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CHAPTER ONE Where Are We, and How Did We Get Here? Dieting is dangerous. The pursuit of weight loss, whether you call it a diet, a lifestyle change, portion control, or “making better choices,” is hazardous to our physical, mental, emotional, and financial well-being. This is a shocking statement. Many people think that even making this statement is dangerous and risky, but there is an expanding awareness that our cultural beliefs and attitudes about weight, eating, and well-being urgently need to be reevaluated. How did this topic become so complicated and contentious? And what can we do about it? Newspapers are filled with headlines about the “Obesity Epidemic,” and bookstores are filled with books that claim to help people lose weight. Gro- cery stores are filled with low-cal, low-carb, low-fat foods, yet people just seem to be getting fatter. Everyone agrees that there is a problem, a big prob- lem, but none of the many solutions suggested seem to work. Perhaps we have been going about it all wrong. I am a psychotherapist trained in several different theories of counseling, and I have been working with people who have eating, weight, and body image problems for more than three decades. I have researched behavioral approaches to weight loss, and I have worked on an inpatient psychiatric unit dedicated to treating people with anorexia and bulimia nervosa. I have attended and presented at several national conferences that focused not only on these life-threatening illnesses but also such related issues as obesity, nutrition, cultural influences, binge eating, body image distortion, and weight stigma, especially as they are related to depression, anxiety, and low self-esteem.