Dr. Kim: Healthy Lifestyles are Portable – 5 D’S of Vacationing

Healthy Lifestyles are Portable

Written by: Clinical Psychologist, Dr. Kim Feinstein, Tucson Medical Weight Loss’s Behavioral Weight Loss Specialist

“Remember to stay on track with weight loss goals while on vacation and don’t abandoning your diet. A vacation is not permission to abandon your diet.”-Dr. Suzanne Bentz D.O., Owner & Medical Director of Tucson Medical Weight Loss

1. Delay
As you see your traveling companion(s) indulging in the local fare and alcoholic beverages, your cravings start to intensify. As the intensity of your craving builds, it feels like it will last forever. However, research indicates a craving typically lasts for about 25-30 minutes before subsiding. So, before you give in to your craving, I encourage you to delay as long as possible. If 25-30 minutes seems like eternity, start with 5-minute intervals and work your way up to 30 minutes. It gets easier the more you practice this!

2. Distract
While you are delaying, it is important to distract yourself with something pleasurable other than food! Try to do something that captures your attention and distracts you from the triggers. Some examples include looking at the beautiful scenery, or if possible, engage in a conversation with your travel companion.

3. Distance
While you are “delaying” and “distracting”, it is best to distance yourself from any food source. This will help minimize the likelihood of giving into the craving. So, see if you can excuse yourself from the table and/or go take a nice walk.

4. Determine
If the craving is still intense and the previous 3 D’s are not helping, I encourage you to determine, “How will eating make me feel in the LONG TERM?” We know that it will give you pleasure for only 20 minutes, before needing another “dose.” So ask yourself, “Is eating this in line with my vacation goals?” “Why is weight loss and weight management so important to me?” See if you can self-talk your way to success. You can use a mantra to help you stay focused. My favorite one is “I can do this.”

5. Decide
If all of the above D’s are still not helping and you must indulge in your craving, decide:

  1. How much am I going to eat? Will I eat the entire bowl of chips? Or will I have some?
  2. Where am I going to eat the food? Am I going to eat it in my pantry, car, standing up, etc.? Or, am I going to eat at a table and enjoy the experience?
  3. How fast am I going to eat? Will I stuff the food in my mouth rapidly? Or, will I chew slowly and savor each bite?
  4. With what hand will I eat? I encourage you to eat with your non-dominant hand (i.e., if you are right-handed, eat with your left hand and visa versa). This will slow you down and prompt you to respond to your craving rather than react to it with old habits.

Tolerating cravings will get easier with practice; and, by practicing in new situations and environments; you will further strengthen your ability to tolerate your cravings. Do not let your summer vacation and the possible related triggers derail you. Use the 5 D’s to enjoy your vacation without packing on the pounds.

Happy Traveling!

*Individual results may vary. Seek medical advice before starting any service including a weight loss program or med spa treatment. Contact us to make sure this is the right solution for you.

Staying Mindful: Are You Hungry or Just Bored? (w/ Self-Test)


Written by: Clinical Psychologist, Dr. Kim Feinstein, Tucson Medical Weight Loss’ Behavioral Weight Loss Specialist

Do you eat meal after meal, snack after snack, barely aware of what you are eating and how much you are consuming? For example, do you mindlessly munch on popcorn at the movies or in front of the television and then, eventually, your hand reaches the bottom of the bag only to find that the popcorn is all gone?  Or, have you ever bought a pizza and thought, “I am only going to have one slice;” however, you go into a food trance and then realize the pizza is almost gone and you don’t remember eating it all? If you have ever continued to snack when you were already full, restrict your caloric intake when you were hungry, or utilized guilt to guide your eating, you have experienced mindless eating. Now, if you ate mindlessly only once in a while, it may not be such a problem. However, it becomes a destructive habit when are in a food trance most of the time.

If you are like most others in our modern culture, you allow other people, events and emotions to control how you eat, how much you eat, how fast you eat and how you use food in your life. Unfortunately, when you give up your control in this way, you allow mindless eating to be the rule. Over time, this unskilled way of eating can result in unhappiness with food and how your body responds to it. It can also lead to chronic dieting, recurrent binge eating, and significant weight gain.

People who habitually eat mindlessly have become disconnected with their internal signals of hunger and fullness. Therefore, learning to eat mindfully and becoming aware of your cues for hunger and satiety is a necessary tool for changing your relationship with food. In fact, research demonstrates that mindfulness training can help individuals lose weight, maintain weight loss, self-regulate eating behaviors, and reduce both the rate of bingeing and the amount of food eaten during binges. Engaging in mindful eating meditation practices on a regular basis can help you discover a far more satisfying relationship to food and eating than you ever imagined or experienced before.

I encourage you to complete the Mindful Eating Questionnaire. It is important to note, while mindful eating can’t be measured with complete objectivity, this questionnaire will deepen your understanding of yourself and of how mindful eating can begin to liberate your relationship to eating and food.

Mindful Eating Questionnaire

INSTRUCTIONS: Answer each question with the number that best matches your experience. Answer as you think you are, not how you think you should be. Treat each question as a separate question. If you don’t know how to answer a question, leave it blank.

1 = Almost always
2 = Frequently
3 = Infrequently
4 = Almost never

  1. I’m unaware that I’m hungry, or full, until sometime after the fact.
  2. I am stressed out.
  3. I don’t really taste or appreciate my food.
  4. I force or control what or how much I eat.
  5. I eat when I’m not hungry.
  6. I avoid eating even though I am hungry.
  7. I rush when I eat.
  8. I eat without being aware that I’m eating.
  9. I eat when I’m stressed out.
  10. I believe that I can only succeed by controlling or being rigid about my diet.
  11. I am unaware of thoughts that precede my eating behaviors.
  12. I find it difficult to remain focused in the here and now.
  13. I don’t love and accept my body and myself as it is.
  14. I don’t regularly feel a desire to exercise.
  15. My body image is negatively impacted by media exposure to the “thin ideal.”
  16. My exposure to media stresses me out or lowers my moods.
  17. I am living or eating “on automatic.”
  18. I am stuck in mental and/or behavioral patterns that I would like to change.
  19. Emotions “take me over” and I am not aware of what has happened until later.
  20. I eat to manage strong or uncomfortable emotions.

SCORE YOURSELF: Add up your answers and divide the total by 20 (or if you didn’t answer all the questions, by the number you answered). Your score will be a number between 1 and 4.

INTERPRET YOUR SCORE: A higher number (closer to 4) reflects more mindfulness (and freedom) in your eating behaviors. A higher number also reflects a more mindful and liberating relationship to the many forces, particularly bodily sensations, emotions, and thoughts, which (usually unconsciously) precede and influence eating behaviors.

What was your score? Try not to worry or judge yourself if you didn’t get a score close to 4.0. Nobody is perfectly mindful all the time! The goal is progress not perfection. Just know, the more mindful you are, the freer you will be.

Hopefully, this questionnaire has given you insight into how mindfulness can transform and liberate your relationship to eating, exercise, your body, your mind, your emotions, and yourself. Mindfulness (awareness) is the foundation for positive change and transformation in any area of life, including in your relationship to food.

The good news is with attention and practice you can re-train yourself to become a mindfully skilled eater and recapture power over food! It’s time to break free from the food trance!



(Kristeller & Hallette, 1999)


*Individual results may vary. Seek medical advice before starting any service including a weight loss program or med spa treatment. Contact us to make sure this is the right solution for you.

Next Stop: Healthy Vacation (Top tips to prevent weight gain while traveling)

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Written by: Clinical Psychologist, Dr. Kim Feinstein, Tucson Medical Weight Loss’s Behavioral Weight Loss Specialist


Does this sound familiar?


With summer quickly approaching, you likely have a vacation scheduled in the near future. So, you go on a diet and spend more time exercising in order to look and feel your best on your summer trip. All of your hard work pays off; you reach all of your weight loss and fitness goals, and are ready to enjoy your excursion. However, while on your vacation you ditch your healthy diet and exercise regime and indulge in high caloric foods and alcoholic beverages. You gain back all of the weight you lost (and then some). You return home feeling uncomfortable, overweight, and unable to button your pants.


If this sounds familiar, you are not alone. Yes, vacation is a time to unwind, escape reality, celebrate, and relax. However, try not to use vacation as an excuse to overeat, drink, or become physically inactive.


Here are some tips to stay on track while on vacation:


Set a realistic goal and plan

Before you arrive at your vacation destination, set a realistic weight management goal and plan for the duration of your trip. Decide at the onset how many extra calories you are going to allow yourself, either each day or for the entire trip. For example, “I plan to continue to eat as I am now but I will also factor in up to 300 extra calories per day of food and/or alcohol.” Try your best to monitor your daily caloric intake. Use your Tucson Medical Weight Loss app and Fitbit®. It will help you to prevent unwanted weight gain and stay on track while you are away! Remember it only takes 3500 extra calories to cause a one-pound weight gain.


Incorporate physical activity into your itinerary

In order to offset the increase in your caloric consumption, make sure you incorporate daily exercise and/or physical activities you enjoy. If you are going to the beach, then you are in for a workout delight. There are plenty of opportunities for exercise at the beach to include walking on the sand, running, beach volleyball, swimming in the ocean, kayaking, surfing, and so much more!


If you are not going to a beach destination, there are other ways you can incorporate physical activity into your routine. For instance, you can take a walk around the property, walk the golf course, play basketball, or go for a bicycle ride. Or, instead of taking a tour bus to visit the attractions, opt for a walking or biking tour. With so many new and wonderful sights to see, you will not even notice you are exercising. Remember, exercise (and/or physical activity) is going to be your winning ticket to preventing weight gain while on vacation. 


Avoid the temptations!

Step away from the hotel room Mini-Bar! 


Don’t even open it! You know that it is only filled with high caloric snacks, candy, and beverages. Instead, request a refrigerator so you can store healthy snacks such as fruit, veggies, egg whites, turkey breast, low-fat yogurt and/or cheese, almonds, etc. Healthy options will help you manage your hunger between meals so you won’t be famished when you go out to eat.


Avoid buffet-style eating. The choices are too overwhelming and tempting and it is guaranteed that you will over consume at a buffet. You can easily eat your entire days calorie requirements at the breakfast buffet. And then there is the feeling of “I have to eat my money’s worth” which is never a good idea. Instead order from the menu where portions and choices are more reasonable.


Beware of Cruise ship eating, which is mostly buffet style or all-inclusive style eating designed to encourage over eating. Instead eat in the dining room where you can order from the menu and portions and choices are more reasonable.


Practice portion control

Even when you are on vacation, you must still practice portion control if you want to avoid weight gain. Try to enjoy small portions and eat slowly so you taste the food and feel a sense of pleasure, satisfaction, and relaxation on your vacation. Limiting portion sizes is a great way to control calories and make room for occasional treats.


Everything in moderation

Feeling deprived is not fun when you are on vacation, so indulge in moderation. This means having a few bites of your favorite main dish, or a taste of your travel companion’s dessert. Eating small amounts of your favorite foods will help you feel satisfied and less deprived.


Also, when it comes to alcohol, the calories add up very fast, particularly if you are consuming those frothy drinks that are typically served with an umbrella. So, indulge in moderation when it comes to alcoholic beverages. For instance, when ordering an alcoholic beverage, choose lower-calorie options such as light beer, champagne, wine, or spirits mixed with water or diet mixes. Additionally, to prevent weight gain, alternate alcoholic drinks with non-alcoholic, zero calorie beverages, so you will reduce your overall caloric intake.


Make it special

Don’t waste vacation calories on foods you can eat any time.


Instead save your splurge for memorable local foods and specialties that will remind you of your trip and add to your special memories. If you follow these tips, it will be possible to enjoy your favorite foods and beverages while on vacation without the resulting weight gain. Remember not to use vacation as an excuse to abandon your diet and healthy lifestyle. Maintaining your weight is a realistic goal while on vacation.


Bon Voyage!


*Individual results may vary. Seek medical advice before starting any service including a weight loss program or med spa treatment. Contact us to make sure this is the right solution for you.


Be Mindful, Not Mindless


Written by: Clinical Psychologist, Dr. Kim Feinstein, Tucson Medical Weight Loss’s Behavioral Weight Loss Specialist

What is “mindfulness”?
Have you ever heard the expressions “be in the moment” or “be in the here and now”? These are different ways of saying, “be mindful of the present moment.” According to the Center for Mindful Eating (www.tcme.org/principles.htm), mindfulness can also be defined as deliberately paying attention, non-judgmentally to the present moment. It is slowing down and being aware of what is present for you mentally, emotionally, and physically in each moment without judgment or criticism. With practice, mindfulness cultivates the possibility of freeing yourself from habitual, unsatisfying and unskillful habits and behaviors. Ultimately, mindfulness promotes balance, choice, wisdom and acceptance of what it.

What is “mindful eating”?
When it comes to eating, mindfulness involves many components such as learning to make choices in beginning or ending a meal based on awareness of hunger and satiety cues; learning to identify personal triggers for mindless eating, such as emotions, social pressures, or certain foods; valuing quality over quantity of what you’re eating; appreciating the sensual, as well as the nourishing, capacity of food; feeling deep gratitude that may come from appreciating and experiencing food, choosing to eat food that is both pleasing to you AND nourishing to your body, and learning to respect your own inner wisdom.

The Center of Mindful Eating suggests someone who eats mindfully:

  1. Acknowledges that there is no right or wrong way to eat but varying degrees of awareness surrounding the experience of food;
  2. Accepts that his/her eating experiences are unique;
  3. Is an individual who by choice, directs his/her awareness to all aspects of food and eating on a moment-to-moment basis;
  4. Is aware of and reflects on the effects caused by unmindful eating;
  5. Experiences insight about he/she can act to achieve specific health goals as he/she becomes more attuned to the direct experience of eating and feelings of health

Mindful eating is about slowing down, doing one thing in the moment, and noticing the entire eating experience without judgment. Mindful eating is a multifaceted experience that involves your body, heart, and mind. It is paying attention when choosing, preparing, and eating food. It is through mindful eating, that you can develop a healthier relationship with food.


  1. Switch hands: eat with your non-dominant hand.
  2. Turn your fork upside down: lessening your chance of scooping large portions of food in one bite.
  3. Try chopsticks
  4. No multitasking: make sure the phone is not at the table and the TV is off.
  5. Put utensils down between bites
  6. Slow down: It’s a meal, not a race!


*Individual results may vary. Seek medical advice before starting any service including a weight loss program or med spa treatment. Contact us to make sure this is the right solution for you.

Stuffing Isn’t Only at Thanksgiving (Are You an Emotional Stuffer?)

Stuffing Isn't Only at Thanksgiving


Written by: Clinical Psychologist, Dr. Kim Feinstein, Red Mountain Weight Loss®’s Behavioral Weight Loss Specialist

  • Have you ever eaten a box of cookies or a pint of ice cream after arguing with your spouse or significant other?
  • When you are stressed and under pressure at work, do you tend to eat an extra slice (or an entire pie) of pizza?
  • When you feel sad and/or lonely, do you tend to eat brownies, chips, or your favorite “forbidden” foods?
  • Do you eat as a way to get through a difficult time (financial problems, relationship struggles, job loss, illness, etc.)?

If you have answered yes to one or more of the above questions, it is likely you are stuffing your emotions with food. Emotional stuffing is when you reach for food to “stuff down” your negative feelings (i.e. stress, anger, sadness, loneliness, guilt, boredom (or any other negative emotion). Eating often feels good temporarily but the feelings that prompted the eating are still there and the real underlying issues are never acknowledged and addressed.  And worst of all, this destructive habit often sabotages your weight loss efforts and leads to significant weight gain. Over time, emotional stuffing erodes your self-esteem by perpetuating feelings of frustration, guilt, shame, inadequacy, and hopelessness. Why? Because after you stuff your emotions with food, you most likely feel guilty for messing up your diet and not having more self-control. You feel increasingly helpless and powerless over your feelings and food.

If you are like most who have been fighting this fight, I am sure you are tired of the struggle! It is truly exhausting! Please know you are not alone. In fact, research suggests 95-98% of diets fail due to emotional stuffing. Also of significance, emotional stuffing has the potential to spiral into type 2 diabetes, cardiovascular and heart disease, and obesity. If you don’t stop stuffing your emotions with food, you won’t be able to lose weight and manage your health.

So, now is the time to stop stuffing your emotions, lose weight, and get healthy! Knowing that you want to stop stuffing your emotions is one thing. Figuring out how to stop is another. Below is my 2 Step Strategy to end emotional stuffing.

The 2 Step Strategy to end Emotional Stuffing:

Step One: Be Aware.

Much of emotional stuffing is so unconscious that it happens automatically. Before you attempt to change this habit, keep a journal. Write down with whom, where and when you stuff your emotions. The office? Late at night? When you are alone? When you are tired, sad, anxious, angry, lonely, or bored? Are there any patterns that you notice? Is there someone or something that triggers you?

Step Two: Feed your Emotions Without Using food!

Once you become aware of your emotional stuffing triggers and patterns, you can learn to feed your emotions without using food. If you stop stuffing your emotions with food, you have to put something in its place. Create a list of non-food related activities and alternatives to food that can help you tolerate those painful feelings. Below is my emergency cheat sheet to use for quick reference. Feel free to create your own version.

If you are feeling lonely and/or sad:

  • Call or go out with a friend or family member who will evoke a positive emotion.
  • Spend time with your children
  • Write an email to a friend or family member
  • Read magazines or a good book that will make you feel better
  • Play with your pet

If you are feeling anxious and worried:

  • Discharge some of that nervous energy by going for a walk or going to the gym
  • Practice yoga
  • Do a breathing exercise
  • Squeeze a stress ball
  • Smell and/or touch something that soothes you
  • Listen to music that evokes a good feeling
  • Clean a room in your house
  • Take a hot bath

 If you are feeling bored:

  •  Read a magazine or good book that will capture and sustain your attention
  • Create a play list on your smart phone or ipod
  • Participate in an activity that you enjoy (i.e., scrapbooking, art, walking, swimming, yoga, etc.)
  • Take a hot bath or shower
  • Watch a movie

 If you are feeling angry:

  •  Talk to a friend or loved one
  • Take 5 deep breaths
  • Recall a very happy time and imagine yourself in it again
  • Punch a pillow
  • Vent to a loved one
  • Go for a walk

So many of us are uncomfortable feeling and tolerating our emotions. We fear that our emotions will paralyze us or break us in some way. So what do we do? We look for food to stuff them down. The longer you have been emotional stuffing, the more automatic this behavior becomes and the less you believe you can handle life’s challenges without food.

As you already know, if you are stuffing your emotions, you are interfering with your ability to lose weight and maintain a healthy lifestyle. So, the next time you want to reach for food to stuff your emotions, try reaching for an alternative activity listed above. Don’t try harder, try different!

You can do this.

*Individual results may vary. Seek medical advice before starting any service including a weight loss program or med spa treatment. Contact us to make sure this is the right solution for you.

Helpful Exercise for Relaxation


Progressive Muscle Relaxation Exercise

(Adapted from The Anxiety & Phobia Workbook, by Edmund J. Bourne)

Progressive muscle relaxation is an exercise that relaxes your mind and body by progressively tensing and relaxation muscle groups throughout your entire body. You will tense each muscle group vigorously, but without straining, and then suddenly release the tension and feel the muscle relax. You will tense each muscle for about 5 seconds. If you have any pain or discomfort at any of the targeted muscle groups feel free to omit that step. Throughout this exercise you may visualize the muscles tensing and a wave of relaxation flowing over them as you release that tension. It is important that you keep breathing throughout the exercise. Now let’s begin.

Begin by finding a comfortable position either sitting or lying down in a location where you will not be interrupted.

Allow your attention to focus only on your body. If you begin to notice your mind wandering, bring it back to the muscle you are working on.

Take a deep breath through your abdomen, hold for a few second, and exhale slowly. Again, as you breathe notice your stomach rising and your lungs filling with air.

As you exhale, imagine the tension in your body being released and flowing out of your body. And again inhale…and exhale. Feel your body already relaxing.

As you go through each step, remember to keep breathing.

Now let’s begin. Tighten the muscles in your forehead by raising your eyebrows as high as you can. Hold for about five seconds. And abruptly release feeling that tension fall away.

Pause for about 10 seconds.

Now smile widely, feeling your mouth and cheeks tense. Hold for about 5 seconds, and release, appreciating the softness in your face. Pause for about 10 seconds.

Next, tighten your eye muscles by squinting your eyelids tightly shut. Hold for about 5 seconds, and release.

Pause for about 10 seconds.

Gently pull your head back as if to look at the ceiling. Hold for about 5 seconds, and release, feeling the tension melting away.

Pause for about 10 seconds.

Now feel the weight of your relaxed head and neck sink.

Breath in… and out. In… and out.

Let go of all the stress In… and out.

Now, tightly, but without straining, clench your fists and hold this position until I say stop. Hold for about 5 seconds, and release.

Pause for about 10 seconds.

Now, flex your biceps. Feel that buildup of tension. You may even visualize that muscle tightening. Hold for about 5 seconds, and release, enjoying that feeling of limpness. Breath in… and out.

Now tighten your triceps by extending your arms out and locking your elbows. Hold for about 5 seconds, and release.

Pause for about 10 seconds.

Now lift your shoulders up as if they could touch your ears. Hold for about 5 seconds, and quickly release, feeling their heaviness. Pause for about 10 seconds.

Tense your upper back by pulling your shoulders back trying to make your shoulder blades touch. Hold for about 5 seconds, and release.

Pause for about 10 seconds.

Tighten your chest by taking a deep breath in, hold for about 5 seconds, and exhale, blowing out all the tension.

Now tighten the muscles in your stomach by sucking in. Hold for about 5 seconds, and release. Pause for about 10 seconds.

Gently arch your lower back. Hold for about 5 seconds, then relax.

Pause for about 10 seconds.

Feel the limpness in your upper body letting go of the tension and stress, hold for about 5 seconds, and relax.

Tighten your buttocks. Hold for about 5 seconds…, release, imagine your hips falling loose. Pause for about 10 seconds.

Tighten your thighs by pressing your knees together, as if you were holding a penny between them. Hold for about 5 seconds…and release.

Pause for about 10 seconds.

Now flex your feet, pulling your toes towards you and feeling the tension in your calves. Hold for about 5 seconds, and relax, feel the weight of your legs sinking down. Pause for about 10 seconds.

Curl your toes under tensing your feet. Hold for about 5 seconds, release. Pause for about 10 seconds.

Now imagine a wave of relaxation slowly spreading through your body beginning at your head and going all the way down to your feet.

Feel the weight of your relaxed body. Breathe in… and out… in…out… in…out.

*Individual results may vary. Seek medical advice before starting any service including a weight loss program or med spa treatment. Contact us to make sure this is the right solution for you.