Fat, Sick, And Nearly Dead: A Guest Post Review

Don't 'Reboot with Joe' A guest post by dietetic intern Shalini.

A little while back I was told about this “life-changing” documentary that I had to watch; it was called “Fat, Sick and Nearly Dead.”  It fell within my scope of interest, so I watched. The cartoon illustrations between the major segments were amusing, but overall I found the content of the documentary to be extreme: a 60-day juicing fast to lose weight? Really? Of course! It all comes back to what extreme measures we can come up with to further destroy our bodies and minds.

In the documentary, Joe wants us to ‘reboot’. He explains to us what that means:
“A Reboot is a period of time where you commit to drinking and eating only fruits and vegetables, herbal teas, and water in order to regain or sustain your vitality, lose weight and kick-start healthy habits that recharge your body and get your diet back in alignment for optimal wellness.”

Well, that sounds fantastic, right? Nope. It sounds more like a disaster waiting to happen! A 60-day all fruit and vegetable juicing diet goes against what our body needs to sustain itself.  With this “diet” we are only getting simple carbohydrates, which digest quickly and do not keep us feeling full throughout the day. Staying hungry all day sounds like a pretty miserable way to spend the day. Our bodies need a mix of carbohydrates (simple and complex), protein, and fat in order to properly function. By cutting out complete food groups we are not only harming ourselves physically, but we are also training our minds to believe that we need to treat our bodies unhealthily to look healthy? Wait… That doesn’t make sense! 

 Even though fruits and vegetables should be a part of a healthy diet, we need more that just that.  Even in the documentary, the individuals who began the “reboot” program felt miserable when starting their juicing way-of-life.  By restricting ourselves, we are just setting ourselves up for future disappointment and loss of control.  When we are hungry, we need to eat; when we are satisfied, we need to stop. That’s it.

If you are trying to lose weight, the best thing you can do is follow a balanced ‘diet’ (and I use the word ‘diet’ loosely), consisting of carbohydrates, protein, and fat.  We should not punish ourselves by having only juiced fruits and vegetables every day, being unable to enjoy the foods we desire!  Is that any way to live? (No, its not.) There are so many creative and tasty meals we can incorporate into our day that can be part of a balanced lifestyle. And guess what? It’s okay to occasionally eat foods that have zero nutritional value just because they taste good – that’s what they are there for!

 By restricting yourself from the foods you love, you will only be setting yourself up for a feeling of failure and regret. Don’t do that to yourself!

 Well, from a nutritional perspective you’ve heard why I don’t feel these quick fixes are a good idea… Do you have any other reasons why you think this ‘reboot’ is a terrible, awful, horrible idea?

Part 1: My Hollywood Experience

Over the Thanksgiving holiday I was talking with a family member about her experience working in PR and Marketing in Los Angeles. I immediately asked her to share her experiences with all of you. She has generously agreed to talk about what she learned and how it influenced her feelings about her weight, body image, and sense of self in this two-part series. I hope you enjoy it.

In the summer of 2005, I worked at NBC Universal and Full Picture PR Firm as an intern. I was so excited to be entering into a world of magic and perfection, where the streets were paved with Chanel and celebrities were wandering about on every corner...or so I thought. In reality, my Hollywood experience was drastically different from what the pages of Vogue and Cosmopolitan depicted. 

At first I was star-struck by working near Rodeo Drive and the NBC Universal lot and what I quickly realized was that nothing in Hollywood is as it seems.  Now, I had amazing experiences with both internships and was so happy to see normal, decent , hard-working people making a living doing what they love. But what took me by surprise was how hard these people worked to keep Hollywood’s façade alive and well. You see, it takes a whole village to keep up that Hollywood veneer.

I would be at photo shoots prepping for the talent that hadn’t arrived yet and when they would walk onto the set, I couldn’t recognize them from the magazines I would read. The stars would be in hair and makeup for hours and hours before they were camera ready and camera ready meant they had a whole bottle of hairspray keeping their hair in place, layers and layers of makeup, girdles to suck in the belly pooch and other tricks of the trade like bean bags in their bras to make their boobs look plumper, and enough light on them to cook a chicken, which helps them look fresh and natural.

When the talent would get in front of the camera, the photographer would start by reassuring that everything and anything can be Photoshopped, so let’s have some fun. And the shoots always were fun, but the real work started after the shoot was over. Graphic designers would get the images and start working their magic by blowing up each image on their huge screen and editing the tiniest details. They would edit out the bags under the actor’s eyes, the blemishes and zits, underarm flab, belly pooches, thigh flat, and anything else you can think of that society deems unacceptable. These actors would look like normal individuals that wouldn’t necessarily catch your eye at first, and some celebrities would come to work looking slightly homeless, knowing that hair and makeup would fix them up for the day and make them look picture perfect. Celebrities that were advocates in the media for healthy nutrition and exercise to lose weight and keep the perfect figure would only eat a piece of celery and a slice of cheese with a side of packs of cigarettes and vats of coffee to keep their figures slim. Some even getting tummy tucks and liposuction in secret while telling the media they did vigorous yoga routines and ate only salmon and steamed veggies. I could see why normal girls were getting so frustrated with their bodies because they weren’t losing their extra weight as quickly as these celebrities were, but without their own personal chefs and those Hollywood tricks, no human being can achieve perfection.

That Hollywood sparkle was starting to fade when I started to all the unhappy celebrities. Maybe it was because they were starving themselves or that they live in a very fake world that seemed normal to them, but I realized I would rather be happy with my size and flaws than harming my body to live up to an impossible standard. So, before you start obsessing about being the same size as your favorite celebrity or starving yourself to reach their standard of perfection, please remember that THEY can’t even live up to their own standard of perfection because it is all fantasy and Photoshop.

Bully Calls News Anchor Fat: When it’s Worse than Bullying

The virtual world of tweeting and blogging was all a flutter when a man called news anchor Jennifer Livinston fat. Many of us applauded Jennifer's direct and powerful response. I appreciated the fact that this issue (which is pervasive in our culture) got some air time! So I posted it on my facebook page to spread the word that weight bias and bullying are NOT ok. But my dear friend and phenomenally talented writer shared her own response to this news clip that I wanted to share with my readers. Thank you Deja Earley, for sharing your thoughts.

Perhaps you’ve seen the recent video on Facebook and elsewhere, which features Jennifer Livingston—a Wisconsin news anchor—responding to an email from a viewer which criticized her appearance, specifically her weight. It’s worth watching for yourself, but, to summarize, the email calls on Livingston’s “community responsibility” as a public personality to “present and promote a healthy lifestyle” and admonishes that “obesity is one of the worst choices a person can make and one of the most dangerous habits to maintain.” In response, Jennifer Livingston called the e-mailer a “bully” and, quite rightly, said that “attacks like this are not okay.”

At first I was pleased and impressed by her response. I’m glad she didn’t “laugh off” the email, as she said she was tempted to do at first, chalking it up to a job in the public eye. But I confess I grew confused by the switch to talk of bullying. In a way, I understand it: cyber-bullying is an important contemporary issue, and one she was perhaps wise to piggyback on.

But is this bullying? It seems to me it’s worse than bullying. To call this man a bully simplifies the grave ignorance of his email, and, at least to me, doesn’t exactly match his tone. The email doesn’t ever outright call her fat, doesn’t actually mock her looks. It would be easier to dismiss if it had. Instead, it strikes me as a carefully crafted expression of concern by someone who considered themselves a responsible citizen. Was it mean-spirited? Perhaps, though it doesn’t strike me as self-aware enough to think so. In light of his clear misconceptions about the real issues of weight and obesity, this email is much more dangerous than what we’re used to thinking of as bullying, and Livingston’s response is far from adequate.

Livingston begins her response by admitting the e-mailer is “right,” that she is “overweight.” “You could call me fat,” she says. Setting aside the fact that Livingston doesn’t actually appear particularly overweight, that she’s lovely and polished and full of poise, and owning up to his label is absurd, it seems to me the next question to answer is whether or not he’s right about his main claim: that she has a “community responsibility” to “present and promote a healthy lifestyle” and the implication that her weight barred her from doing so. Livingston, surprisingly, doesn’t address this, but the answer is a resounding no. She doesn’t have a community responsibility that she’s neglecting simply by the nature of her appearance.

The fact that this man thinks her credibility rests so heavily on her size is a problem, and perhaps not a surprising one in light of his other misconceptions: he calls obesity “one of the worst choices a person can make” and then, confusingly, “one of the most dangerous habits to maintain.” In one sentence, he manages to imply it is a both a single overarching choice, and a habit. Which is it, Sir? For anyone who struggles with weight, it’s clear that neither is accurate. Instead, one’s weight is a product of literally thousands of choices, many of them weighed down by social pressure, shame, nutritional confusion, fear, and the parade of misleading and contradictory messages about dieting that as a culture we schizophrenically embrace. Add to that mix health issues, genetics, and body chemistry, and you have a recipe for something exponentially more complicated than a single choice, or even a habit. The research is out there now that diets don’t work, that they do more damage than good, that calories-in-calories-out is a cozy but inaccurate myth, that our bodies and our minds are much more complicatedly involved in the process of weight gain and loss than we ever thought previously. (Which is why people like Marci Anderson—trained to navigate this minefield—are so important.

This man strikes me as someone who simply hasn’t heard the real news about weight, and maybe wouldn’t understand it if he had heard it. More disturbingly, I’m confident he’s speaking for a large sector of society, a group that could have used a more meaningful message than what I think Jennifer Livingston’s response boiled down to: she seemed to say, ultimately, “You’re right, but it isn’t nice to say so.” And while it’s true that it isn’t nice to call someone fat, it’s more than not nice. A statement like this man’s is wrong because it’s ignorant, because it’s pervasively and damningly ignorant, and the message against it needs to be significantly louder and much clearer. What Jennifer Livingston has done by speaking up is a start, but she didn’t go nearly far enough.

So I'm eager to hear your thoughts! What did Jennifer do well? Where did she miss the boat in her critique? How can we change the current shift of thinking that obesity is a choice? Is it possible to spread the message that you can be both fat and fit?

**For research that supports all of the claims listed above by both myself and Deja, please see the Health at Every Size website. We're not just making this stuff up!

"I'm No Longer Trying to be Airbrushed in Real Life"... So take THAT Shape Magazine

Blast

Burn

Sculpt

Flatten

Tone

Tighten

Shrink

Change

Drop

Lose

Banish

Zap

Kick

Firm

Better

Perfect

I did a google image search for Shape magazine. And the words above grace the cover. Read through the list. Think of those words being directed at you and your body. Think of those words being directed at your friend and her body. How do you feel?

In my opinion, media is our culture's most powerful medium for shaping womens' views and expectations of themselves. Media is the measuring stick that facilitates self-criticism and hurtful comparisons with one another. We are reduced to a litany of BARBARIC terms (excuse me- burn, blast, and banish?!) and hate ourselves for never getting it right. We begin to see ourselves as a body, something for looking at. And as a result our minds become limited, our creativity stunted, and capacities under-utilized because we are so busy counting calories and hating ourselves. Ladies, THIS. IS. CRAZY.

This post was inspired by a client who said to me yesterday "I'm no longer trying to be air brushed in real life." How's that for a declaration?

I want to hear yours! It could sound like....

• I'm human, I'm meant to get hungry.
• I'm not flawed if a 1200 calorie diet plan leaves me hungry and unsatisfied.
• My energy is precious and cannot be depleted by self-hate.
• I can't be happy if I'm pursuing something I am not.

Skinny Cow, How 'Bout a Name Change?

This post is brought to you by a student enrolled in the Eating Disorder Institute Program at Plymouth State. I know you'll enjoy it.

I’ve Got Beef!

SkinnyCow products perplex and infuriate me. I have two major issues with them at the moment, one being the name and two being their recent declaration that women can now eat brownies again.

First of all I would like to say that a cow is a certain size based on genetic make-up that makes it look like a cow! A cow cannot loose weight and be a “skinny cow” if it did it would be sick and the owners would be very concerned. The name outrageously implies that a cow can change it’s size meaning then, that SkinnyCow’s general market they are selling to which is no secret.. WOMEN!.... can therefore just change their genetic make-up and then be “skinny women”. This idea not only encourages the altered view of our society that anyone can be a size zero and be healthy and discourages a healthy body image and health at any size.

Second I would like to bring everyone’s attention to the latest law that has been appealed in america... women can now eat brownies.. that is right girls head on down to the supermarket for the celebration! SkinnyCow states that we can now eat brownies again! I was unaware that I could not eat them prior to this ridiculous commercial and marketing campaign by the SkinnyCow brand of dieting foods. This again only contributes to “good” and “bad” foods and the forbidden fruit for all women and wouldn’t you know it SkinnyCow figured it out, our kriptonite is brownies, but luckily they have found the antidote... a diet brownie... yum. yum. yum. All sarcasm aside this is very discouraging and this type of message should not be accepted and should be highlighted as how NOT to market towards women, because this is one cow who is now “mooing” for more.

What do you think, should Skinny Cow change their name? What would you re-name their product line as?

#ENDED Twitter Chat with Dr. Deah

Help us ring in a body positive summer by participating in our #EndED twitter chat on Wednesday, June 27th 2012. I'm honored that Dr. Deah will be joining us to talk about body image, self/size acceptance and Expressive Arts Therapies.

Dr. Deah Schwartz has more than 30 years of experience using therapeutic expressive arts in psychiatric hospitals, residential and day treatment programs with clients struggling with Eating Disorders and Body Dissatisfaction. Deah was also a professor at San Francisco State University for ten years and coordinated the Therapeutic Recreation Degree program.She is the author of the size acceptance syndicated blog, “Tasty Morsels”, co-author of Leftovers, DVD/Workbook Set, a multimodality resource for therapists and educators, and has a private practice.In all aspects of Dr. Deah’s work, she strives to provide assistance in preventing and treating eating disorders by switching from a weight based to health based paradigm, defining one’s own standard of beauty, challenging the discrimination that exists towards anyone that doesn't fit the media's expectation of perfection, and finding ways to make peace with one’s body. You can learn more about Dr. Deah by visiting her website or her Facebook page

These are the questions we'll be discussing:

1. What does the term expressive therapy mean? What are some examples?

2.1 What are some of the benefits to incorporating expressive therapy into eating disorder treatment?

  2.2 Why are the Ex. Arts Therapies helpful for this population?

3. Often people feel vulnereable creating art, music, dance or other means of self-expression. What might help break through the intimidation?

4. In what ways can a RD use Ex. Arts Therapy Activities to achieve their treatment goals?

5. What is HAES? 

5.2 What are common misperceptions about a HAES approach?

6. Why is it important to emphasize HAES as a society and as a therapist? 

6.1 How can we stay HAES focused this summer? 

 If you're new to Twitter, here's a primer on how to participate. It's simple, go to www.tweetchat.com and enter the keyword "#endED" and it will appear as if you're in a chat room. Watch the tweets stream live and join in on the conversation. Be sure to follow @MarciRD and @Dr_Deah

We hope you can join us on the 27th at 8:30 EST. Feel free to RSVP on Facebook as well!

The War on Obesity: A War Worth Fighting?

A few days after the FNCE (the American Dietetic Association’s annual conference) dust has settled, I still find my emotions riled up about the very first session I attended. John Foreyt, renowned obesity research and Linda Bacon, Health At Every Size (HAES) clinical researcher and advocate stood head to head to duke out their views on the “obesity epidemic.” John Foreyt staunchly defended his position that the war on obesity is a war worth fighting and Linda Bacon asserted that this war we are waging is ineffective, misguided, and even harmful.

I cannot escape the fact that I write this post from a very biased point of view. I simply cannot give a neutral, objective review of the debate because my feet stand so strongly in the HAES camp. I use a non-weight focused approach in my nutrition counseling and I am a certified Intuitive Eating (IE) Counselor (which means I teach my clients how to respond to internal cues of hunger/fullness rather than dieting).

So, I questioned whether to write this post at all, knowing I don’t currently have access to a recording of the debate and my memory seems to have only held on to the pieces of Dr. Foreyt’s arguments that I found uniformed, inaccurate, and downright offensive. So despite all of this, I sit here writing my two cents, which are heavily influenced by my flawed memory, passion for a non-weight focused approach to health, and personal experience in my own clinical work (and in my own life).

I cannot adequately re-cap the 90 minute debate. But I will recount my top 5 assertions that Dr. Foreyt made that I whole-heartily disagree with. If you are interested in learning more about HAES and Linda Bacon’s perspective, keep reading. I’ll share some fantastic resources at the end of the post.

Top 5 Unscientific, Unsupported, Inaccurate Assertions made by Dr. Foreyt:
1. There are no negative side effects to yo-yo dieting and weight regain (except “some bad feelings like depression for some people.”)

If Dr. Foreyt had properly done his homework, he would have known that dieting is the #1 PREDICTOR OF FUTURE WEIGHT GAIN! See here and here for two examples. And I think it’s a bit crazy for him to undermine the negative mental health consequences that are a by-product of weight cycling. Anxiety, depression, and chronic self-esteem issues are serious concerns. He treated them like nothing more than a pesky skin irritation, when in fact mental health problems are like a deadly form of cancer; challenging a person’s ability to live with a quality of life everyone deserves. We cannot minimize the effects of re-bound weight gain and mental health challenges.

2. Some of your clients will be failures and some will be successes. That’s no reason to stop trying to diet and lose weight. Just keep trying.
Whoa, hold it right there. I cannot stomach the notion that anyone I work with is a failure. But I suppose if there is only one way to measure success that might be the case. If there was a chemotherapy treatment that created more cancer than it eliminated, would we keep using it? No. So why do we keep using the same methods for weight control when the research shows that a weight-focused approach leads to more weight gain? I have learned something magical in my work. When I take the focus off the scale it allows me and my clients to work on core issues which affect body weight, food choices, and self-esteem.

3. Intuitive Eating is a cause of today’s obesity epidemic. Intuitive Eating doesn’t work.
#1 I about jumped out of my chair when Dr. Foreyt stated this. How on earth can he say that Intuitive Eating contributes to obesity when virtually no one in the US practices it?!? Not practicing Intuitive Eating is THE REASON most people struggle with food and many carry more weight than they naturally would.
#2 The principles of IE are often misconstrued or improperly applied. Dr. Foreyt, have you read the book or the research on IE? It is not eating with reckless abandon. No, quite the opposite. It is eating what you want in response to physical cues for hunger/fullness, while attending to emotional needs without using food. I cannot fathom how this can lead to increased rates of obesity.
#3Please see the IE website, where there is research showing the effectiveness of IE.

4. Dieting does work.
Unfortunately, every long-term clinical trial aimed at reducing body weight by placing clients on a specific diet that I’m aware of results in the lovely “J-Curve.” The J-Curve illustrates rapid weight loss, followed by creeping weight gain over time. The LOOK AHEAD trial, led by Dr. Foreyt is an interesting example. Like all obesity research, interventions like a healthier/reduced calorie diet and exercise protocols are given. Consequently, weight decreases but a whole slew of other parameters improve (ie blood sugar, fitness levels, cardiovascular health). What's really fascinating is that the decrease in weight is sometimes quite small, like less than 10 pounds. But the researchers always cite the improved parameters secondary to weight loss, rather than a natural consequence of eating healthier and moving more. Why the focus on weight loss?

 
Many people love to cite the National Weight Control Registry as an example of permanent/lasting weight loss. Dr. Bacon informed us that weight loss must only be maintained for 6 months in order to be added to the registry, with no clear way to have your name removed if you have re-gained your weight. Dr. Bacon shared a story of a student whose name is on the registry, but has since gained back more weight than she lost and hasn’t been able to remove her name from the list. The weight loss research we have shows the majority of lost weight gained after two years. So the National Weight Control Registry may not be a reliable measure of successful "losers."

5. It’s better to be skinny than fat.
Again, Dr. Foreyt needs to check the research because it actually shows that the life expectancy for a person who is categorically overweight but exercises regularly is longer than someone of a “normal weight” and doesn’t exercise. Having dedicated my career to working with eating disorders, I can promise that it is better to be healthy inside and out regardless of your body weight. Being thin is absolutely no guarantee than you are healthier or “better” by any standards.

Please let me make myself clear. I am an advocate for HEALTH. This means I am an advocate of:
1. Eating a balanced, nutritious diet that includes all foods
2. Eating when hungry and stopping when full MOST of the time
3. Learning to cope with emotions without using food
4. Learning to eat in a way that leaves you feeling energized and satisfied
5. Eating by your own rules and no one else’s
6. Incorporating exercise in a way that keeps your body strong (this can only be done if you are eating well first)
7. Eating guilt and stress free
8. Enjoying and finding pleasure in what you eat and how you move your body

And I believe that this is possible at any weight. I stand with Linda Bacon when she says that “fat” is not the problem, it’s the war on fat that is making us sicker and more miserable.

Finishing remarks:

My regret is that the session left a divided group more divided. If we are going to figure out how to create a nation of healthier people, those of us in the eating disorder field have got to come together and truly dialog with those in the obesity field. And until then, the war will certainly continue.

This is a controversial topic. What are your thoughts?

Linda Bacon's FNCE Handout

Validity of Claims Made in Weight Management Journals

Weight Science: Evaluating the Evidence for a Paradigm Shift

*Picture Source

Does This Uterus Make Me Look Fat?

E! News 6 Part Series: "What's Eating You"

E! will be running a new documentary on eating disorders. Below is a clip from their press release.  And here is a link to an article with a bit more information on what the series will feature.

E! Explores Extreme Eating Disorders In The New 6 Part Series "What's Eating You" (Los Angeles, CA, August 18, 2010) - E! Entertainment Television brings viewers into the often misunderstood world of eating disorders with the premiere of "What's Eating You," a six-episode television event. The show chronicles the challenges of women and men whose lives are at risk as they battle not only their distorted body images, but also self-created, life-threatening food rituals and compulsions. As participants share their true stories of food, fear and obsession, "What's Eating You" reveals the severity of eating compulsions on levels never before seen on television. "What's Eating You" premieres October 13 at 10:00 PM, ET/PT.

I am glad to see E! address the issue of eating disorders, rather than solely glamorizing the thin ideal ( which we see constantly portrayed all over the media).  But reading the article I linked to above has left me a bit skeptical.  My fear is that E! will simply glamorize the world of eating disorders.  I guess we'll see.  

If you tune in, I'd love to hear your thoughts.
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Food For Thought: Omega-3s and Brain Health

I am fascinated by the connection between the fuel we put into our bodies and how it affects the way we think, feel, and act.  I am a believer that how we nourish ourselves plays a huge role in not only our physical health but also our mental health.  Yes, our diet has an impact on our mental and emotional well-being!

Because nearly all of the clients I work with struggle with an eating disorder (or some form of disordered eating) many of them are fearful of high fat foods.  Additionally, the majority of my clients (and let's be honest, the majority of Americans!) struggle with depression and/or anxiety.  Turns out that a diet that is too low fat in fat can actually exacerbate symptoms of depression and anxiety.

Interested in learning more about how healthy fats can improve your brain health?  Check out this fantastic interview: Food for Thought: Omega-3s and the Brain.  It is very cool stuff.
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