood by my mother. She cooked everything from scratch, even the chocolate syrup she poured lavishly over her homemade chocolate ice cream.

Response to self: Wake up, Sharon! I will eat the “real thing” but I will eat less of it and less often without making an issue of it.

Small Steps Toward Big Results
It has been two months since I had the counseling session with myself. I am here to report that I have managed to break through many of my excuse barriers.

I am trying to eat only when I am hungry. I am not trying to stave off hunger by eating when it is convenient, hoping that I will not get hungry when it is inconvenient. I have relinquished the feast or famine mentality. There is always food to be had. I am eating what is available, making the best choice possible, and eating modestly when the choice is not so great.

I am serving myself less than what I used to and sometimes I do not even finish that smaller serving. I am more in tune with what it feels like to be “satisfied.” I stop eating when I am satisfied, which comes long before I am “full.”

I am eating slower, especially when I am with friends. I have been watching lean people eat in restaurants. I notice that they put down their forks a lot. I notice that conversation flows while their forks are on their plates. The pacing of my meal seems to be the most valuable tool I have learned. Slower eating definitely equates to eating less.

I am not thinking of this as all or nothing. I do not have good days and bad days; I have healthy meals and not-so-healthy meals all on the same day. I am satisfied with that. I strive for balance. If breakfast is not stellar, then I work hard to make lunch better.

My greatest accomplishment came at the end of a recent restaurant meal. The waiter asked if I had “saved room for dessert.” Surely he knows that dessert does not go where vegetables go. There is always room for dessert. I surveyed the dessert tray with “big eyes” but made my choice with my satisfied stomach. I chose creme brulee, a dessert that is not on any weight-loss diet I have ever seen. But this is Dietitian Sharon’s diet. The top of the creme brulee was especially crisp, expertly torched to a golden brown color. The custard underneath was as thick and creamy as I have ever seen. I took two bites of the luscious dessert and put my spoon down. My companions each took a bite. Loud “yums” were heard around the table. Four women, one dessert. That is an achievement for me.

The road is still bumpy. My intentions are honorable, but old habits die hard. Knowledge is not necessarily the best defense against slipping back into old ways. I am meeting my personal goals. I can do abdominal exercises with ease, my jeans zip up, and I managed to keep all of my body in one seat on my last flight. I am a realist. I will never be the size I was 30 years ago. Bikinis are not in my future. But I can continue to make small changes to the way I eat until I have reached a comfortably healthy place. Dietitian Sharon is indeed an expert.

— Sharon B. Salomon, MS, RD, is the owner of FoodSense, a food and nutrition consulting company. She has been a spokesperson for food trade and health organizations and is coauthor for the American Dietetic Association publication Eating Well with HIV and coauthor for the self-published manual Cooking Show and Tell for Dietitians.