Notes on "The Park Avenue Diet Show: The Capacity for Close Relating"; March 20, 2011

What are the most important defining characteristics of someone who has lost weight, changed his or her image, and maintained their new-found health consistently? Surprisingly, this subject has rarely been addressed at the annual convention of the American College of Physicians, a convocation I have attended almost continuously since 1983. But this year at the upcoming meeting in San Diego in a few weeks, an answer might be forthcoming.

In a seminar entitled "Treatment of Obesity", Dr. Robert Kushner will present data that provide a fascinating but not surprising set of answers. He asks: "What behavioral issues need to be appreciated for successful weight loss?" And he provides a partial list, one that dovetails remarkably with the philosophical and psychological infrastructure of The Park Avenue Diet.

First we should mention what is not important or predictive of success, namely the macronutrient food constituents of a weight-loss program. Endless ink has been spilled over the supposed benefits of the American Heart Association/ Atkins/ South Beach/ Weight Watchers/ Pritikin/ etc program--take your pick because their results are almost uniformly identical and depressing: a 5-10% "success" rate, with "success" being defined as approximately 10-15 pounds in one year, hardly a remarkable achievement. The American College of Physicians and the AMA have stated that they will not be accepting papers for presentation on the supposed benefits of any of these programs anymore. There is no point comparing one "therapy" to another when none of them isn't even remotely beneficial to a majority of people.

On the other hand Dr. Kushner provides a list of seven defining characteristics of the successful weight-loss patient, and here they are exactly as enumerated:

1) Coping capacity
2) Self-efficacy
3) Autonomy
4) Healthy narcissism
5) Motivation for weight loss: more confidence
6) Stability in life
7) Capacity for close relating

Virtually all of these are covered in one way or another in The Park Avenue Diet by either the famed humanistic psychologist Dr. Stanley Krippner or the glamorous, wise socialite Tinsley Mortimer. And the publication of the book predates this ACP academic presentation by two years.

Several of the behavioral issues might be defined by Dr. Krippner as offshoots of personal myths, the rulebook, narrative, or code we have formulated based on our life experiences and upbringing. Autonomous, efficacious people are self-reliant and self-motivated. Those of us who are better at coping with stress may avoid relying on "comfort foods" or high-calorie snacks for temporary pleasure during life crises. And more self-confidence means more pride in appearance, behavior, and physicality.

But it is the inclusion of "the capacity for close relating" that most interested me. One's need for intimacy, close relationships, bonds based on trust and affection--this is also crucial for maintenance of weight, a matter I can attest to professionally and personally. The converse situation, wherein an individual eats, relaxes and sleeps alone, is sometimes a scenario for introversion, loneliness, carelessness, self-neglect, depression, and an unhappy existence.

Except for The Park Avenue Diet I have never seen "the capacity for close relating" applied to any medical condition. But it certainly is important for one's health, especially as defined by the World Health Organization. "Physical, mental and social well-being, and not merely the absence of disease." Social health depends in part on self-confidence and good interpersonal skills, two of the seven most important components of image. And social health is a dynamic construct--you cannot measure it by weight, height, or a blood test value. You must actually do something, namely interact well with others on a professional, familial, and personal/intimate level.

We'll return to this topic after I return from my ACP conference in about three weeks. But you can certainly learn a lot from my guest expert Bernadette Penotti--in our book, on the radio, on her website, or in person !