"Diet" is a Four-Letter Word with Guest Dr. Lori Fishman

This week the Mental Health Mamas are joined by guest Dr. Lori Fishman, child and adolescent psychologist and parenting coach. Lori’s focus is on behavioral weight management with an emphasis away from dieting and shaming and more toward overall wellness. Listen in as Tina, Serena and Lori talk about what we’ve all gained during COVID, why diets don’t work, how to make a change and more!

Notes and Mentions

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Serena: Hey Everyone, I’m Serena.

Tina: And I’m Tina and we are the Mental Health Mamas.


Serena: Welcome to No Need to Explain, we are so glad you’re here.

Tina: First, as always, a quick disclaimer.

Serena: We come to you NOT as mental health professionals or experts in the field, but rather as the parents of kids who struggle with their emotional health.

Tina: If you or someone you love is experiencing a mental health crisis, please seek professional support. You’ll find a variety of resources in our show notes and on our website, NoNeedToExplainPodcast.com.

Serena: The global pandemic has brought with it many losses, but also some gains as well. Usually we talk about gains as a positive, but there’s something we’ve all gained that is not a good thing.

Tina: Not a good thing. Weight! How about weight? We have all gained weight.

Serena: Mmhm. Yeah. Sadly, yes. And I think there were many people who were predicting this, but the numbers are pretty staggering. And it’s more than just the “COVID 19” that has been kind of the running joke.

Tina: At the one year mark (March of 2021), half of Americans were self-reporting weight gain with an average of 29 pounds. And of course this means that our kids gained weight as well.

Serena: Hmm. Yeah. And that can be such a challenging topic for so many of us and it can be especially hard to know how to handle this as a parent so we are bringing you a guest today to help us figure some of this out.

Tina: We are so excited to be joined today by Dr. Lori Fishman. Lori is a child and adolescent psychologist who specializes in health and wellness and coaching parents on this very important topic. She is on a mission to help parents talk with their kids about health and weight in a non-shaming way. Lori, we are so happy. Welcome to the podcast!

Lori: Thank you so much guys. Thanks for having me.

Serena: Yeah so Lori, let’s talk about why this has happened. I would say that I have some guesses, but from your perspective as a professional, why have we all gained weight? And why is this happening not just for adults, but for our kids as well?

Lori: So I think the number one culprit from the pandemic is lack of structure and routine. With kids not having in-person school where they would only normally be eating during lunch or snack time. I know with remote learning my daughter was trying to eat snacks in front of her virtual learning at the computer basically all day.

Then the other important thing that happened was that there was no phys ed, no gym classes, all the sports were cancelled. So a lot of the activities that kids were doing to get exercise every day kind of naturally and in a social way were also cancelled. And I think that the schools being closed just decreased the regular steps that we all take, even for those of us who stopped going to work in person. We didn’t just walk to the bathroom, walk to the cafeteria, walk to and from the bus. You know, things like that. Kids as well would just walk to the kitchen or walk to their bathroom which meant just going a few steps or maybe even up and down stairs once or twice.

Serena: Yeah, right. These are, you know, such good points and I think about that too. Even as somebody who normally works at home, yeah, I wasn’t going anywhere for anything. So yeah. A lot fewer steps. And Tina can confirm that our meetings, our Zoom meetings, are often interrupted by one of my kids asking for a snack!

Tina: Yes! Confirmed! And it always made me hungry. We had so many interruptions! Lori, can you share a little bit about what drew you to do this work?

Lori: Sure. So I was an overweight child and growing up in the 80’s and 90’s, my parents really had no idea how to help me with that. And so throughout my childhood I was put on many adult diets and I think these only actually worsened my relationship with food and weight. So later in life when I decided to become a child psychologist I knew that I had wanted to work in healthcare and health promotion and since then I have been working as an attending in the Optimal Wellness for Life Program at Boston Children’s Hospital which I started around 2009.

Tina: Yeah so say a little bit more about that program and your role in it.

Lori: Sure. So it’s “OWL”, the Optimal Wellness for Life Program and it’s basically a hospital-based weight loss program for children - which has its pros and cons. So if you come it includes a visit with a nutritionist and a medical provider who specializes in weight management and endocrine issues and then the third component is a behavioral provider like myself who helps families with habit changes.

Serena: So recently you’ve created some online workshops for parents based on this work. Can you talk a little bit about what you’re offering online?

Lori: Absolutely. I’d love to. So my online program is similar to a course you would take online or a membership for parents and it includes videos and worksheets that provide parents with the exact same experience they would get from consulting with me in person about how to manage their child's weight without having to come to the hospital or even needing to bring or involve their child directly. I also offer online private consultation in the same way you would get if you came to my office. The goal of my interventions with parents are really to help create an environment around weight management that’s more about health promotion and less about weight and minimizes shaming or feeling like you’re going to shame your child.

Serena: Right, right. So talk more about that. Talk about the shame around weight.

Lori: Right. Well I think most parents avoid the topic altogether with their child because they feel like if they bring it up then they are criticizing, right? You know, if I say something like maybe to try something healthier then I don’t want my child to be assuming that I’m calling them fat or saying something more shaming. On the flip side, though, if I say nothing at all and don’t intervene at all then my child might continue to have difficulty with making healthy choices or having healthy habits. So I do, as a parent, have a responsibility to make some kind of intervention but it’s really tricky to know where that line is between shaming and advising.

Tina: Yeah. And let’s just go there. Serena has three girls. I have a girl. And the idea that the culture is just so unhealthy and so it does kind of promote that. What do I do? Do I say something? Do I not say something? And I’m grateful that you have ideas out there for that because it’s such a hard, pressure-filled thing. I don’t want my child to feel like she has to live up to every bikini model out there, right?

Lori: Right. And I also have a girl who is 13 now so I’m also dealing with that personally. And I think that it’s not gender exclusive, right? Because boys are also involved in a bullying culture around being athletic. So I think where we have girls, and we’re women and moms, right, talking about these things, it’s easy to think about how much pressure there is on us as women to adhere to a societal weight standard. But boys are definitely dealing with this too in a different way but they are. And I think really it’s just, to answer one of your earlier points about how do I do this, I really think it’s about focusing on health and using words like being fit, being strong, being healthy as opposed to focusing on weight, size, how you look in something, how good you are at a sport. It’s really just more about, you know, are you getting the right amount of exercise per day because your heart needs it. It doesn’t matter how big or small you are. Your heart needs exercise. You know, really just more focusing on the health aspects as opposed to the weight aspects.

Serena: Yeah, so we’re going to talk about that a little more because I had the amazing opportunity to work through some of your online workshops and your Parenting Wellness Program. And I really appreciate that opportunity. I love your approach being behavioral in nature and that focus on health and wellness rather than the idea of being on a diet, right, that’s sort of pervasive in our society. So can you share a little more about that with our listeners?

Lori: Yeah. And thank you so much Serena for taking the Parenting Wellness Program. It was really great for you to be able to check it out and for the feedback you provided me. So I mentioned my own history with dieting and I think what I drew from this is the diet mentality just does not work to change long-term habits. I mean if you think about it, if a diet worked we would all have gone on our one diet and then never need to go on another one again because it worked. Or we’d be able to do it forever because it wouldn’t be too hard or too restrictive. And most of the diets I’ve been on, clearly I haven’t been able to do them forever or I’d still be on them. So it’s really focusing on without changing our daily habits for a lifetime, we cannot be on a diet. It will not be sustainable. Behaviors and habits are the things that we need to work on to have life-long change. Behaviors like emotional eating, eating in front of screens, not moving enough - if you don’t work on these you could go on any diet you want but if you’re still doing these behaviors in the background, they’ll continue to creep up. And they’ll interfere with your diet which will eventually lead to, I’m trying to do air-quotes but you can’t see me, will lead to “cheating”. And cheating is just a terrible word. I mean cheating is wrong, it’s bad, you get in trouble for it. It’s the worst word, right? So when we cheat on our diet we use that as a reason, usually to give up entirely because we feel so bad about ourselves for cheating and then typically we end up doing more emotional eating. Like, well, I already had that cookie so I’m just gonna have three more because I messed up on my diet. Familiar, right?

Tina: OK, yes. Hmm. Right. Maybe a little. Knowing that so many families are struggling with this right now and perhaps don’t even know where to begin, what might you suggest for them?

Lori: So I always say, just change one small thing. So for example, add some more moving to each day. A short walk. Maybe a family walk after dinner, right? Or maybe cut out juice in favor of sparkling water or make your own infused water that doesn’t have sugar. If you just change 1 small thing to start you’re going to have success over time and you don’t have to do it all at once. I do think that if you try to make too many changes at once it can feel so overwhelming that you get paralyzed and don’t want to do any of it at all.

Serena: Yeah, I love that idea of small, making one small change and I think you do a lot of reframing which we talk about, Tina and I. This idea that just stood out to me as you were talking that you use the term “moving” rather than “exercise” and that somehow feels so much better. So another theme that often surfaces for families that we work with and perhaps even for ourselves sometimes, is a sense of guilt. Coming out of COVID it does seem that this has taken on an extra level over all the things we think we should have done or the things we think we shouldn’t have done. Clearly we’ve all experienced a significant increase in screen time that was unavoidable both for parents and for kids. What might you say to the parents out there who are maybe feeling some guilt over screen time or lack of exercise or food choices...things like that?

Lori: I would say that there is absolutely no precedent set for How to Be a Great Mom during your first ever Global Pandemic! Think about that. We had no clue what to do. And we were freaking out. I mean as parents, our kids were looking to us as well, what did you do when you were my age and there was a global pandemic? Yeah. That never happened to us. So I think our job as mothers first was literally survival, right? So yeah, it’s ok if your kids watched too much TV because there was really nothing else to do. And maybe you were trying to work from home and needed them to be quiet. No one is doing everything perfectly all the time myself included.

And I think we also want to think about, well one, self-care, which I know you guys mentioned on your early July podcast about COVID guilt and self-care and the importance of taking a break and not blaming yourselves which I thought was fantastic. But thinking about guilt, right? If we’re all sitting around feeling guilty about things we didn’t do, how does that actually serve you? What are you getting out of that, right? We can’t change what we’ve already done. So the only thing we can do is focus on what we’re doing today. So what one small thing can you do today that’s positive? Maybe positive for your family’s health? Let’s start there. Then you’re doing something with action, with intention, instead of sitting around thinking about all the things you could have done before that you didn’t do and just feeling miserable. And you can be proud of yourself for making that change. And then do one more small thing tomorrow.

Tina: Love that. Love the small change! Love the release from guilt. We all have a lot of guilt about a lot of things and no, we don’t. Thankfully, hopefully we’ll never need another, How to Be a Great Mom during a Global Pandemic guide. I hope that that’s not true but, you’re right. We’re all just doing what we know how to do and we didn’t know how to do this. For sure. So for parents out there who would love to connect with you or learn more about what you have to offer, what’s the best way to connect with you?

Lori: Check out my website. It’s www.pastparentfuture.com or you can follow me on Facebook.

Serena: And we will definitely put that in the notes so that people can click on that. Knowing that you are a parent as well as a professional and that you bring your lived experience to the work that you do, what’s something you know now that you wish you had known earlier in your journey?

Lori: I think really just that, like we were saying earlier, we are all just doing the best we can and there is no one right way to do things. I think, you know, coming from an academic background where I went to school forever, I just figured that there was some one right way to do parenting. No one has all the answers and what works for one family may not be right for you because your child may have different needs. Or you might have a different kind of role as a parent. Or you might have a partner who parents differently from you. So I think most importantly, we need to stop believing that what you see on social media is real life. You know, I’m always going back joking with my daughter about, you know, in my day we didn’t have Instagram. My friends and I are always talking about how wonderful that was, right? To not know that your other friends were doing things without you or that everyone is leading these seemingly fantastic lives. You wouldn’t have ever known who was on vacation and when you weren’t. So I just think that social media is really distracting us from reality and that people are only posting what looks ideal and that no one is actually posting their true daily struggles.

Tina: I do think that is certainly contributing to it. I would agree with that. And I do think that when I became a parent, it looked like everyone else was doing it right and there was no social media then. I did think I could read all the books, right? Serena and I often go to those academic places, right? Like if I just read all the books then I’ll be a really good parent. It is so not like that.

Lori: One of the biggest ways that we influence our children is not necessarily by what we say but by what we do. Or by what they overhear us saying to ourselves. So if we’re role modeling, we want to role model self-care and role model healthy behaviors. We also want to be careful about how we describe ourselves in front of our children. And I’m thinking....this just came to me in thinking about social media. You know if I’m saying something to myself like, oh, don’t post that picture of me, I look fat in it, right? I’m already presenting a whole world to my daughter of, you shouldn’t post certain things. You shouldn’t look a certain way. How other people look at you matters. And so being very careful about those comments that we make about ourselves, like ugh I have a double chin in that picture, take it down. I can hear myself saying these things. But then thinking about how they’re interpreting that because when they see pictures of themselves are they saying, I’ve learned from that inner voice growing up that I shouldn’t like this part of me or I shouldn’t share this part of me with the world because they might think I’m a certain way. So I think it’s really important for us to be good role models to our children about how we’re talking about ourselves and our image and our self-image.

Tina: Well, and I’m just gonna add this piece and say, even if you do feel like you’re saying the right things, there is always that external world that’s telling them, you know, showing them only perfect pictures of people. And other people. I mean, there were other moms in my life who certainly were giving those messages. You know, they were hearing those messages. So yeah, it’s tricky, it’s so tricky. And since you are a parent, as we’ve said, and have been parenting during COVID in addition to all of your professional roles, we are curious about what you are doing to take good care of yourself.

Lori: Yeah. I’m a sucker for in-home exercise programs and COVID really gave me an opportunity to have time to do more of those so I use Peloton. And I also have felt like what’s been even more important than exercise and other types of self-care have been keeping my connections with my girlfriends. I think that’s been so important to just someone outside of the home who you don’t see every day to connect with and kind of banter with and feel like you’re having a shared experience.

Serena: So Lori, is there...leave us with a tip today so that we can go out there and do something different, do that one small thing.

Lori: Great. Yeah. So my biggest tip is about mindful eating. I call it focused eating because, again, like you mentioned earlier about reframing when I say moving instead of exercise people are more receptive. When I say focused instead of mindful people also seem to be more receptive because, especially kids, when they hear mindful, they’re like oh this mindfulness stuff, we do this all the time. I know mindfulness is great, but I’d rather coin it as something that’s more tolerable. So focused eating. Focused eating is when we are paying attention to our food and nothing else. So the best way to describe, and I do this in my wellness program Serena, as you know since you’ve watched this video that I did. It’s basically when we’re not eating focused, we’re eating on the couch, we’re eating in front of the TV, maybe we’re eating with our phone in our hand, maybe we’re standing up, maybe we’re in the car, maybe your kids are eating in their bedrooms. All of these things just lead to distracted eating which makes us tend to eat more for a couple of reasons. One is that we’re so focused on what we’re watching on TV or what we’re doing on our phone that we don’t even realize that we’re full and we might just keep eating without listening to our bodies’ fullness sensor. So my stomach might be telling me, Lori, I’m full. Can you just stop? And I’m not listening to that because I’m watching Gray’s Anatomy or whatever I’m doing. I’m certainly not listening to my stomach. And the other thing that may happen if I’m watching a TV show is that I might run out of my little snack that I brought with me, even if it’s healthy, I might run out but since I still have 20 minutes left in my show I might pause and refill because I enjoy eating while I watch this show. But the more alarming thing that happens when we set up a routine or a habit is that we tend to repeat it. So it’s kind of like when you go to the movies and you just have to have popcorn. If you are someone who is constantly snacking in front of screens like at night or maybe you put on a particular show and you bring your lunch or your snack or your breakfast then in the future just putting that show on is gonna send a message to your brain that you’re hungry. So it’s actually one of those things where you get conditioned to be hungry when it’s not even time to eat. I think it’s a really good way to distinguish between boredom hunger and emotional hunger versus true hunger is if you’re doing something and you’re hungry, you decide you’re hungry. Are you willing to stop what you’re doing entirely, go to the kitchen, put your food on a plate, like not eat right out of the bag, not eat right out of a box, not eat while you’re standing up looking for something to eat. Put your food on a plate. Sit down at a table or counter meant for eating, not a TV table in the living room. Put away your phone for five minutes. You know it will all be there when you get back. Teenagers have such a hard time with stepping away from their phones so that’s something I’m really working on with them as well. So put down your phone. Go put it on the charger in another room. Sit down. Eat your food on your plate. Enjoy it. Eat it slowly. Taste it. And then go back to what you were doing. And if you’re thinking to yourself, I’m not doing all that. That’s way too much work. I’m just hungry, I’m not trying to go to the kitchen and do all of that. You’re probably not actually physically hungry. Maybe it’s not actually time to eat. And maybe you’ll get something in an hour. But if you’re willing to stop and take the effort to eat mindfully or eat focused then you might be more likely to eat only when you’re hungry, truly physiologically hungry versus boredom hunger.

Serena: Hmm. That is an awesome tip. So Lori, thank you so much for joining us today and sharing some really important information about this work that you’re doing and hopefully people are hearing this out there and we can all be a little healthier!

Lori: Thank you so much. I have loved connecting with both of you and it has been so fun and I really appreciate what you ladies do as well!

Tina: And it is an admiration fest. We clearly totally love what you do as well. And so podcast friends, we are, as always, grateful for all of you listening and supporting us. You can help us out by visiting Apple podcasts, leaving us a review, subscribing and please share with others. You will find more content on our website, NoNeedtoExplainPodcast.com. You will also find an email address and we would love to hear from you.

Serena: And this is your gentle reminder to take good care of yourself while you are also taking care of your people.

Tina: Thanks for listening!

Serena: Bye!