Friday, May 23, 2008

An open letter to parents

Dear Parents,

I know it's hard to raise a child in this day and age for all kinds of reasons. And I know that one of those reasons is all the messages you get about your child and weight.

I know that parents often get shamed, these days, if their child's weight is too high (or too low). That there's enormous pressure for kids to slim down and look a certain way. To fit the current cultural norms around appearance and weight.

But for god's sake, I beg you, don't send your child off to a place like this. If you've ever been tempted to send your child off to fat camp, read this article in the Washington Post. Read about a "camp" where growing teenagerss are forced to eat such a low-fat low-everything diet that eight of them developed gallbladder disease in the last year.* Where six of them needed gallbladder surgery. Where kids routinely douse their food with ketchup and mustard.** Where hungry teenagers drink 12 or 15 cans of diet soda a day, all of it laced with Splenda.*** Where the director of the whole place thinks it's OK if kids gorge on cake occasionally because they'll just throw it up again.**** Where kids are put into "solo" when they break the rules.

Most of all, what a place like this does is reinforce the idea to your child that s/he is not OK as s/he is. That she's acceptable only if she loses weight. That she's not lovable as she is.

And that's the very worst part of this whole trend. As parents, we're supposed to build our children up, not undermine them. We're supposed to be voices of reason in a sometimes crazy world.

So if your child doesn't fit today's paradigm for weight or attractiveness, love her anyway. Tell her she's beautiful and strong and lovable and smart. Teach her to love herself. That's the way to health and beauty. The other will lead her down a lifelong path of hating herself. And I can tell you from personal experience that that's not the way to health and beauty.

*Gallbladder disease can be caused by weight loss that's too fast.

** A classic sign of malnutrition/starvation. The volunteers in Ancel Keys' starvation study did the same. So did my daughter when she was anorexic.

***A friend of mine was temporarily blinded by Splenda. She leaned over a pot on the stove at just the wrong moment, and was blinded by the chlorine gas released from the Splenda-laced concoction. You definitely don't want your child drinking Splenda. Especially not 15 servings a day.

**** As my friend Jane says, hello bulimia.

Thursday, May 22, 2008

The real face--and sound--of Russian ballet

The online trailer to David Kinsella's new film about Russian ballet, A Beautiful Tragedy, shows a young woman who is training at one of Russia's premier ballet schools. Against a background of piano music we see her beautiful, expressive face contort with effort as she works. And we hear--most extraordinarily--her panting. It's the sound of ballet, a sound you don't hear from the audience at a performance. It's the sound of a young athlete and artist working to her fullest capacity.

We also see her face, and the faces of several other young dancers in the film. They have the gaunt and haunted eyes, the protruding bones, of anorexia. According to Kinsella, dancers at this school in Russia must keep their BMIs down to about 14. These young, growing girls learn to punish themselves, to starve, to obsess about fat, all in the name of beauty. A particular notion of beauty.

I'm glad I'm not a ballet lover, because I don't think I could sit through another ballet without seeing these girls' faces and hearing, in my mind, the sound of that determined, exhausted breathing.

Wednesday, May 21, 2008

Childhood obesity: the deconstruction

Over at the Rocky Mountain News, Paul Campos has posted a brilliant response to some of the hyped-up points made in the Washington Post's current (and ridiculously overblown) series on childhood obesity--and issued a challenge. A $10,000 challenge, to be exact, to the lead author of the 2005 study that predicts a two-to-five-year drop in life expectancy "unless aggressive action manages to reverse obesity rates."

Campos rebuts some of the war-on-childhood-obesity's usual points with elegance and clarity. For instance, to put some of the current hyperbole in context, he points out, "Ever since public health records began to be compiled in America in the mid-19th century, the following statement has always been true: Today's children are both larger and healthier, on average, than those of a generation ago."

One of the most commonly repeated predictions by fervent generals in the war on childhood obesity is that because children are fatter today, their lives will be shorter. What could possibly strike more fear into a parent's heart? I think this prediction is at the heart of the current hype, and clearly Campos agrees, because his challenge to the author of the 2005 study involves a more thorough examination of the data:

If, at any decennial census going forward, obesity rates have risen or remained the same, and life expectancy in America has declined, I'll pay [the author] $10,000. If we don't get any thinner but life expectancy has risen, he'll pay me the same sum.

I look forward to Round 2.

Monday, May 19, 2008

Sex and drugs and pharmacies

Over at Junkfood Science, Sandy Szwarc had an excellent post today on the rather incredible prevalence of prescription drugs in America today and the financial motives behind such large-scale prescribing.

Full disclosure: I'm in favor of meds for those who need them. Actually, I often wish SSRIs had been around when I was a teenager. I often wonder who I might have become had I not had to deal with the continuous panic attacks that started around age 11. Living in constant terror shaped me, body and soul. For better or worse.

Still. Some of the statistics Szwarc quotes are staggering: More than half of all insured Americans take some kind of prescription for a chronic condition. (Note that it's 50 percent plus of insured Americans.) Nearly half of all young women in this country now take ongoing meds. Likewise one in three children.

As Szwarc points out, pharmacy benefit managers stand to gain big bucks from the rise in chronic prescriptions. But most doctors don't benefit directly from prescriptions. They have patients' best interests at heart. The trouble is in how one defines best interests.

Case in point: The women in my family tend to have high cholesterol. My mother has it. My grandmother had it. And I've got it. When my cholesterol level first turned the wrong way, my (former) doctor encouraged me to "eat right and exercise." I did, and I do. I'm no fitness queen, but I try to walk or bike for 45 minutes every day, and I try to be active in other ways too. I eat a wide variety of foods, including plenty of fruits and vegetables. None of this affected the cholesterol numbers, which continued to inch upward. Then my doc started trying to convince me to go on statins. Every time I saw her she suggested I give them a try. After about two years of this she sat me down and said, "If you were my sister I'd put you on these right now." She went on to scare the living crap out of me with accounts of young people who'd had heart attacks and strokes. Statins, she said, would prevent all that.

Never mind the fact that there's pretty much no history of heart disease or stroke in my family. None of us are thin. Few of us die early. I've got grandparents and great-grandparents on both sides of the family who lived into their upper 90s.

Still. I was scared. I went on a statin. I felt like crap, but I kept taking it. I never developed the full-blown myopathy that some people get from taking statins, but I did get increasingly depressed and never felt good. Two years later, I got a new doctor, and at our first appointment she asked about the statins. I told her how I felt--scared and crappy--and she took a thorough family and personal history. She told me my risk of having a heart attack or stroke were less than .5 percent, at least at this point, and took me off the statins. Within a couple of weeks I felt great again.

Back when Doctor #1 prescribed the statins, I asked her if she really thought a relatively healthy woman in her early 40s needed to be on cholesterol-lowering drugs for the rest of her life. She looked at me like I was nuts.

I'm sure she believed she was doing the right thing. And I'm just as sure that she wasn't. I guess time will tell.