5 New Year's resolutions worth making

I'm ready for the rash of media stories about New Year's resolutions with my own list of 5 resolutions that are truly worth making. Read all about it over on my Psychology Today blog.

Fat Body (In)Visible

Kudos to fat activist Margitte Kristjansson, whose new video, "The Fat Body (In)Visible," is a compelling look at the world of fat acceptance and what it's like to be a fat woman in America today. Watch it below, and then leave Margitte a comment at her blog, Riots Not Diets.

fat body (in)visible from Margitte Kristjansson on Vimeo.

White Plains tomorrow!

My apologies for not keeping up with the blog. Between full-time teaching and lots of travel for the book, it's been a challenging few months. But I promise more posts coming soon.

In the meantime, if you're in the White Plains, NY, area, consider coming out tomorrow night to hear the fabulous Dr. Evelyn Attia (pictured) and me talk about teens' relationship with food. Dr. Attia is a wonderful, smart speaker and I expect an exciting event.

Details:
New York Presbyterian Hospital
21 Bloomingdale Road
White Plains, NY

6:30 p.m.

Free!

See you there!

Maudsley Parents conference: San Diego, Jan. 21, 2011

For those of you on the West Coast (or those who wouldn't mind a sunny interlude in January), Maudsley Parents is pleased to announce that registration is open for our next conference, scheduled for Jan. 21, 2011, in San Diego.

The fabulous lineup for this one-day conference includes a talk on the neurobiology of eating disorders by Dr. Walter Kaye of the University of California-San Diego; a talk on family-based treatment (FBT) by Dr. Daniel le Grange of the University of Chicago; an interactive session on FBT by Dr. le Grange and Dr. Renee Hoste, also of University of Chicago; and a dynamic presentation on multi-family treatment for eating disorders by Roxanne Rockwell, the lead therapist at the University of California-San Diego's Eating Disorders Program. I've worked with all of these professionals, and they're amazing. I'll also be doing a reading from my book, Brave Girl Eating.

Register before November 30 and get the early bird rate of only $60 for a day full of education (and lunch!). For more information, click here. Hope to see you in San Diego!

Reviewers wanted

One of the most dispiriting aspects of book publishing these days is the disappearance of outlets for reviews. Once upon a time there were hundreds of newspapers that ran book reviews. Today there's just a handful. The result is that many, many books get no reviews in the mainstream book reviews.

I've been lucky to have Brave Girl Eating mentioned in a couple of magazines. Thanks to those editors! And a number of bloggers have reviewed it too, and I am grateful. Thank you!

Still, reviews are important to people considering buying the book, and so I'm asking you, dear readers, if you would consider writing a review of the book on Amazon.com if you haven't already. The book has been doing reasonably well and I'd love to see that momentum continue. New reviews help, believe it or not.

You have my eternal gratitude. :)

Another brave girl eating

There are many roads to recovery from an eating disorder. Unfortunately, they're all hard roads. Some are longer, some are shorter, but all of them are steep and scary and require immense courage and persistence and support.

Which is why I find myself so moved by the story of Sofia Benbahmed, a young woman who's fighting through a long recovery made even longer by the fact that her insurance company refuses to cover her treatment. When I look into Sofia's face, I see my own daughter--the same spark, the same hope, and the same terror.

Please take a minute to read about Sofia and her struggle, and help her if you can--for all the brave girls out there.

Guest post: Shan Guisinger

In my book Brave Girl Eating, I wrote about one theory of the origins of anorexia: psychologist Shan Guisinger's adapted-to-flee-famine theory.

I'm very pleased to have Dr. Guisinger writing about her theory on the blog today. I think it's a fascinating concept that deserves further thought. Please write in with comments and questions.

_____________________

Dear Harriet,

I’m happy that you described the adapted-to-flee-famine explanation for anorexia in Brave Girl Eating. I have found that it helps patients understand and fight their urges to restrict food and compulsively exercise.

The adapted-to-flee-famine hypothesis (2003) states that the distinctive symptoms of ignoring hunger, hyperactivity and denial of starvation were evolutionary adaptations that once helped starving hunter-gatherers make a last ditch effort to find better foraging grounds. This theory is supported by data from genetics, molecular biology and neuroimaging, yet eating disorders experts turn away from evolutionary explanations saying “we can never know for sure.” In fact, we regularly use circumstantial evidence and evidence based on probabilities to come to conclusions in science, the law, and in our lives.

For example, the criminal justice system has careful rules for evaluating circumstantial evidence because criminals rarely come forward to confess their crimes. Suppose someone were murdering teen-aged girls in your town. You would expect the police to arrest a man who had blood from the victims in his car, and you would expect a jury to convict him if the police found the murder weapon with his fingerprints, and if he had no alibi for where he was when the murders took place. How would you feel if the police let him go asserting that, without a confession, “we can never know for sure?” We would also be shocked if the judge let him go because he didn’t accept evidence based on probabilities, such as the DNA and fingerprint data.

This issue is not simply academic jousting. According to NIMH, the mortality rate for anorexia of 5.6% per decade is twelve times higher than the annual death rate due to all causes of death among young women between the ages of 15 and 25. And treatments based on the conventional assumptions have a dismal success rate. In fact McIntosh and colleagues found that patients in what was supposed to be the control group, given only nutritional counseling and emotional support, did better than those given cognitive-behavioral or interpersonal therapy which assume that anorexia is caused by psychological issues.

What is the evidence for the adapted-to-flee-famine hypothesis?

First, anorexia is now accepted as genetic. Although rare in the general population, if one identical twin has it, there is a 50% chance the other will develop it. Studies comparing identical and fraternal twins found that the increased risk is due to genetics and not to family environment. Moreover, the lack of long-term success of weight-loss programs demonstrates that without anorexia genes it is very difficult to maintain weight at 15% below normal. What anorexics do is physiologically and psychologically remarkable.

Second, denial of starvation and body size overestimation are demonstratively the result of unconscious machinations at the neuronal level. Brain imaging shows that the brain alters the reality that an underweight anorexic individual consciously perceives. When an anorexic looks at herself, her brain actively inhibits perceptual processing of visual input. This makes sense if the brain were trying to fool a starving person into thinking that she has the physical resources to travel.


Third, neuroendocrinologists have described the complex physiological changes that enable starving people with anorexia to feel like running for miles and refuse food offered. When leptin, a hormone that tracks fat stores, falls below a critical level, it activates neuronal circuits that reduce food intake and increase activity (Muller, 2010). Chen and colleagues (2004) have identified the gene, SIRT 1, that turns on hyperactivity in starving mice.

Natural selection is the only process that can produce such a network of specialized abilities, but ED researchers explain them as the result of a hodgepodge of biological breakdowns. Each favors a different dysfunction, for example, excess serotonin, impairments in set shifting, errors in reward pathways, and breakdowns in sensory integration.

The idea that biomedical dysfunctions are responsible for anorexia nervosa does not stand up to logic. For a person to develop the standard presentation of anorexia (difficulty eating, hyperactivity and body image distortion) at least three different accidents would have to happen together. The likelihood of this is very small. Moreover, the fact that the crucial biological changes of anorexia normalize with weight restoration indicates that they are a response to very low body weight, and not the cause.

In your book you eloquently describe how hard it is to recover from anorexia. It matters why people with anorexia feel they must restrict food and exercise. It matters in order for treaters to understand and help their patients; it matters to the person with anorexia to make sense of her experience of difficulty eating, drive to move, and body image. Treatment is often ineffective because, still today, most patients, therapists and doctors believe that anorexia nervosa is caused by the patient’s willful refusal to eat due to a need for control or to trying to be model thin. Their false belief is the result of the mind’s automatic attempt to make sense of anorexia’s puzzling feelings and behaviors.

Realizing that their bodies are trying to migrate helps people with anorexia overcome their anorexic urges; and, it helps their loved ones and their therapists to understand their struggle and perhaps support them in recovering their health.

Sincerely,

Shan Guisinger, PhD
shan.guisinger@mso.umt.edu

Family-based Online Bulimia Study

Hi y'all,

Please pass the word about the study below. I'm thinking it could be wonderful treatment for the right families. University of Chicago is at the forefront of research on ED treatment, and I trust their protocols completely.

************************************

The University of Chicago is conducting a research study designed to examine the efficacy of an Internet-based program for parents with adolescent children who show early signs of bulimia nervosa. We are seeking families who have an adolescent (ages 12-17) who engages in binge eating (large amounts of food in a short period of time) and/or compensatory purging (e.g., vomiting). Participating families will use an Internet-based program to address their adolescent’s eating disorder symptoms.

To be eligible:
* Families with an adolescent child (ages 12-17)
* Adolescent demonstrates eating disorder symptoms

For information call:
Colleen Stiles-Shields at 773-834-5677 and mention your interest in the Family Internet-based Early Bulimia Nervosa Study

or e-mail Jocelyn Lebow:
jlebow@yoda.bsd.uchicago.edu


or, to learn more, or to register online, visit:

http://epathprogram.org

Family-based treatment in the New York Times

Great story by Roni Rabin in tomorrow's New York Times about family-based treatment for anorexia. Nice interviews with Rina Ranalli, whose daughter recovered using FBT; Dr. Daniel le Grange of the University of Chicago; and moi.

Change is coming. And it's about bloody well time.

In honor of Love Your Body Day

I thought I'd repost Joy Nash's original Fat Rant from 2007. It still rocks, y'all, and sadly, it's still oh-so-relevant.

Hope for teens with anorexia

The release last week of the long-awaited results from a five-year multi-site study confirmed what many of us already knew: family-based treatment for anorexia works. In a controlled randomized study, FBT worked better than traditional individual-based psychotherapy: More than half the patients getting FBT recovered, compared with less than a quarter of those getting the other treatment. And far fewer in the FBT cohort relapsed.

This is great news. There's more work to be done, of course; a 50 percent recovery rate is not acceptable. But it's so much better than the usual statistics: people with anorexia stay sick for five to seven years, and only about a third recover.

Read more here on my Psychology Today blog.

Watch this, then watch what you watch

Thanks to Lori Shuldiner Schor for sending this great video my way. Take a look. Pass it along.

NEDA, here I come!

Looking forward to meeting some of you at NEDA this weekend. Tonight is a dinner for the PFN--I'll be there along with my ch-chair at Maudsley Parents, Jane Cawley. Saturday night there's a meet and greet and signing for authors at the conference--I'll be signing Brave Girl Eating. And I'll be presenting along with Dr. Walter Kaye on Sunday afternoon at 3. Hope to see you there and around the conference!

Serotonin and depression

I just couldn't resist reposting* this link to a blog that questions the relationship between serotonin levels and depression. The conventional wisdom is that antidepressants like sertraline and fluoxetine increase levels of serotonin in the brain and that's what alleviates depression. This blog asks why, then, antidepressants don't work right away, since they begin raising those levels immediately. And if you've ever started an antidepressant feeling rather desperate, you're extremely aware of every day it's not working.

It's all about neurogenesis, according to this blogger—the ability of the brain to generate new cells. Depression may be linked to lower levels of neurogenesis. One thing antidepressants do—after several weeks—is increase neurogenesis.

Fascinating stuff.


*Thanks to Carrie Arnold at Ed Bites for the original link.

University of Wisconsin Medical School talk

I find it uber-creepy to watch myself on video, so I'm linking this talk I gave last week at the UW Medical School without actually watching it.

If you happen to take a look, let me know how it looks. I'll take it down if it's not very good.

The study results are in!

And they're clear and well-supported: For teenagers with anorexia nervosa, the first-line treatment should be family-based treatment (FBT), also known as the Maudsley approach.

I think the days of FBT being labeled as a marginal, alternative, or "very special" treatment for "very special families" are officially over. For a high percentage of teens with anorexia, FBT works--they recover, and they stay recovered.

Does it work for every single family? Nope. But then neither does chemotherapy, or penicillin, or other mainstream treatments we don't question. (For an inside look at how it worked for our family, see my new book, Brave Girl Eating.)

Now, the hard part: Training enough FBT therapists so that more families have access to them. Luckily, someone's already on the case.

We still need more research. We still need better techniques. But there's no question that this is big news, and important news, for families and clinicians.

Big congratulations to Dr. Daniel le Grange and Dr. James Lock, who co-authored the study.

Can you say disconnect?

That's the only word that came to mind when I read this story on Time.com about the extra costs women pay for being obese.

According to researchers at George Washington University, women who are obese lose twice as much money—nearly $5,000 a year—as their obese male counterparts. But not because they use more health-care dollars. The difference comes mostly from discrimination.

Fat women are paid less than women who aren't fat; fat men, on average, earn comparable salaries to men who aren't fat. So women are penalized by employers for being fat.

This says something about how women are perceived in our culture, and it's not news. But it is newsworthy, because, damn it, it's 2010 and we're supposed to be better than this as a society. All the young women who don't identify as feminists because they don't have to fly that flag anymore should take note of studies like this one. Gender discrimination is alive and well in 21st-century America.

But that's not where the writer of this story went. No, her conclusion was quite different. She wrote, It's bad news, but maybe it will help fund better prevention strategies and new treatment methods for this growing scourge.

Excuse me? Did I hear you right? The answer to discrimination is getting rid of the quality that's being discriminated against? How about taking on the concept of discrimination instead? How about educating people about the emotional and other costs of fatphobia, and about how discrimination (and its attendant stressors) actually makes people fatter?

I'm not surprised; this is exactly the kind of disconnect I've seen over and over in the media. It's as if we are constitutionally unable to see the logical extension of our behaviors around weight, especially when it comes to women.

Big fail.

Going through hell? Keep going

That's one of my favorite quotes, from Winston Churchill, as it happens, and the title of my newest post over at Psychology Today. See you over there.

Interview at CarolineLeavittville

Thanks to writer, reviewer, and blogger extraordinaire Caroline Leavitt for posting a thoughtful, thought-provoking interview about Brave Girl Eating on her blog today. I love it when interviewers really get the book--and Caroline did.

Reviewers wanted

I have a favor to ask, dear readers.

If you've already read Brave Girl Eating: A Family's Struggle with Anorexia, would you write an Amazon review of the book? It doesn't have to be long or complex--a two-sentence comment can work just fine.

People actually read those reviews, and make decisions about what to buy from them. I'm doing everything I can to get the word out--not just about the book but about family-based treatment as an option for families.

A great big thank you to you!

Photo ©Forest Wander.

Getting her to eat

In my new blog, Brave Girl Eating, for Psychology Today, I wrote about how we got our daughter to eat when she was in the grip of anorexia. Read it here. I hope it's helpful to those of you who are struggling to help a child or teen with anorexia.

The Diane Rehm Show

Thanks to Lynn Grefe, CEO of the National Eating Disorders Association, and Ovidio Bermudez, M.D., for taking part in the Diane Rehm Show yesterday with me. The subject was eating disorders, and we talked a lot about family-based treatment (the Maudsley approach) as well as Brave Girl Eating. It was an inspiring conversation and I am grateful to all who took part.

You can listen to the segment here.

Atchka!

Thanks to Shannon Russell (alias Atchka) for a good interview about anorexia, Brave Girl Eating, evolution, and other enthralling subjects. You can listen up here.

Russell blogs on a site called Fierce Fatties. It's worth checking out.

I'm happy to report I did not drop the F bomb in this interview. But, like, I really have to, like, stop saying like all the time. Like, know what I mean?

Good Morning America: Cancelled

Please note that my Good Morning America appearance, scheduled for 8/24, has been cancelled for reasons beyond my control.

But there are plenty of other stops along the book tour! Next week: a talk/reading at the Center for Eating Disorders at Sheppard Pratt in Baltimore, and a stop at the Diane Rehm Show in D.C.

Please pass the word about the book--my publisher tells me that early sales figures are the most important. I'd love to see the book gain some momentum in the first weeks after it goes on sale 8/24.

Thanks for all your support!

*I don't know why this image from Mrs. Doubtfire comes up when you search for brave girl eating, but it amuses me.

5 warning signs that your child might have anorexia

Read it at Brave Girl Eating, my blog on Psychology Today's website, and please pass the information to any parents you know who might need the information.

How I wish I'd had this list before Kitty got sick.

Sheppard Pratt Q&A, part III

I'm looking forward to speaking at the Center for Eating Disorders at Sheppard Pratt in Baltimore next Wednesday, Aug. 25, at 7 p.m. I'll be talking about and reading from Brave Girl Eating. Please come out and say hey if you're in the Baltimore area!

Meanwhile, check out Part III of an online Q&A I did with them, which includes 4 essential tips for parents.

For a complete list of stops on the book tour, click here. Hope to see you somewhere along the way.

Memoirville

Here's an interesting interview about Brave Girl Eating on Memoirville, home of Smith Magazine's Six-Word Memoir Project. You'll have to get all the way to the end to read mine.

Note to self: Do not drop the F bomb during interviews.

When families deal with health crises

If your family has ever dealt with a health crisis--whether it's an eating disorder or not--you've probably noticed that some friends step up while others back away. This New York Times piece looks at some of the very common and human reasons why we all back away sometimes, and offers advice for how to be a better friend when those you love are going through something big.

And if you'd care to join an online discussion on the subject, you can do that here.

Jezebel on parents and eating disorders

Jezebel writer Anna North put up a piece today based on an interview we did last week about not just my new book, Brave Girl Eating, but the whole notion of family-based treatment.

The comments, sadly, reveal some of the biases against FBT (the Maudsley approach). Take a look and leave a comment if you are so moved--I think Jezebel readers would benefit by hearing from some who have had positive experiences with FBT.

I'm off to do some deep breathing.

She's not that skinny. Is she?

Why you can't tell if someone has anorexia just by looking. Read about it on my new blog, Brave Girl Eating, here at Psychology Today.

Photo © Steve Pope Photography

We need more FBT therapists!

If you're a therapist who treats eating disorders and you'd like to become certified to do family-based treatment (also known as the Maudsley approach), you're in luck. The Training Institute for Child and Adolescent Eating Disorders, run by Drs. Daniel le Grange and James Lock, is hosting a two-day training in Chicago, September 13-14.

For information and to register, visit the Training Institute's website. Because heaven knows we need more FBT therapists around the country/world!

"My daughter's not fat"

This kind of nightmare is what happens, folks, when we have mandated "reporting" of BMIs and other ridiculous "measures" of thinness/fatness. Especially for children, who are still growing and who do not grow in a linear fashion.

This particular incident happened in the UK. But it could easily happen here, now that states like Arkansas and New York require it, and other states are considering it.

You say that this is an extreme case? That overall, BMI reporting is a good idea? Read these talking points from the Eating Disorders Coalition.

Our language around these issues is loaded and complex, because we have made it so. We've made fat a dirty word that connotes so many negative qualities: lazy, greedy, sloppy, messy, stupid, unattractive . . . . No wonder 11-year-old Katie Owen reacted the way she did. She's not the first, and she will not be the last.

Brave Girl Eating: Q&A, Part II

The second part of the Q&A on Sheppard Pratt's blog is now live. I hope you'll check it out. Drop me a comment if you're in Baltimore and think you might make the reading--I'd love to meet you!

Brave Girl Eating: Q&A

In preparation for my upcoming book talk at the Center for Eating Disorders at Sheppard Pratt, the kind folks there are posting a Q&A interview on their blog over the next 10 days or so. Part 1 is up. And if you're going to be in Baltimore on August 25, please stop by the reading--I think it's going to be an inspiring event.

100,000 hits

When I started this blog in 2006, I had no idea I'd still be at it four years later.

Today, the 100,000th visitor stopped by the blog. I realize that's not a huge number, given stats on the big blogs. But for a little independent blog like this, it feels huge.

So thank you to my readers, those who agree with my opinions and those who don't, those who educate me and those who merely lurk. I am richer for having you as part of my community, and I hope I've offered something back in return.

As a way to say thank you, I'm going to run a book giveaway on the site. Stay tuned for details!

Don't get mad. Get out your Exacto knife.

That's what this furious citizen did when confronted by an offensive ad for thin pretzels.

What if we all "corrected" ads like this? They can't arrest all of us. . . .

Annals of retouching disaster: The Ann Taylor shirt

Thanks to a technical screw-up by someone at Ann Taylor (I'm thinking heads will roll over this), Jezebel was able to grab screen captures of a model before and after retouching.

Here's what the site ran:



You can see the work that's been done. As Jezebel put it, the "unretouched thumbnails . . . transform [models] into ribless monstrosities."

The model on the left--the unretouched one--is beautiful, shapely, and wears the clothing well. So why, why, why turn her into the absurd image on the right? I don't think it's enough to cite the pursuit of thinness. The model on the left is already thin--you can see her ribs, for God's sake. I think there's something more at stake here. Something that has to do less with beauty-qua-beauty and more to do with how women are perceived in 21st-century America--and how we perceive ourselves.

I can't help thinking about the timing of all these retouching debacles. There was the Calvin Klein photoshop disaster:



Then there was the Self magazine Kelly Clarkson debacle (see below).



Technology has something to do with it, of course. We photoshop because we can, because human beings are compulsive changers-of-reality and even more relentless self-improvers, and can't pass up an opportunity to "iimprove" ourselves.

Except that these kinds of "improvements" are so far out of the mainstream, no one (I hope) would confuse them with reality. Which brings me back to the idea that there's something more going on here.

Women have never been as powerful in America as we are today. And even though we still have a ways to go (can you say "woman president in my lifetime?), we've made enormous progress since I was a young thing. And thanks to the Great Recession, women's work and employment levels may be surpassing men's for the first time.

And maybe that's the problem. Maybe the Trojan Horse of self-loathing embodied in images like these is meant to put us uppity women in our place. I've said it before and I'll say it again: So long as we're obsessed with our appearance, our looks, how thin we are or aren't, we're missing the boat on a whole lot of more important issues.

I can't help thinking there's a connection.

Psychology Today

Over the next few months I'll be blogging over at Psychology Today as well as here on Feed Me!. PT has an impressive roster of bloggers who tackle some fascinating issues, and I'm honored to be among them. I'll link to my posts there, starting with my inaugural post; those posts will focus on eating disorders. I'll still post here about other issues of interest.

If you head over there and read the blog, and like it, leave a comment if you would--make me feel at home there. :)

Happy Monday!

Book tour!

The last few weeks have seen a lot of action on the book tour front. I'll be traveling quite a bit to readings, events, and conferences to talk about Brave Girl Eating: A Family's Struggle with Anorexia.

I thought I'd post an up-to-the-minute calendar of where I'm scheduled to be so far, with more to come. You can also look for my schedule here. If you come to a reading, please introduce yourself! I look forward to meeting some of you while I'm on the road.

8/24: Appearance on Good Morning America, 7 a.m.?
8/25: Reading at Sheppard Pratt Center for Eating Disorders, Baltimore, 7-9 p.m. in the conference center
9/20 The Book House, Albany, NY, 7 p.m.
8/26: Appearance on the Diane Rehm Show, 10 a.m.-noon
9/24: Presentation/book talk, Lake Forest College, 10 a.m., Lake Forest, IL
10/1: Reading/book talk, University of Wisconsin, Room 1244, Health Science Learning Center, noon
10/2: Reading/book talk, Wisconsin Book Festival, 10 a.m., A Room of One's Own Bookstore, Madison, WI
10/4: Reading/book talk, Moline Public Library, 10 a.m. (subject to change in location)
10/4: Talk/reading, Quad Cities Eating Disorder Consortium training for therapists, 3 p.m., Moline, IL
10/10: Presentation with Dr. Walter Kaye, National Eating Disorders Association annual conference, 3 p.m., Brooklyn, NY
1/21: Presentation/book talk, Maudsley Parents conference, University of California San Diego, 11:30 a.m., San Diego, CA

Poor Dr. Lundberg

Apparently Dr. George Lundberg is a little upset because back in 2004, he put forth his ingenious stop-obesity plan and it didn't work. And it didn't work, he tells us, because fat people just didn't listen to his plan, which is really simple and practical when you think about it. It consists of two words:

Stop eating.

Dr. Lundberg goes on to clarify what he means:

I did not say fast; I did not say starve. I said Stop Eating too much; stop eating high calorie snacks between meals, stop eating everything on your plate; stop eating such large portions; stop eating desserts; stop routinely eating bread and butter; stop eating three full meals a day when two are enough; stop eating fats and refined carbohydrates when you can eat fresh fruits and vegetables and complex carbohydrates.

And while you are at it, STOP DRINKING alcohol and sugary drinks.

I wonder if Dr. Lundberg understands anything at all about metabolism. If he did, I suspect he would not so angrily and aggressively put forth his diet plan--because that's what it is, a diet plan, one built on restriction. He would know that dieting, restricting, whatever you want to call it, ultimately makes people fatter, not thinner. He would show more sensitivity to the link between dieting (or restricting, etc.) and eating disorders. And I hope he would not so blithely recommend gastric "interventions," as he writes a few paragraphs farther down, which not only are often unsuccessful but which carry relatively high risks of death, infection, malnutrition, blood clots, and other consequences.

He writes rather plaintively, toward the end of his editorial, "A lot of obese people got really angry at me for hurting their feelings. But I don't really care that much, as long as we did get some people to adjust their eating and drinking behavior. STOP EATING and DRINKING EXCESSIVELY and STAY HEALTHY."

Tell me, Dr. Lundberg, what is "excessively"? To me it sounds like you think three meals a day is excessive. You think any amount of dessert is excessive. You think any amount of fats or refined carbohydrates is excessive.

Whereas actually, I think you're the excessive one. Your rules, restrictions, and most of all your rigidity and, yes, rage--what do these remind me of? Oh, yes, I remember. They remind me of the rigidity, rules, and rage of an eating disorder. You know, a lot of people think there's nothing wrong with having a little eating disorder, as long as you're not fat.

Those of us who have seen or experienced an eating disorder up close feel rather differently about that, of course. And I'll tell you what I think, Dr. Lundberg: I think you should confine your judgmentalism to yourself. You are free to eat and drink (or not eat and not drink) to your heart's content. You are free to manipulate your weight as much as you want.

And you're free to say whatever you want, of course, just as I am. But I hope to God, Dr. Lundberg, that you might educate yourself a little more before you spout off next time about obesity. I hope you'll talk to some people who know a little more than you about eating disorders and metabolism and all that complicated science-y stuff. I hope you'll talk to some families with children with eating disorders, and listen to them say their daughters and sons developed those eating disorders after middle school wellness classes that scared the crap out of them around being fat.

Until then, I hope you're not a practicing doctor anymore. I would hate to think of anyone I care about experiencing your judgmentalism, rigidity, and rage.

Guest post

Thanks to Amy L. Cambell for letting me write a guest post on her blog, A Librarian's Life in Books.

Campbell asked me to talk about why I wrote the book Brave Girl Eating: A Family's Struggle with Anorexia. I'm glad to have the chance to articulate it, to you as well as to myself.

Hop on over and visit Campbell's blog if you have a chance--I love supporting people who love books!

Distortions

When it comes to talking about eating disorders, there's no end to the distortions that often get trumpeted as "new." If you've had a loved one suffer with an eating disorder you know what I'm talking about. One of the things I teach my magazine journalism students is the fine art of taking a press release and turning it into a compelling and accurate piece of journalism. It's the toughest lesson we do all semester, which is no reflection on them. I think it's a challenging task to pull off, and very few news or public relations entities do it well.

To wit: This story from PR Newswire, whose headline trumpets "Mommy Not Always Dearest During Treatment for Eating Disorders." If you read only the headline and the first paragraph or two you'd come away with the idea that mothers were devastating, damaging, and destructive factors in their daughters' recovery from an eating disorder.

If you can force yourself past those first paragraphs, you'll be able to intuit a slightly more nuanced story. The family therapist quoted in the story, Catherine Weigel Foy, makes comments like "The mother-daughter relationship can be a complicated one." Um, yep. There's nothing particularly ground-breaking or earth-shattering in that statement. She goes on to say, "A mother's love begins before a child is born, and can create an unrealistic expectation that the connection between mothers and daughters will be as strong and free from limitations in adulthood as it was in early infancy."

I'll buy that, too, though perhaps I'm a bit more optimistic than Weigel Foy about the potential for good relationships between mothers and daughters.

Read down another paragraph or two and you find this:

Weigel Foy endorses an introspective look at this unique relationship and believes temporary distance from family members allows many adolescent and teenage girls to feel safe exploring the mother-daughter relationship in ways they haven't been able to during prior treatment for anorexia or bulimia. Weigel Foy and her colleagues at XX XX Residential Treatment Center work together to foster a nurturing environment that helps teen girls gain a realistic view of their relationship with their mothers. In turn, the girl and her mother are better equipped to support each other on their path to recovery.

Aha. Here, ladies and gentlemen, if we are attentive readers, the light bulb goes off. We understand that the piece we're reading isn't journalism at all but PR on behalf of XX XX Residential Treatment Center (I've deleted its name because I don't want to give it more publicity). Weigel Foy may be a good therapist or she may not; we really can't tell from this paraphrasing of her work in the service of publicity.

But certainly, the average reader will come away from the headline and opening paragraphs thinking, "Wow, this doctor thinks mothers are responsible for their daughters' eating disorder and/or get in the way during recovery."

Later in the piece, the writer concludes, "Through residential treatment and therapy this relationship can be explored and these young girls can come to better understand its affect on their diseases – and in turn help build a foundation for lifelong recovery." The mother-daughter relationship is being offered up as a reason to send your child to residential treatment.

Here I must point out that not only is there no evidence whatsoever that the mother-daughter relationship plays a causal or continuing role in eating disorders, but there is also no evidence whatsoever that exploring this relationship helps anyone get over an eating disorder. To the contrary: The most effective treatment for adolescent eating disorders is family-based treatment, which enlists the support of the family--mothers included--to help teens and young adults recover. And when I say "the most effective treatment," I am referring to real studies with real results, not one therapist's opinion (no matter how good she may be).

This kind of media deconstruction is important for everyone these days, as we're bombarded by information. But it seems to be especially imperative in the murky, vague, profit-seeking world of eating disorders treatment. Caveat emptor.

New website

Here's a huge shout-out to my talented husband, photographer Jamie Young, who is creating a new website for me. Take a look and tell me what you think--your input welcome! I'll be posting some of the fall events I've got lined up for the Brave Girl Eating book tour in the days and weeks to come.

The book is coming, the book is coming . . .

There seems to be some buzz building for the Aug. 24 release of my new book, Brave Girl Eating: A Family's Struggle with Anorexia. I feel honored! And I wish I had galleys to send out to everyone who wants to read it. (My publisher would like me to say instead, "I wish you would all buy it!")

So I thought I'd post a link here to the incredible book trailer a student, Shelby Haddon, made for me last spring. It uses some of the material that opens the book.

In the weeks to come I'll post short excerpts from the book. Of course I wrote the book and I want it to find an audience. But beyond that, I want it to make an audience--people who don't know much about eating disorders except what they hear on the news or in magazines. Why should they care? Because chances are, someone they know and care about has an eating disorder but isn't talking about it. People feel shame and stigma about having eating disorders, and unfortunately the secrecy around them feeds the flames of that kind of stigma.

No more secrecy. No more stigma. I believe in telling the stories, true stories. People need to know and understand and empathize with what other people are going through.

Enjoy the trailer.

Looking for young adults with anorexia

Researchers at the University of Chicago, under the direction of Dr. Daniel le Grange (pictured, left), have just won an NIH grant to study family-based treatment (FBT, also known as the Maudsley approach) in young adults. If your family lives in the Chicago area, or within driving distance, you could get free treatment if you qualify for the study. Not to mention the chance to get some of the best treatment for anorexia in the country. It's a win-win!

Here are the study parameters:

This study is a good match for you if you are:
• 18 to 25 years old
• Meet diagnostic criteria for anorexia nervosa
• Are prepared to participate in assessments
• Interested in cost-free psychotherapy treatment with a family member of choice

Treatment involves up to 6 months of free individual and family therapy sessions.

For more information, please contact the Participant Coordinator at 773-834-9120 or visit University of Chicago here.

Michelle Obama: Starting to get it?

Maybe so, if this story from the Christian Science Monitor is to be believed.

The First Lady goes on record saying she "tries to stay away from discussions about weight with her daughters," focusing instead on health. Though I notice she's still willing to talk about weight with the rest of our daughters. And sons.

Well, change comes slowly. Good start, Mrs. Obama! I hope you'll keep listening as well as talking. And if you've got another place at the table for your September summit on childhood obesity, please count me in. . . .



PHOTO CREDIT: AP PHOTO/ED ZURGA

UC-SD is looking for research participants

One of my next posts is going to be a love letter to the team at UC-San Diego.

Meanwhile, if you live on the west coast and would like to participate in a brain imaging study there, please consider doing it. The folks at UC-San Diego, under the direction of Walt Kaye, are doing some of the most important cutting-edge work on the neurobiology of eating disorders. This is your chance to help them out, get a scan of your brain, and make a little money. Details are below.


RESEARCH PARTICIPANTS WANTED
In conjunction with Dr. Walter Kaye and his research team, Dr Amanda Bischoff-Grethe is seeking female participants between 12 and 18 years of age who have a recent (within the last six months) diagnosis of Anorexia Nervosa. Qualified participants will be asked to answer questions regarding their personality and cognitive abilities and will also undergo a 1.5 hour brain imaging study. By participating in this research study you may assist physicians and researchers in developing treatments for these complex and serious disorders. You may be compensated up to $175 dollars plus mileage. For more information, please contact the UCSD Eating Disorder Treatment and Research Program at edresearch@ucsd.edu or the Research Coordinator, Zoë Irvine, at 858-246-0699. We look forward to working with you!

Independence Day

July 4th is a time to celebrate freedom: freedom from tyranny, from oppression, from authority. These are concepts we typically think of in the context of politics. I've been thinking about a different kind of freedom this year: freedom from eating disorders.

The analogy is apt, though most people don't know it. Having an eating disorder is like being a slave, subject to the whims and demands and impossible expectations of a taskmaster well-versed in the art of punishment. When you have an eating disorder, you do what it says, whether that's to refrain from eating even though you're starting, or to purge every calorie you do eat, or to stay awake when you're exhausted (because you don't deserve to sleep/eat/live). Having an eating disorder is the very opposite of freedom. You're not free to choose when it comes to some of the most fundamental elements of your life.

Anyone who's had an eating disorder can tell you that it's not a choice. You are not exercising free will every time you stick your finger down your throat, or push away a plate. You're in the grip of an irrational tyrant who has no regard for your feelings, your health, your sanity.

So this July 4th, I'm thinking about everyone who's ever struggled with an eating disorder, who's felt the iron grip of tyranny around her throat, stomach, mind, and who is struggling to become free. I want you to know that you can become free. There is hope. There is life outside of the crushing oppression of an eating disorder.

And here's to it, and to you.

Project BodyTalk goes live!

After nearly a year of development and work, I'm pleased to announce that thanks to my fabulous graduate assistant, Megan Swann, we've got a website up and running for Project BodyTalk. I've been writing about eating disorders for a while now, and at some point I began thinking that it would be really fabulous to be able to hear the actual voices of people who struggle with EDs. I'm also a radio devotee and big fan of shows like This American Life and the StoryCorps project.

From these sources, Project BodyTalk was born. It's an audio project that collects commentaries on the subjects of food, eating, body image, and eating disorders. Here on the Syracuse University campus, we opened a recording booth for a couple weeks last fall and collected a number of commentaries from students, faculty, and community members who came up to campus to record. Since then I've had people send me mp4 and mp3 files. A couple of teachers at a high school in Baldwinsville had students record commentaries.

The first commentators were told to record a commentary anywhere from 1 to 10 minutes, on any related subject. Some people told stories about friends and family members struggling with body-related issues. Some talked about foods they love. Some talked about what it's like to be fat, or thin, to have anorexia or binge eating disorder, to feel pressured to look a certain way. It's turning into a wonderfully eclectic, diverse, and moving project.

So . . . the website is up and running with the first half dozen commentaries. Over the next few months I'll be editing and uploading more commentaries, and, I hope, collecting them too.

We've also got a page labeled ACT, where I'm posting links and descriptions of other body-positive projects. If you've got one to share, send me info, and I'll happily add yours to the page.

I'd love your feedback--and your commentaries.

*Image by Megan Swann.

Bring Brave Girl to your town!

I've started planning a book tour in earnest for BRAVE GIRL EATING, my memoir about our family's struggle to help our daughter recover from anorexia. My goal: To visit as many towns, especially university towns, as possible, and to get in front of as many pediatricians, doctors, therapists, and families as I can.

Here's where you come in, dear readers: I need your help arranging events in your town. I'm aiming to get on the schedule for university lecture and talk series, because I know this book will be of interest to both the scientific community (it's got lots of science and neurobiology for all you geeks, and I count myself among you) and to college audiences. The best way for me to make contact with folks around the country is through someone who's already in the community and who can broker an introduction and help me connect with the right person.

I'd love to come speak in your town, at your university, in your state--hell, in your doctor's office. So if you can help please let me know. My email addy is harriet at harrietbrown dot com. Tentative schedule to come in the next few weeks, I hope!

Are you a size-accepting fat woman?

If so, please consider helping grad student Micheala Null, a doctoral student in sociology at Purdue University, by taking a brief study and potentially doing an interview. Details are below.



*********************

Call for Participants

Hi, my name is Michaela A. Null, and I am a doctoral student in Sociology at Purdue University. I am doing a study about the embodiment of size-accepting fat women, with attention to the ways in which gender, race, sexual orientation, and
body size intersect.

I am currently looking for individuals who are interested in volunteering to participate in my study. If you are interested in volunteering to participate in an interview, I ask that take an electronic informational survey, which will take approximately 5 minutes. Please go here and complete the informational survey. After all survey data has been collected, participants will be selected for interviews, which will be conducted in-person, by phone, or via internet chat, and will last between an hour and an hour and a half.

Participation is voluntary and participants must be at least 18 years old.

This project has been approved by my university’s Institutional Review Board, which protects human subjects of research. I will provide confidentiality to all volunteers and participants will be referred to by a pseudonym in all research documents.

If you have any questions regarding this study, you can contact me at mnull@purdue.edu. For more information on me, you can access my university profile here.
You can also contact Professor Eugene Jackson, Assistant Professor of Sociology at Purdue University, at jacksone@purdue.edu.


Sincerely,

Michaela A. Null
Doctoral Candidate
Instructor for Women's Studies
Purdue University
Department of Sociology
700 W. State Street
West Lafayette, Indiana 47907-2059

Check the Huffington Post . . .

for my response to the White House Task Force on Childhood Obesity.

Add your comments, please. I'm sure there will be plenty of the wrong kind up shortly.

Kudos to the eating disorders work group on DSM-V

for deciding not to make obesity a disease in the next edition of the Diagnostic and Statistical Manual of Mental Disorders.

This decision has significant ramifications for how docs treat and to some extent see obese patients. I'm a big proponent of changing the dialogue around obesity from a discussion of weight to a discussion of health. The two are not synonymous. I'm also hoping this will stop bariatric surgeons from marketing their surgeries as eating-disorder treatments, for instance.

The group also recommended changing criteria for anorexia and bulimia:
• Now patients must weight 85% of ideal body weight or less for a diagnosis of anorexia; in future, if the changes go through, the criterion will be "restriction of energy intake [leading to] markedly low weight." This rightly shifts the emphasis from the rigid weight characteristic to a pattern of eating and relationship with food. Now insurance companies will have a harder time cutting people off from treatment once they hit 86% of ideal body weight.
• Loss of menstrual period is no longer one of the criteria for anorexia. Some women never lose their period, no matter how thin they get; others keep menstruating even at very low weights.
• Bulimia will be diagnosable with purging episodes of once a week; right now, the criterion is two episodes a week.
• Binge eating is likely to become a diagnosable eating disorder.

New film: Fat

A filmmaker named Jennifer Jonassen sent me a link to this trailer for a new documentary, FAT, due out later this year. I think it looks pretty interesting. What do you think?

"You're so fat!"

The car was a beat-up sedan crammed with college kids--guys--who had clearly started their Saturday night partying on Saturday afternoon. My husband and I were out for a short three-mile bike ride. I heard the guys yelling and carrying on from a block away, and I knew they would yell something at me. And they did.

"You're so fat!"

As I pulled up alongside my husband, he asked, "What did they say?" When I told him, his jaw dropped.

"I can't believe they would say something like that!" he fumed.

I could. And as I told him, it didn't bother me all that much. I'm used to it. Guys have been yelling things at me since I was 15. Like any woman, I've learned to tune it out. It's a power trip, a form of misogyny, a reminder that women are vulnerable to men in a variety of ways.

Still, I thought about it all the way home. It reminded me of the way boys at my junior high school used to drop pennies on the ground, and yell "Kike!" at anyone who picked one up. And with that recollection, I realized viscerally, profoundly, and in a deeply emotional way that what those guys in the car were doing has a name: hate speech.

And although I've been thinking and writing and talking about this subject for years, I think this was the first time I truly got it in a fundamental way. And that is something I'll be thinking about for weeks to come.

Book trailer

A very talented student at Newhouse, Shelby Hadden, created this trailer for my forthcoming memoir, BRAVE GIRL EATING: A FAMILY'S STRUGGLE WITH ANOREXIA. Isn't technology great?

Let me know what you think.

One more reason NOT to get bariatric surgery

Bariatric surgery--the practice of deliberately mutiliating the gastric anatomy in order to lose weight--is being pushed harder than ever these days. The latest claim: it cures Type II diabetes instantly.

Not so fast. Apparently the issue is more nuanced than that. Researchers at the University of Washington recently found that people whose fasting blood glucose levels came down after having the surgery were still spiking diabetes-level glucose levels after meals.

The money quote:

"I don't think the procedure cures whatever it is that's causing diabetes in the first place," said Arthur Chernoff, MD, chair of endocrinology at Albert Einstein Medical Center in Philadelphia, who wasn't involved in the study.

SHocking, isn't it? Fat may not be the only cause of diabetes.

In fact, the weight-diabetes link is one of doctors' strongest arguments against fat acceptance and health at every size. Bariatric surgery is very serious business--and I mean that in both senses of the word. It's a multimillion-dollar industry based on the premise that it's a good idea to take out part of your guts--forever. Once you've had the surgery, your body is unable to process nutrients the way it used to. You may or may not become thin (some people lose weight only to regain it after); you may or may not experience some of the serious complications of the surgery; you will be permanently malnourished.

And now you may not have an instant cure for Type II diabetes after all. Because the equation may be a bit more complex than fat = bad, thin = good.

Bravo to Gawker

That sound you hear? It's me clapping for this tell-it-like-it-is piece from Gawker, which deftly skewers the mainstream media's not-so-hidden obsession with thinness.

My favorite quote:
The purpose of working out is get in shape. Not to get "thin." To be in shape, for the average person, connotes being healthy, and improving on the basic elements of one's own fitness: muscular strength, endurance, cardiovascular, flexibility, etc. . . . designing a workout and nutrition program with the goal of being thin will almost certainly ensure that you cannot achieve a high level of fitness; you would eat a low-calorie diet, thereby robbing yourself of muscular gains.

Note that I deleted a sentence or two in here. Even Gawker falls prey to the knee-jerk obesity-is-bad syndrome. (We really have to have a chat about that, Nick Denton.) But it's not so easy calling out the Gray Lady herself on the assumptions and obsession with thinness. So kudos to Gawker, and Hamilton Nolan, who wrote this post. Let 'em know what you think.

Fat and thin: It's all in your brain?

A new report from Brigham Young University suggests that women may be hardwired to worry about body image. Using functional MRI scanners, which record which parts of the brain light up while it's engaged in a task, researchers have discovered that women's brains react differently than men's to images of fat and thin. Study subjects, who were all thin, passed a screening test for eating disorders and so were presumed to have no overwhelming body image concerns.

When women were shown images of overweight women and told to imagine that someone commented that they looked like the woman in the image, a part of their brains that engages in self-reflection lit up. When looking at the images, says Mark Allen, a neuroscientist at BU, "women are actually engaging in an evaluation of who they are and whether they are worthwhile as a person. Even though women might claim to be well adjusted and not care about body issues, subconsciously they might care."

But couldn't this be the result of the overwhelming socialization American women experience on the subject of fat? Would the brains of women in a different culture--a culture that didn't put so much value on the thin ideal for women—light up the same way?

I'm not a neuroscientist, but I wonder if this study is flawed. Or maybe I simply don't want to accept that there's a biological limit to self-acceptance on this issue.

I'd love to hear what you think.

Britney does Photoshopping

Kudos to Britney Spears, of all people, for releasing some before and after photos of herself--before and after airbrushing and photoshopping, that is. She's the latest in a trickle of celebrities doing this. It's a commendable effort, even if, as Jezebel rightly points out, the before images are still unrealistic, thanks to makeup, lighting, and other props ordinary women don't have when they look in the mirror.

Still, it's a start, a small stone rippling the surface of the unattainable thin ideal. Me, I'm hoping for the rockslide. Any day now.

Health Care for the Obese

A new study published today reports that overweight and obese patients get the same or better quality of health care than "normal" weight patients.

Researchers at the University of Pennsylvania say they looked at quality of care across eight performance measures among Medicare and VA patients, and found no difference in the kinds of treatments doctors prescribed for obese and non-obese patients.

According to a s tory on MedPage Today, "Performance measures included diabetes care management (such as lipid and HbA1c monitoring and eye tests), pneumococcal vaccination, influenza vaccination, screening mammography, colorectal cancer screening, and cervical cancer screening." The story goes on to quote one of the researchers commenting that while doctors do "harbor negative attitudes" toward heavier patients, that prejudice doesn't affect the quality of care delivered.

I think this is a pretty grandiose conclusion to draw from such a limited study, and the researchers themselves cautioned against extrapolating these results too broadly. To me, the study raises some interesting questions: Are doctors more tolerant of overweight vets and/or poorer patients? Is "quality of care" strictly a function of which treatments are recommended?

I don't think so. I wonder what the patients would have to say about the quality of care they received--not just the treatment recommendations (which are of course important) but the relationship they had with their docs, and how it affects their long-term care. I wonder whether these two populations typically have long-term relationships with the same doctor, or whether they often see a revolving cast of medical providers, and whether that might make doctors react differently to them than to patients they see regularly.

Thoughts?

Warning: The Images You Are About to See May Be Damaging to Your Health

I'm a big fan of Jezebel, but I think they've got it wrong this morning. In a post discussing a recent editorial in the Daily Mail by grieving mother Rosalind Ponomarenko-Jones, whose 19-year-old daughter died of anorexia, Margaret Hartmann argues against the notion of labeling photos of celebrity "twiglets" when they get too thin.

Ponomarenko-Jones argues against the current appearance-driven culture, which calls out celebrities not for achievements but for appearance. And "calls out" is the right expression, since we're all familiar with the standard scary-skinny-celebrity story these days: Publish a photo of a woman so emaciated that it's painful to look at her, along with a headline that screams a fake concern for her well-being. The whole exercise feels prurient and voyeuristic.

Hartmann centers her argument on the logistics and legality of the question: How would we determine when a celeb is "too thin"? How would we know when to label an image and when not to? It's a valid point. And before commenters jump on me for this, I acknowledge that you can't tell whether someone has an eating disorder just by looking at her. Some people are naturally skinny, and there are other reasons (other illnesses) for gauntness.

But Ponomarenko-Jones has the moral high ground here, and I wish there were a way to honor the spirit of her request. Because we (and by "we" I mean the media) don't go around publishing photos of, say, recent cancer victims, who may be every bit as scarily skinny as an actress in the grip of anorexia. Yet magazines and websites are full of images of "twiglets," young women so thin you can see the shape of their femurs. Why is it OK to publish these images and not, say, images of Farah Fawcett as she lay dying of cancer?

It comes down to our blindness to eating disorders as "real" diseases. We would cringe at the idea of violating Fawcett's privacy in that way. Yet the young celebrities who walk so scary-skinny among us are dying of an illness, too, an illness that will kill them as surely as cancer killed Fawcett. The difference is that with treatment, many of these women can recover; for Fawcett and many other cancer victims, alas, treatment did not save their lives.


And of course treatment won't always help with eating disorders, either. But the point here is that instead of parading these images as models for women--whether this is openly acknowledged or not--we should label them for what they are: images of the gravely ill, who are struggling with their own terrible reality and heart-breaking health battles.


Jezebel got it wrong. The real shanda (as my grandmother would have said) is that we pretend there's no such thing as too thin.

Conference in Chicago--register now!

In just over two weeks Maudsley Parents will sponsor its second conference on eating disorders--this time in Chicago. This one-day conference, aimed at parents, therapists, and researchers, features some of the best thinkers on eating disorders in the country--including Dr. Daniel le Grange and Dr. Walter Kaye—plus a panel of parents who will talk frankly about what they know about combating their children's eating disorders.

It's going to be a fabulous event. I'll be there, along with my two partners in crime from Maudsley Parents--Jane Cawley and Ann Farine. We've worked hard to keep it affordable so everyone who wants to come can manage it.

For more information or to register, click here. We'd love to see you in Chicago!

Book Giveaway: 100 Questions & Answers About Anorexia Nervosa

Dr. Sari Shepphird is one of my favorite "experts." Shepphird, a clinical psychologist from Los Angeles who specializes in treating eating disorders, has a new book out, 100 Questions & Answers About Anorexia Nervosa. The book tackles the complex and confusing subject of eating disorders by posing and answering questions like "Are athletes at greater risk for developing anorexia and eating disorders" and "How do I know if I have a healthy body image?" The book is written for people with anorexia, their friends and families. I admire its clear, practical approach, and think it will be of great help to many.

And I've got a copy to give away! If you'd like to enter the drawing for a free copy of Dr. Shepphird's new book, leave a comment on this post telling me why you're interested in reading it. I'll draw names at random next Monday, March 29.

Good luck!

A troll among many trolls

I don't normally bother with trolls, but this one sent me an email to my work address that is so vile, I have to share it here with all of you.

Barry, I suspect you are what I think of as a self-loather. Maybe you were once fat. Maybe you're fat now. Maybe you're deathly afraid you will be fat in the future.

Personally, I love how you toss aside research in favor of your own baseless and warped opinions. That Barry, he sure knows better than those high-falutin' doctors who actually research this stuff!

Since you think shame is a good health-care strategy, I'll take your idea a step further and see if shame is a good strategy for curing haters like you. Probably not, alas.

I hope my readers will respond to you in the same spirit in which you wrote to me.



I was mystified and angered by your article in the Times today. Are you actually arguing that obesity is a healthy lifestyle? Are you really saying that fat people have no control over their food intake and amount of exercise? Eating too much is nothing to be proud of, just as drinking too much alcohol is nothing to celebrate. You are lying to yourself if you think you are not shoving far too many calories into your mouth. You're fat because you can't control yourself--it's that simple.

The reason we stigmatize obesity is because it really is a choice, unlike skin color, ethnicity and the religion you were raised in. Obesity is a signal to others that this fat person is living an important part of his/her life totally out of control. It signals a lack of self-discipline and a warped sense of self-worth. Your position on this means means you're proud of your lack of control about how much, and what, you eat. It's delusional to be proud and pleased that you are out of breath when you climb stairs, that you are heading for a horrible old age--if you live that long, that making love to your partner is a problem instead of a happy event, and that you can't perform simple tasks from properly wiping your ass on the toilet to picking up an earring you've dropped.

Delusional: For example, you state that the emotional stress of the prejudice against fat people causes the health issues that result from obesity. That is not science, that is nonsense. We know stress can be a contributing factor to poor health, but you're trying to blame others for the conditions you create by eating too much. Reminds me of alcoholics saying they drink too much because of all the pressure on them to stop drinking.

On the one hand you blame doctors for relating to obese people differently than normal weight folks because, as you say, doctors believe fat patients won't follow orders, won't show up for appointments etc. Then later in your article you say fat people don't show up for doctor appointments because they feel bad about themselves and worry about how doctors will relate to them. Doctors know from experience that fat people miss appointments and can't or won't take care of their own health. Of course they relate differently to people like you who disdain main stream medical advice.

When Lincoln University tried to help fat kids get well and avoid incipient heart and other diseases, you condemn them for their efforts. What you fail to understand is that your stance actually kills people by making gluttony and self abuse through food a good choice, a choice to be proud of. What you are doing diminishes the real harm of prejudice which punishes innocent people for the color of their skin or their ethnicity--things they can't and should not want to change.

But obesity is a lifestyle choice, like smoking and alcoholism, a self-destructive lifestyle choice that harms the people who choose to follow that course. Anyone can get thinner and improve their overall health. It is not easy but rarely are the important life choices easy. That doesn't make your choice a virtue. It is difficult to diet and exercise on a regular basis and change your attitude about stuffing as much food as you can into your face. We've all heard the reasons people live your way, and none of them are good, abuse as a child, the comfort derived from eating lots of fatty creamy things, the hit of sugar, the bad habits of a deprived upbringing blah blah blah. We rightfully despise drunks who abuse themselves and others, ruin careers and the lives of those who love them. Similarly obese people are wearing a big sign that says "it's all about me and screw you who object to my overeating, it's costs to society, it's bad example to young people, it's strong signal that I'm out of control. I do it because it feels good and I'm proud of that." This is called selfish and irresponsible--nothing to be proud of.

Think about the damage your article has done. Making a virtue out of a lifestyle that any scientist, medical person or just plain educated folks know is harmful. Shame on you.
Barry XXXX
NY

PLEASE NOTE: THIS THREAD IS NOW CLOSED.