"Get a grip on yourself. All it takes is willpower." There isn't a single chubby person who has not heard this irritating advice at least several times in their lives. But nutritionist Rachel Granot says there is no less effective way to shed or maintain weight. Willpower, she maintains, is not the problem.

"For example, a couple sits in my office and the man doesn't understand what is happening to his wife," says Granot. "'She has no willpower,' he says. And I tell him that a thin individual would have failed to endure many of the diets that his wife has maintained. She's amazing. The problem is, no one can endure these diets for long.

"When I began working, 20 years ago, we didn't need scales that went past 160 kilograms. Now, I have many clients who weigh more than that. A horrendous diet industry developed, and we are raising a generation of obese and anorexic children," Granot adds.

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In part, she blames members of her own profession. "We are particularly problematic," she admits. "Every nutritionist says something else. This person is supposed to eat only protein. That one can also eat carbohydrates. This one is supposed to eat three meals. The other one is supposed to eat every three hours. What are people to do?"

Maybe it's the doctor's fault

"Let's say a nutritionist or doctor puts me on a diet that says I have to eat vegetables and cheese all week. If I can't stand it, I consider myself a failure. But why doesn't it occur to me that, perhaps, the doctor doesn't know what he's talking about?

"A 14-year-old girl told me, 'You are looking at a hopeless case. I have no character.' But I wouldn't stand a chance of maintaining the diet plan they gave her. We are guilty. What do we want from our clients?"

Granot, who earned a master's degree in social medicine at the University of California, treats clients at the Herzliya Medical Center. She considers "diet" a dirty word, and tries not to use it. Nonetheless, she says that with new clients, "one of the first questions I ask is, 'What does diet mean to you?' People say, 'Punishment, deprivation, to refrain from eating.' We have introduced many judgmental concepts in this sphere. We take leave of chocolates or bourekas as if it were a death sentence. I say you can actually eat anything, the question is how much."

Granot does not hand out standard diet plans. "How could the same menu suit every individual?" she asks. "Moreover, every individual is a completely different person at home, outside, on vacation, and at work. Each individual has to know who he is, what food suits him, and when. Many people have a problem in the evening. They eat a light meal and remain very hungry. So, why not eat a larger, hot meal? If they were to eat a serving of pasta, for example, they could relax and stop their endless grazing and trips between the living room and the kitchen."

What tools does she provide to her clientele? "I work with calories," Granot says. "That isn't a bad word, despite its bad public relations. Calories merely tell us how much what we eat will cost us." Each of her clients constructs his own menu. Much of her work focuses on emotions. "The questions that arise examine how food serves the individual," Granot explains. "In what situations does one turn to food? The goal is to map their eating style."

'Leaving a certain framework'

Not only does Granot not like the word "diet," she also is not comfortable with using the term "break" in connection with it. "'Break' is an overly harsh description. Eating the entire cake is not breaking one's diet. It's leaving a certain framework." When that happens, she says, it is important to immediately return to the framework. Not to say, "I ate a lot, so I'll skip dinner." One has to eat the next meal in accordance with the customary menu.

Granot recommends realistic planning in her "user-friendly, not petty" approach to counting calories. She suggests that clients keep an eating journal "that is honest but not judgmental. Many clients stop writing in their journals when they encounter difficulties. But documentation makes it possible to see patterns and problems and to deal with them."

Granot counsels individuals and groups in Herzliya. Four individual meetings cost NIS 410, and four group meetings cost NIS 290. Group members often ask each other, "How much did you lose?" and "How long did it take you?"

"These are relevant questions," she says. But, she adds, "'How long' is an individual matter. As far as time is concerned, I want weight loss to take time. The point is how long one maintains one's achievements. In any case, the success rate is 70 percent. There will always be bingeing. I do it, too. The question is what one does afterward. There are stations in the journey. I ate? No problem. I just have to get back on course."