DATE: Monday, October 6, 1997               TAG: 9710040044

SECTION: DAILY BREAK             PAGE: E1   EDITION: FINAL 

SOURCE: BY PAT DOOLEY, STAFF WRITER 

                                            LENGTH:  125 lines

EVMS DEVELOPING NEW APPROACH TO WEIGHT LOSS PROGRAM INCLUDES MIND, SPIRIT IN QUEST FOR PERMANENT CHANGE.

FOR ANNETTE AUSTIN, the end of a diet is more traumatic than the diet itself.

That's when the weight comes back.

The 54-year-old has lost weight countless times. She's followed fad diets, liquid diets, diet programs.

Losing it is easy, says Austin, who lives in Norfolk.

In 1992, she was only 5 pounds away from her goal - 125 pounds. Then the program she attended went out of business, and Austin was left without a maintenance plan.

The weight came back with a vengeance, along with plentiful helpings of self-reproach.

At 252 pounds, she says, ``I hate the body I'm in.''

Now, she's trying something different - a new weight-loss program at Eastern Virginia Medical School in Norfolk that looks at mind and spirit, as well as body, to bring about permanent change.

Called Weight and Well-Being, it is one of three new programs offered by the school's Behavioral Medicine Clinic that use nontraditional methods to treat common problems, says clinic director Dr. Olafur S. Palsson. The others involve biofeedback to soothe migraine and tension headaches, and hypnosis to ease irritable bowel syndrome.

But weight loss, perhaps, is most in the spotlight.

Last month, two popular diet drugs were pulled from pharmacy shelves nationwide because of apparent connections to heart-valve disease. Meanwhile, surveys show 30 percent of adults in the United States are seriously overweight. That's up a hefty 25 percent from the 1960s, according to a report by the Los Angeles Times.

The Norfolk program will emphasize change from within instead of external options like diet drugs.

Clients will learn how their thoughts, feelings, behaviors and relationships affect eating. And how changing those patterns, along with exercise and proper nutrition, can lead to a desirable weight.

Many weight-loss programs focus primarily on diet, says Dr. Daniel Bluestein, the program's medical director and a member of the school's Department of Family and Community Medicine. ``Here, we're putting the behavioral change first.''

Because enhanced self-esteem can lead to permanent change, clients will learn to improve their coping and problem-solving skills and to build social support, he says.

Angela Stroup, director of Weight and Well-Being, calls it a balanced approach, a journey of self-discovery.

Clients won't be encouraged to meet some set number on a height-weight chart, she says. Instead, they will be guided toward manageable, personal goals.

Although weight-loss medications that remain on the market may be used to help some patients shed pounds, that would be a small part of treatment, says Stroup, a registered nurse and assistant professor.

Hypnosis or psychotherapy also will be available.

The six-month program costs $350 and generally is not covered by insurance. The cost is competitive with other programs, Stroup says.

The first four sessions are one-on-one. In the first, Stroup will take a medical history and get to know clients - their strengths, goals, eating behaviors. They will be asked to keep a ``food and feelings diary.''

In the second week, clients will meet with a registered dietitian to review the diary and begin to understand the relationship among food, mind and body.

In a third session, Stroup will assess clients' progress and share ways to improve relaxation, problem-solving and stress-management.

Clients visit with the dietitian again in week four and then move into eight weeks of group sessions lead by Stroup and a clinical social worker.

The meetings will give participants a chance to share their feelings and talk about changes and challenges, Stroup says. Sessions will include homework, mild physical activity and stress-reduction exercises.

Clients can then re-enter the program at half-price, or go into maintenance, consisting of two visits a month for three months. The clinic also will follow up with clients to help them maintain their goals.

To be eligible, a person needn't be morbidly obese but should believe that his or her weight has a significant effect on health and lifestyle, Stroup says. The program also can help people with weight-related medical conditions, such as diabetes. Clients do not need a doctor's referral.

But they must be ready to examine their hearts as well as the image in the mirror.

``This program is really for people who are ready for action,'' Stroup says.

People like Annette Austin.

She has lived a roller coaster of emotions and eating, and spent thousands of dollars losing weight.

``I learned very young to turn to food for emotional backup,'' she says.

She remembers as a child accidentally jabbing her thumb into a batch of potato salad. The stepmother with whom she lived spotted Austin licking her thumb and accused her of sneaking a sample. She was made to sit and eat the entire mound of salad in the bowl.

In her teen years, Austin lived with her natural mother. Food was no longer a punishment but a cause for celebration.

After that, ``any escalated emotion'' such as anger, joy or fear might be soothed by a plateful of brownies, a bowlful of cold spaghetti.

The resulting weight gain became a wall that kept others away, and a potential health threat.

Austin searched for a program that would fit her needs. Then her doctor told her about Weight and Well-Being.

She's been through three of the first four sessions and says she likes that the program focuses on emotions as well as eating.

Austin is ready to deal with both.

``I want to find a solution that I can live with,'' she said. ILLUSTRATION: [Color Photo]

MOTOYA NAKAMURA

The Virginian-Pilot

Annette Austin, right, meets with nutritionist Lynn Earle-Cookson to

plan changes in her eating behavior.

WANT TO LEARN MORE?

An information session on the Weight and Well-Being program of

the Behavioral Medicine Clinic at Eastern Virginia Medical School

will be held at 6 p.m. Monday, Oct. 20, in Hofheimer Hall

auditorium, 825 Fairfax Ave., Norfolk. It will be open to the

public.

For more information on Weight and Well-Being, biofeedback to

treat migraine or tension headaches, or hypnosis to ease irritable

bowel syndrome, call the clinic at 446-7484.

The clinic also is recruiting participants for a study of the

effects of hypnosis on irritable bowel syndrome, which is

characterized by abdominal pain, diarrhea and/or constipation.

Participants must have been diagnosed with the syndrome, be

experiencing symptoms, and be 18 to 55 years old. Participants are

paid $150 and receive free treatment. Call 446-7484. KEYWORDS: WEIGHT LOSS

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