Learning how to listen to body's cues

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  • I need some advice on how to tune into my body's cues about actual vs. perceived hunger. I have not regained approx. 50% of the weight I worked so hard to lose over the summer.

    I am following WW Flex program, exercising, using portion control, tracking everything. Where I am having trouble: stopping once I'm actually full (or even before then), and also doing a lot of mindless snacking when I get home from work.

    I refuse to admit defeat--I know I will the weight again and I continue to try to learn the lessons I need in order to maintain the loss. They are sure hard to learn!
  • Typo--I mean I have NOW regained...that's why I'm so frustrated.
  • Take a deep breath, my dear ... we're all going to put our heads together and help you get handle on this and get it turned around.

    OK, you posted:
    Quote:
    I am following WW Flex program, exercising, using portion control, tracking everything. Where I am having trouble: stopping once I'm actually full (or even before then), and also doing a lot of mindless snacking when I get home from work.
    Let me throw out a some ideas/questions and you can see if any of them sound like they're on the right track ...

    *When you say you're doing a lot of mindless snacking and having trouble stopping eating, are you going over your daily Points or staying within them? Are the snacks over and above your daily meal plan or part of it?

    * Are you gaining despite staying within your Points or because you're eating more calories than you used to?

    * Do you think you're eating despite not being hungry? Or do you feel hungry when you do the snacking? Are you eating all your maintenance points? Have you increased your exercise lately? - sometimes that can increase your appetite.

    * Are you too hungry when you sit down to eat a meal? Like 'ready to gnaw your arm off' hungry? I have a lot of trouble ever feeling full if I let myself get too hungry. It's like a pit I can't climb out of - maybe it's low-blood sugar, I don't know. If I don't eat small amounts every three hours, I'm asking for trouble.

    * Are you starving when you get home from work? Could that be why you're snacking?

    * Do you have a lot of tempting food in your house to snack on?

    * After working so hard to get to goal and being so 'good' for so long, do you feel like you need a reward? - lots of time we tend to think of food as a reward.

    * Do you ever find yourself feeling like you can afford to 'ease up' a little since you're at at goal? - little of this, taste of that, just this once, other people are eating it so why can't I etc. Little things add up into weight gains, unfortunately.

    * Messed up body cues, like you said? Some of us here feel like we have faulty hunger cues. I know that Ali (Sweater Girl) and I have specifically talked about how we don't feel full after eating a meal until a LONG time later - like 45 minutes to an hour later. It can be very hard to keep from eating more when you feel just as hungry when you're done eating as when you started.

    * Do you ever catch yourself feeling like now that you look 'normal' on the outside, you should be able to eat 'normally' (in other words, more food than we usually do)?

    * Do you sometimes just want a vacation from dieting and counting Points? Just one lousy day or week?
  • I have a slightly different and probably unpopular response to this.

    I really believe that some of us have bodies that just plain send out the wrong signals. I've done everything Meg suggests above, and they are all necessary questions to ask yourself and address. But once you've cleaned your environment, made sure you are eating nutrient dense food every few hours, have eliminated all the obvious sources of stress or boredom related eating, and you know that you are being adequately nourished, if you're still hungry, then ignore it and go do something to take your mind off it.

    I'm often hungry while I'm eating, after I'm eating, and until I eat my next meal. I'm eating enough, not losing or gaining, but the brain is just sending out WRONG signals. In some cases, you have to learn to NOT listen to your body.

    OK, I'm Just my 2 cents.

    Hmmm...just re-read Meg's post. I think she covered this one in her last bullet point "Messed-up Body Cues".

    Mel
  • I think that I am wired that way too Mel. The only time that I know that I am not hungry is when I get to that over stuffed, bloated, right after thanksgiving dinner feeling. That is pretty much how I became overweight, I ate to that point all the time. I've always preferred to eat fairly healthy foods, just way too much of them. The WW Flex plan hasn't been very helpful in teaching me to recognize when I am full but it has taught me about portion control. I may never be able to recognize internally when it is time for me to put the fork down, but as long as I count my points I can rely on that to help me determine when my body has had enough.
  • Yep, me too -- that's why I still weigh and measure my food and write it down. If I relied on my internal cues, I would definitely be eating twice as much as I need, even of the good, healthy stuff.
  • When I was younger I too had great difficulty with when I was truly physically hungry, and when I was hungry for emotional reasons. In fact I had not clue there was even a difference in these kinds of hunger. I just thought I was 'hungry'.

    You can learn to differentiate between the two, but it takes great practice and perseverence, as well as a belief there is a difference. We learned to blurr the lines between hunger and non-hunger beginning when we were mere babies. The first time our poor tired mom's put a bottle in our mouths when we were crying and we werent. Maybe we just wanted to be held, or had been frightened by something. But we were given food instead. It was just easier sometimes, and it worked. We stopped crying because the food was good. But in those early events, we began to lose the ability to discern between moments when food was really needed, physical hunger, and when we needed something else, emotional hunger.

    And how often were we rewarded with a cookie or candy because we were a 'good girl' or boy. That too is not in response to real hunger and further blurs the line.

    When I first began reading about these sorts of things I thought it was nuts. Hunger was hunger, and I was hungry all the time. Or at least it sure felt that way to me. Then I began remembering eating a very large meal, being very satisfied, then calling this cute boy I really wanted to talk to. He did not answer his phone, and as I hung up the receiver, I felt immediate strong hunger. Even back then I thought 'what the?...' because I had just eaten! There was no way my body could want food so soon after a large meal, but it seemed to be asking for food. It was years and books later before I realized there was a very quick chain reaction at work. First I anticipated something pleasant - talking to the cute guy. Second, I was disappointed. Third, instead of dealing with that disappointment directly, from years of erroneous conditioning around food in my family, I felt phantom hunger instead when there was no possible way I was. And it sure felt real. In fact I am sure I probably ate in response to it.

    So how do you re-learn to indentify the difference between real hunger and emotional hunger? You need to start identifying your bodies physical signals. They do exist. Perhaps more weakly in some, but they are there. In me they are an empty sensation in my stomach, as well as occasional growling or movement in my stomach. In other people they feel different. Some people feel light-headed, or weak. There are other cues, but since they werent mine, I dont remember. I have a book that lists some. When I find it, I can sent them along if you are interested.

    You do need to watch for them when you have not eaten for several hours. Perhaps you might want to take notes about what you observe with your body and hunger. As Geneen Roth said: Hunger is alot like being in love, if you are not sure, you are probably not.

    Then of course that leaves you with dealing with the emotional hunger, and that is a whole 'nother ballgame.

    Feeling satiety is also a physical signal in the body, but it is far more difficult to discern, and some people such as myself have very very poor satiety signals. I have watched for mine for months and months and there is no one tie when I can pin-point satiety. For me, I must serve myself a serving I know will satify, then eat it, and then wait to see if it was enough. I generally know when I am satisfied, but that comes much later after the meal. If I try to serve myself less than I think will satisfy, sometimes it works, and sometimes an hour later true physical hunger returns.

    If you are talking about learning to stop eating after you start, that usually is not solely a satiety issue. It is one of the most difficult eating issues around, as most of us know.

    Jan
  • As always, your collective advice is so on target. I read everyone's posts and thought hard about how they could apply to me. A big part of what I am experiencing, I think, is extreme disappointment/disillusionment with how hard maintenance is. When I joined WW, I lost the weight fairly easily. I expected to breeze thru the 6 weeks of maintenance and become a Lifetime member right away. It was a real shock when that was NOT what happened. Instead, I gained some weight during maintenance, took it back off, ended the 6 weeks 2 pounds above goal (and that was after revising my initial goal upward to reflect what I thought my body could reasonably handle).

    What seems to be happening now: I need to readjust my thinking big time and accept that this is a very long journey, not just finishing the program and going la-de-da into the "normal weight" sunset.

    Also, I am exercising pretty regularly (aerobics, weights 3x/week, Pilates or stretching) so maybe I am hungrier.

    I keep very decent food around the house and know I feel better when I am making healthy food choices. I ate half a York Peppermint Patty today; it didn't even taste good to me--way too sweet. I proudly threw the other half in the trash.

    So I think I will make the necessary mental adjustments (long haul vs. short haul thinking), make sure I stick to my points target (I have been going over it), try to use fewer Flex points of the 35 weekly ones, and most important of all, not feel defeated! I can lose a few pounds and keep it off. I can and I will!

    Andele!
  • I have a feeling that most of us can identify with your feelings about maintenance. When you think about it, pretty much the whole diet industry is focused on getting to goal, usually ASAP. Who ever talks about the rest of our lives?

    Let me tell you about how I used to go on "a diet" : I'd decide that I had to lose a lot of weight and it would be as fast as possible, since of course, I'd be "perfect". So I'd pull out a calendar and write down what I would weigh by certain days (like my body pays any attention to the calendar?). THEN I would dutifully starve myself but all the while be fantasizing about what I could eat when I made it to goal. And I didn't even realize how that was! I would lie in bed at night, hungry, and think about pizza and cake and ice cream -- because I would be able to eat all those wonderful foods again when I got to goal, of course.

    I don't need to tell any of YOU how well that didn't work! But ... even though I finally figured out what doesn't work (took me long enough! ) no one told me what does work for maintenance. Maybe some of you can identify with the panicked feeling that I had the day after I reached my goal - what now? How do I keep it off? I've worked so hard to get here - how can I stay here?? At least I realized that my old food fantasies weren't going to do the trick.

    But nothing and no one prepared me for the reality of maintenance: this is for the rest of our lives. We don't ever get 'cured'; we're never going to be able to go back to eating the way we used to (except under limited and controlled circumstances ). Another reality: we still need as much support and encouragement to keep the weight off as it took to lose it in the first place. Maybe no one in the diet world wants to say these things because they don't want to deter people from even starting the weight loss journey? Maybe no one would buy the glossy book if it said that the diet lasts for the rest of your life instead of two weeks?
    Quote:
    What seems to be happening now: I need to readjust my thinking big time and accept that this is a very long journey, not just finishing the program and going la-de-da into the "normal weight" sunset.
    I think that's the key to maintenance, in a nutshell.

    In the thread about Maintainers 2005, a number of people made the excellent point that we need to make it better known that everyone is welcome here in the Maintainers Forum. I don't think it's ever too early in one's weight loss journey to start to think about maintenance and life after goal. After all, most of us have lost countless pounds in our lives (hundreds, in my case) - losing the weight really isn't the hard part; keeping it off for life is the challenge. But ... the good news is that you can look around our little place here and see all the people who are happily living maintenance and loving every minute of it!
  • Jansan said:
    Quote:
    "I felt phantom hunger instead when there was no possible way I was. And it sure felt real. In fact I am sure I probably ate in response to it. "
    I soooo had and rarely still do have that "phantom hunger" !! My mom used to tell me at 10PM at night when I was heading for the fridge after Thanksgiving or Christmas supper, "what! you can't be hungry after that large meal!" but I "thought" I was because of boredom probably...
    Meg said:
    Quote:
    "Let me tell you about how I used to go on "a diet" : I'd decide that I had to lose a lot of weight and it would be as fast as possible, since of course, I'd be "perfect". So I'd pull out a calendar and write down what I would weigh by certain days (like my body pays any attention to the calendar?). THEN I would dutifully starve myself but all the while be fantasizing about what I could eat when I made it to goal. And I didn't even realize how that was! I would lie in bed at night, hungry, and think about pizza and cake and ice cream -- because I would be able to eat all those wonderful foods again when I got to goal, of course. "
    Ain't that the truth sistah!!!!! I did the same darn thing!

    You gals cannot imagine how good it feels to realize I am not alone in my thinking or my former thinking... That's why I keep repeating how much I this site ! Bears repeating doncha think?
  • Meg Said:<<But nothing and no one prepared me for the reality of maintenance: this is for the rest of our lives. We don't ever get 'cured'; we're never going to be able to go back to eating the way we used to (except under limited and controlled circumstances ). Another reality: we still need as much support and encouragement to keep the weight off as it took to lose it in the first place. Maybe no one in the diet world wants to say these things because they don't want to deter people from even starting the weight loss journey? Maybe no one would buy the glossy book if it said that the diet lasts for the rest of your life instead of two weeks? >>

    There is indeed no cure, just containment. Constant vigilence. Effort and committment, but it can be done. I do not believe that old 95% number.

    Another thing that make maintaining more difficult- When you are losing, you are getting all kinds of accolades (if you like being noticed that is) and compliments on wl. But when you are maintaining, that will decrease over time when people get used to the new body. The thrill of working on something active and losing is gone.

    Too many people also think weight loss will fix all their problems. "I will be happy when I lose xxx pounds, and my life then will be wonderful in every way". Of course many things will improve. WL will do what weight loss will do. It will allow one to wear a smaller size and have a whole range of new styles available to wear. It will allow more flirting and general acceptance. It just makes life easier (or so I have heard). But it wont fix everything. Some of the same old problems will still be there that never were weight related. WL wont fix a bad job, or a bad relationship. Wl wont fix a mean MIL, or an abusive spouse or children that wont obey, or pay the rent.

    In the end, wl improves many things, but not everything. In the end, not only do we need to learn to maintain the loss, but we still will have some of the old problems that perhaps we used to use food to comfort ourselves from . And now the dysfunctional crutch of food is gone so we will have to find new ways of dealing with life's everyday problems. Its not just a new way of eating that we will have to learn and sustain, but a new way of dealing with problems.

    Jan
  • Your former diets remind me of me Meg. I'd go on a diet and eat salad after salad after salad...til I was sick of salad. I'd eat no meat, no sweets, nothing with any fat at all, skip breakfast, tried diet pills, diet drinks, etc. And I'd lose the weight. But when it came back, it came back in spades and always brought extra pounds with it.
  • Quote: Your former diets remind me of me Meg. I'd go on a diet and eat salad after salad after salad...til I was sick of salad. I'd eat no meat, no sweets, nothing with any fat at all, skip breakfast, tried diet pills, diet drinks, etc. And I'd lose the weight. But when it came back, it came back in spades and always brought extra pounds with it.
    Amen, sister! I wish people would start off a diet by asking themselves if they can live that way for the rest of their lives. In my years and years of experience with diet failure, deprivation inevitably led to binging and that ended up with regain, plus those bonus pounds.
  • Jan--Absolutely on target!
    Quote:
    In the end, wl improves many things, but not everything. In the end, not only do we need to learn to maintain the loss, but we still will have some of the old problems that perhaps we used to use food to comfort ourselves from . And now the dysfunctional crutch of food is gone so we will have to find new ways of dealing with life's everyday problems. Its not just a new way of eating that we will have to learn and sustain, but a new way of dealing with problems.

    Jan


    Jan, This is so articulate and really spoke to me. It made me think about why I snack after school (I teach 6th grade) even when I am absolutely not hungry. I need to acknowledge stress from the day--teaching 11 year olds brings plenty of that!--and find a different way to deal with those feelings. Eating will not help me manage the feelings--it will only make me feel worse and I'll pass up another opportunity to figure out when I am truly hungry.

    Today I will take my son for a walk at the reservoir instead of eating after school. He is 12, but most of the time still willing to talk to me!
    It will get me out of the house during one of my danger zones and give me some time with him when we are not discussing his homework or upcoming Bar Mitzvah. It feels good to have a plan!
  • Food For Thought
    As soon as I read this article, I thought of our discussion about eating cues and satiety. It doesn't have any definite answers but it's sure thought-provoking:

    Quote:
    Bottomless Hunger
    It's Not a Lack of Willpower That Drives Her to Eat Constantly. It's Her Genes. What Can Obesity Experts Learn From Her?

    By Ranit Mishori
    Special to The Washington Post
    Tuesday, November 2, 2004; Page HE01

    Around the time Kate Kane turned 3, her parents realized that their little girl had a big appetite. Unusually big. At mealtime, the Towson, Md., tot would finish everything on her plate and then demand more. Never satisfied by what the rest of the family was served, she would go hunting for food on kitchen counters and in the breadbox. Eventually, her parents had to put padlocks on the cupboards and an electronic deadbolt on the refrigerator.

    That was at home. In the outside world, Jim and Kit Kane had to warn neighbors, relatives, teachers and babysitters not to give her anything to eat outside of her scheduled meals, no matter how hard she begged.

    As Kate grew older, her parents had to block the phone numbers of all the pizza parlors and delis in town and have their address put on a "Do Not Deliver" list. (She once at age 12 had a local restaurant deliver to a house down the block whose owners were away on vacation.)

    Kate Kane, now 22, stands 5-5 and weighs 235 pounds. In medical terminology, she is "morbidly obese" (more than 50 to 100 percent or 100 pounds overweight), like some 5 percent of the U.S. population. But while many overweight Americans may say they just cannot stop themselves from overeating, Kane really can't. She is driven every minute of her life by the feeling that she is starving, because of a defect in her DNA.

    Kane has Prader-Willi syndrome (PWS), a genetic disorder that occurs in about one of 12,000 live births. First diagnosed in 1956, it has several features, including reduced fetal activity in utero, poor muscle tone at birth and feeding problems in infancy. Others may include underdeveloped sex organs, short stature, small hands and feet, and skin and hair color that is a touch lighter than everyone else's in the family. PWS children typically have developmental delays, and most have some form of cognitive impairment.

    But the defining characteristic is hyperphagia -- in plain English, an insatiable appetite. Obesity is the inevitable result for people like Kate -- unless someone figures out how to help them.

    The obesity epidemic among Americans at large has given medical researchers new incentive to understand what's happening to Kane. In theory, if they can find a way to reduce her appetite and get her weight under control, they can use the lessons learned to create treatments -- perhaps even the elusive "thin pill" -- for the obese people in the general population who struggle with appetite control.

    Obesity Unplugged

    Obesity has become one of the biggest medical problems of our time. In 1999-2000, an estimated 64 percent of U.S adults aged 20 years and older were overweight or obese (more than 20 percent overweight), according to the Centers for Disease Control and Prevention. Fifteen percent of U.S. children and adolescents aged 6 to 19 were considered obese.

    Obesity is a health issue, a social issue and an economic one. Obese people are often perceived as lazy, self-indulgent and lacking in willpower -- not the kind of profile likely to further career advancement. Obesity, in this light, is seen as a character issue.

    But the case of Kate Kane, and others with PWS, tells us that sometimes it really is just a matter of biology.

    Kate had a very short umbilical cord -- an indication that something was amiss -- when she was born. She was also "floppy," or lacking in muscle tone, and couldn't eat; doctors had to deliver formula via a tube from her nose into her stomach. The first few months of her life were dominated by what doctors call "failure to thrive." Then she stabilized.

    Around age 2, things started to change for the better. Or so her mom and dad thought. "Kate was so skinny and thin," Jim Kane recalled. "We kept trying to get her healthy and fatten her up. Then all of a sudden she's 2 years old and she's pretty heavy. And we said, 'Oh, good, she's turned the corner.' "

    Only Kate, having finally started eating, couldn't stop. Her big appetite was not the only sign that something was amiss. "It was the whole package," said her father. "Social, learning and developmental difficulties, all things put together." A Johns Hopkins geneticist diagnosed Prader-Willi based on her symptoms, even though Kate tested negative for the single genetic defect researchers then linked to the condition. (Today, a test looks for three distinct genetic errors, any one of which is considered a PWS indicator.) It was Kate's case, in fact, that led Hopkins researchers to tie the disorder to more than one genetic defect.

    PWS presents obesity researchers with a unique opportunity: the chance to study "pure obesity." It is one instance in which whatever causes overeating and weight gain is not related to external factors. Ethnic and dietary factors are not involved, and neither are socioeconomic or emotional issues. Not even exercise habits -- or lack thereof -- cloud the picture. People with PWS are endlessly hungry no matter what, because of something that involves only the body's internal mechanisms.

    Doctors had no clue what caused PWS until 1981, when researchers discovered that many people with PWS shared an abnormality: a segment of genes missing from chromosome 15, one of 23 pairs inherited from our parents and found in every cell of our bodies. They found that about 75 percent of people with PWS had this abnormality.

    This information offered obesity researchers some important direction. Said Robert Nichols, a geneticist at the University of Pennsylvania School of Medicine: "Once we know genetic pathways, like in the PWS, we can investigate whether there are any specific components of the pathway that are common pathways involved in obesity."

    Defects in chromosome 15, it turns out, also characterize another condition, Angelman syndrome, which also has obesity as a cardinal feature. So, is chromosome 15 to blame for obesity in the general population? Researchers know nothing is ever that simple. Still, chromosome 15 may be a piece of the puzzle for at least some obese people.

    The Ghrelin Factor

    If researchers cannot yet isolate and repair genetic defects, they can perhaps discover what is going wrong at another level -- with the glands and hormones that control hunger and satiety.

    An endocrinologist looks at a Kate Kane and sees a problem with the delicate system of metabolic controls that tells a human being it is time to stop (or start) eating. In a person with PWS, said Nicholls, "the feedback mechanism is missing that would tell the hypothalamus, 'Look, you've got plenty of energy, you don't need additional nutrients.' They're not getting this feedback and rather they're getting this feedback saying, 'You're starving.' "

    Quite possibly this failure occurs in people other than those who have PWS, which again opens the possibility that research aimed at treating PWS would have benefits for others with "broken" metabolisms.

    Duke University endocrinologist and researcher Andrea Haqq and others are following a hormone called ghrelin. Made in the stomach, it tells the hypothalamus to control appetite. The more ghrelin in your stomach, the more you want to eat.

    Haqq found that ghrelin levels in children with PWS were four or five times higher than in age-matched controls. What if you tried to lower ghrelin levels in people with PWS, she wondered. Might that solve some of the hunger issues?

    In a small pilot study, Haqq gave four PWS children octreotide, an antidiarrheal drug that has been shown to reduce ghrelin levels in healthy adults. Ghrelin levels, she said, "dropped by about 67 percent in these kids." More research is needed to observe long-term effects and determine if indeed lower ghrelin levels lead to reduced appetite.

    Ghrelin's potential hasn't escaped the attention of the pharmaceutical industry. Several drug companies are investigating synthetic and natural compounds that may help regulate ghrelin levels.

    Being Kate

    Kate Kane, like others with PWS, will stop at nothing to get food. She has been known to sneak into the kitchen when the rest of her family is asleep. She has ordered deliveries over the phone when no one was listening. She has even shoplifted.

    "I was right next to her" when it happened at a local Starbucks a few weeks ago, recalled her father. "I must have turned away or reached into my wallet, and she grabbed a muffin from the counter and stuck it down her shirt."

    By now, Jim Kane has developed a sense for these things. Suspecting that his daughter had snatched something, he confronted her in the car. "You just know something is up," he said, "and she'll deny it till the cows come home. I found the thing and I walked back to the shop."

    But Kate's parents are entirely on her side. In order not to embarrass her, they usually return later to hand back the goods Kate has taken and to explain the situation. They have even created a brochure that introduces Kate to store owners and other strangers as a young woman with a problem, asking for understanding and seeking cooperation.

    One paragraph, co-authored by Kate, goes like this: "My appetite hardly ever goes away. If I see food or think food is around, then my thoughts are going to stray in that direction. . . . You can help me by locking up any lunches or snacks you may have. If I take something that is yours, it may seem like stealing but I really can't help it."

    Kate, who graduated at age 18 from Towson High School, now lives in a Wisconsin group home for people with PWS, where she earns a small income from Harley-Davidson for stitching and packaging microfiber cloths for wiping down motorcycles. The job is performed inside the group home, where, of course, the cupboards and the refrigerator are padlocked. She could have a "fairly normal job," said her father, "if it weren't for the appetite."

    A previous job -- as an assistant at a nursing home near Towson -- was short-lived. When she was hired, her father said, "we thought, 'Great. She loves old people. Personality-wise she is very compassionate and loves to help.' " She was fired the first week after she was discovered taking food and candy from residents' rooms.

    What is it like when the thing you want most is locked away where you can't get it? Anyone who has ever gone on a diet will understand Kate's answer.

    "I get angry," she said -- about that and people's lack of understanding. "People don't know what it feels like," she complained. "It makes me mad. . . . People call me fat . . . and [say] stuff behind my back."

    Not coincidentally, anger management is an integral part of her therapy at the group home, and a constant struggle for many people with PWS.

    Still, Kate Kane's advice to others who struggle with intense food cravings: "Keep stuff locked up."

    Looking Ahead

    Research, said Jim Kane, is beginning to produce some benefits for people with PWS. Growth hormones, for example, are being used experimentally to improve the height and muscle development of children with PWS, making them less conspicuous. Because of the hormones, the children also have higher levels of energy, which of course helps burn more fat.

    "Twenty years from now those kids are going to have a very different life," he says.

    In the meantime, Jim Kane, who is an active member of the Prader-Willi association, has been working hard to get more publicity and push for more funding for research on this disorder. He recently helped organize the annual family picnic for the PWS Maryland chapter, where, of course, he had to give thought to how much food to put out, and when to lock up the leftovers.

    It went off well, he said, partly because he's developed a strategy on where to locate the group's advocacy materials, donation forms and information booklets: He places them on a small table right near the food. That, inevitably, will be where the kids congregate. And if the kids are there, so are their parents, keeping endless vigil on their children's eating habits.•

    Resources

    • The Prader-Willi Syndrome National Association has good links to resources, scientific information and frequently asked questions about the disorder. Includes links to local chapters and a Spanish version. www.pwsausa.org/

    • The National Institutes of Health offers patient information with links to current clinical trials: http://www.nlm.nih.gov/medlineplus/p...isyndrome.html.

    Ranit Mishori is a family practice resident at Georgetown University/Providence Hospital.
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