Another book the world doesn't need

Spring is here, and I've been feeling mellow. A new book deal is proceeding apace. Life is good. I was beginning to think I'd used up my quotient of outrage for the year.

And then Maggie sent me this.

"This" is a book written by a plastic surgeon, aimed at kids to explain their mothers' plastic surgery.

As you can see from the sample panel I've included, it's worthy of outrage on many counts, including lousy illustrations and self-serving, poorly written text. Amazingly (or not), it's gotten quite a bit of national press, much of it rather positive.

I'm giving it two thumbs down. I only wish I had more than two hands.

Penny wise, pound foolish

That truism can apply to so many corporate decisions, can't it? But when it comes to treating eating disorders, the truism becomes both literal and deadly.

Take the case of this Connecticut family, fighting for their insurance company to do the right thing and cover treatment of their 17-year-old daughter's anorexia. While insurance covered her previous treatment, her last admission was kicked out because of a treatment delay that triggered a "within 3 days" rule.

In fact, treatment delays are common and are usually--as in this case--the result of a shortage of beds or space in treatment programs. There's nothing a family can do to prevent them. To have coverage denied because of such a delay--a delay that can be lethal to the adolescent being treated--is both cruel and immoral.

Readers of this blog know how I feel about the health insurance industry: Any industry that profits from people's pain and suffering should be abolished. Until that day, the industry should be held accountable for decisions like this one, which risk lives and add suffering for families already dealing with the torments of an eating disorder.

The girl in question said it best: "If someone needs help, give it to them. Because people don't ask for help if they don't need it. Trust me."

This is especially poignant given the fact that so many people with anorexia cannot recognize that they're ill or ask for help.

Our former insurance company denied coverage for much of my daughter's treatment because we live in a state without mental health parity. (One more reason why I can't wait to move back to New York.) As we know, there are people whose entire work life consists of looking for reasons to deny people coverage. How do they sleep at night?

I hope folks from the company in question read this. And I hope they do the right thing. For once.

Race and place (off-topic)

So after 16 years of living in the midwest--a place I hated passionately for at least the first 6 or 7--I've come to appreciate some of its finer points. Like the access to nature. The relative cleanliness of my small city. The neighborly feeling on our block and on many blocks.

I'm actually going to miss all that when we head east to Orange Country this summer. But there are things I won't miss, like the totally whitebread nature of our small city.

We bought a house this weekend (a house!) in the university neighborhood, which, unlike the one in this small midwestern city, is gritty and urban and integrated. I remember when we moved here from Manhattan's Lower East Side. I remember thinking, Where are all the African American people? They're here, of course, but there's not much integration here. People divide along race and class lines. I don't think I've made a single black friend since moving to the Midwest.

On our new block, on a chilly Saturday afternoon, we saw two kids on bikes. One was learning to ride. The other was running along beside her friend, holding on. Both were black. Both were adorable. A few minutes later we were able to meet one of the families on the street, a white couple in their late 50s with two soon-to-be-adopted African American daughters, former foster children. They were friendly-ish, and I'm looking forward to getting to know their family better.

Right now, our move seems scary and ridiculous. I mean, why change everything when we're relatively comfortable? So what if I don't love my job? How do I know I'll like the new one any better?**

But another part of me looks forward to adventure and change and challenge. Or at least it will when I can shake this damn midwestern flu we've all had going for weeks now.

Our new house has no fireplace (even though we've hardly used ours I like having it) and very little yard, but it does have a pantry, which will be lovely once we've gutted and redone the kitchen, redone the roof, stripped the godawful paint off the woodwork, installed full-size toilets (for some reason the previous occupants put in teeny-tiny toilets; maybe they all had teeny-tiny tushies), redone the attic, propped up the carriage house in the backyard (which Mr. Professor is thrilled to have), and a few other things.

I'm going to grow some things in pots this year in the front yard. Next year we'll figure out how to put in some raised beds somewhere. I'm a rotten gardener but I love picking veggies out of the backyard.

There's a metaphor in here somewhere, but I'm too congested to figure it out.



**The boss thing I already know is better. My new department chair is fabulous--warm, friendly, outgoing, funny.

For readers in the U.K. . . .

Maybe you've already heard about Scarlet Magazine's campaign to ban fat jokes on TV. As editor in chief Sarah Hedley puts it:

Ordinarily, I’m a big fan of Alan Carr, but I only got as far as the second episode of his new Channel 4 show Celebrity Ding Dong before I began to feel uncomfortablewith the format. Pitting celebs against ‘civilians’, as we’re referred to on the show, is one thing, but having a laugh at the expense of the morbidly obese is quite another. Sadly this is what viewers were expected to do in episode two when Davina McCall and team were asked which was bigger, Posh Spice’s waist or obese civilian Tracey’s arm. The celebrity team hazarded a guess, then Tracey was brought on set and measured to prove just how big she was, while the world was invited to point and laugh.

She then goes on to compare obesity to cancer, unfortunately. Still you have an opportunity to sign a digital petition on the subject if you like.

Makes you wish for the good old days of Benny Hill, now, don't it? :-)

Wow

What an outpouring in response to yesterday's Times piece. I had no idea so many people had gone through the same kind of experience. I heard from many, many parents who had nearly lost a child through illness or accident, and from a few who went through the same set of feelings around a parent or sibling.

So I just wanted to say thanks to everyone who wrote and shared a bit of their story with me. You reminded why it is, exactly, that I am a writer. Writing makes me feel not so alone--and I hope it does the same for some of you.

New piece in the New York Times

Here's the linky. Enjoy. And let me know what you think.

Thank you, Canberra Times

for publishing this opinion piece about the connection between anti-obesity hysteria (my word, not theirs) and eating disorders.

Thank you for pointing out the real and tragic human anguish behind eating disorders. Thank you for daring to question the tactics, if not the content, of campaigns against fat.

And thank you for this last line:

. . . let us not forget to protect the innocence and confidence of a child's innate self-image.

Amen.

Recovering from anorexia: a parent's journey

I've come to realize that this is the year I'm recovering from our family's struggle with anorexia. It's been just about three years since my daughter Kitty got sick. She's been physically healthy for nearly two years, and mentally healthy for almost that long. She's happy, engaged in the world, healthy in every measure. For her, anorexia is thankfully in the past.

For me, though, it still feels very present. It took me a while to realize this because things are so positive.

It's little things that trigger the feelings for me right now. Things like the image above, which appeared in our local paper recently as part of an article about a student art show at the university here. It's called "The Fruit Eaters," by student Aniela Sobienski, and looking at it puts me right back in the land of anorexia.

Another trigger: Last night we went to see the movie Miss Pettigrew Lives for the Day. Great movie, about a proper middle-aged woman who finds herself in unusual circumstances. (Go see it. It's worth it.) Every time the main character tries to eat something it escapes her--it falls on the ground, someone knocks the food out of her hand, etc. In one scene she's having a facial; the attendant puts two slices of cucumber on her eyes and walks out. Closeup to her face, which is covered in goo that makes it look bizarre and distorted. Miss Pettigrew looks around and then eats the two cucumber slices. The look on her face is positively blissful.

Me? I was right back in anorexia land.

Maybe some of this reaction is because I am writing the book about our family's experience that I've been wanting to write for a while. It's a useful catharsis for me and, I hope, useful for others.

I can't imagine what this process of recovery is like for parents who have been pushed out of their child's recovery. Who have been the victims of "parentectomy." I am so grateful that we went the route we did in helping our daughter through anorexia.

Can eating disorders be prevented?

Laura Eickman thinks so. She's a Psy.D. with a private practice in Kansas who makes presentations on what she calls the danger zone, which she defines as the area between eating disorders and "healthy" behaviors. (Which, by my reckoning, is everything else. But I digress.)

Eickman gave a talk recently at Pittsburg State University, a fact that caught my eye because of her emphasis on prevention. The question of whether prevention efforts are effective is a controversial one; some say that few to none show any tangible results, while others see value in certain kinds of interventions.

It's a question that weigh heavily on my mind. Could my daughter's anorexia have been prevented? Her younger sister is at greater risk of developing an eating disorder now; what, if anything, can be done to prevent it?

I don't think Eickman has any answers, at least not judging from the news articles about her presentations. (I haven't seen them myself.)

This quote, from Collegionline, the PSU student independent online paper, disturbed me greatly:

Eickman says people in the danger zone take only one to two years to treat, while those with fully developed disorders take five to six years.

As I have reason to know, at least the last half of that sentence is a lie. My daughter was weight restored from severe anorexia in 11 months; her mental recovery took another 6 months or so. Today, about 3 years after she developed anorexia, she is healthy and happy, with a positive relationship to eating, food, and her body, thanks to the fact that we used family-based treatment to help her recover.

Maybe it's PTSD on my part, but I don't trust "experts" who make statements like the one attributed to Eickman. And somehow I suspect her so-called prevention program is little more than words.

Which is too bad. Because God knows we need prevention that works.

Feminism and the pressure to be thin

Celtic Chimp posted this comment on another thread, and it inspired me to write a new post:


I have never understood how women can have such a wrong impression of themselves. Healthy, beautiful women obsessing about their weight. If women could just see themselves from a blokes perspective for five minutes they would be very confident! I and most men I know find very thin women to be extremey unattractive. Now I'm not saying it is all about what men want or that that is why you lot do the whole weight thing but it is most perplexing to us men-folk. Whilst I agree that aiming that sort of complete bollox at young girls is completely irresponsible, I do think that adult women have got to take some responsibility and teach girls a little common sense. Maybe when their mothers stop fretting about their weight and image so much they will follow suit.

Well, Celtic Chimp, here's the thing: The pressure to be thin is not about what men want. It's not about sexual attractiveness. It's about power.

As you point out, many men--maybe most men, I don't know, as I'm not a man--do not find extreme skinniness sexually attractive. So the thin-is-sexier argument doesn't wash. Most men I know want women to look like women, not prepubescent boys.

No, this is about power. It's about wanting women to be small in the world, to take us less space, literally and metaphorically. This of course is not a new idea; it's one of the underpinnings of first wave feminism, and sadly it still holds true.

I think there's something else going on here, too. I think so long as women are obsessed with our weight and eating and body image, we aren't focusing on other, much more important things. Anyone who's ever had an eating disorder can tell you that while you're in the grip of one, you have no energy or concentration or ability to frocus on anything else. An eating disorder is a kind of closed loop. A dead end. Something to keep the circuits busy so they don't go exploring.

I think the cultural norms today around women and food and eating amount to an eating disorder, or at least highly disordered eating. Women's "place" used to be in the home; that was the 19th-century way to keep women down. Now, maybe, dieting and exercising and obsessing over weight is taking on that role.

Either way, the result is the same. So long as we're busy weighing ourselves, we will never measure up and never get any bloody real work done in the world. In that sense I think you're right: We, women, have to stand up to the culture, reject the pressure to be thin, protect our children from it.

It's not easy to swim against the current. But it's necessary.

So thanks for making the point. I'd love to hear what my readers think.

You tell 'em, Daniel Engber

In this article from the Dallas Morning News, Engber deconstructs a couple of the myths of the obesity "crisis." Nothing particularly new, but nice to see it in a big paper/national format.

When were you born?

I stumbled on this via Laura over at Eating With Your Anorexic, and expected it to be kinda silly.

To my surprise, some of it holds true for our family:

I have panic disorder; I was born in October.
My husband has dyslexia; he was born in July.
My younger daughter also has panic disorder, but she was born in July.
My older daughter had anorexia; she was born in February.

I have no idea what it means, though these people have attempted to make sense of it. Is this soothsayer science or is there some truth in here?

It's interesting to think about, either way.

18 minutes that will change your life

That's what watching this video will do: change your life. It will change forever the way you imagine your brain. The way you understand your relationship to the world, physiologically, psychologically, and spiritually. Watching this was one of the most profound experiences I've ever had.

Watch it, and tell me how it affected you.

Score one for FA

As reader Annie McPhee points out, the appalling article on the "Being Girl" website (that's not even grammatical, folks!) conflating the war on terror and emotional eating has, thank the Goddess, been removed.

It's a start. But this site still has plenty of egregious content up, including this, this, and this.

Come on, people! You can't write a piece bemoaning the pressure on girls to be thin and wind it up with these words of non-wisdom:

There's no need to eliminate any food you enjoy from your diet. Just learn to make trade offs and balance unhealthy foods with healthy ones. And keep on the move. The safest and most appropriate obesity prevention strategy is to get rid of those "automobile feet" and exercise.

This site can't decide what its prime directive is. Oh, wait, yes it can: to sell "feminine hygiene" products.

All this cognitive dissonance is giving me the urge to go eat some unhealthy foods. Pie, anyone?

Dangerous words

I know of people who have recovered from eating disorders at Remuda Ranch (don't you love the name? don't forget your 10-gallon hat, little lady). But I am no fan of places like Remuda and Renfrew, big profit-making chains of residential treatment programs. They're a real mishmosh of treatments, their long-terms statistics are crappy, and, most of all, they imply through their very existence that families are a liability, not an asset, when it comes to recovering from an eating disorder.

Now they've pretty much come out and said so.

And I'm glad. You know why? Because now at least it's out on the table. I'd much rather have someone say it out loud--Families cause eating disorders--than get the knowing looks, the condescending body language, the unspoken judgment.

The stigma of eating disorders is vile and deep. It kills people as surely as starvation does.

The first step to fighting stigma? Get it out into the open. See it for what it is. Name it. Yank it out of the closet of politeness and into the hard light of reality.

And then stomp the shit out of it.

Oh for fuck's sake

I was already feeling testy when Kate Harding forwarded me a link to this abomination.

Titled "What Does the War Have to Do With Your Weight?," it's an absurd conflation of talk about terrorism and overeating. The worst part is that it's aimed at adolescent girls.

Here's a wee sample from the opening paragraph:

Are you one of the millions of teens who overeat when they are under stress? If you are, we've got some good news and some bad news. The bad news is that rarely in history has there been a more turbulent time. Since 9/11, it seems as if the problems of the world are growing larger and scarier... and looming closer than ever before. The good news is that you are not alone. Fifteen percent of Americans confessed that after the towers fell, they turned to comfort foods while another 14% reported eating more sweets. Two months after the terrorist attacks, one in ten Americans had gained weight. Anyone versed in psychology is familiar with the relationship between mood and food.

If this was a writing assignment I'd give it a big red F for conflating disparate ideas that have nothing to do with each other (9/11, eating), for catastrophizing and distortion of facts (if 15% "turned to comfort foods," that means 85% didn't--a much more significant number), for piss-poor organization (the "good news, bad news" conceit is grossly inappropriate), and for failure to show cause and effect (even if 1 in 10 Americans gained weight after 9/11, it does not prove the central point here). We'll throw in a bonus point for that last line, which does a better job of rhyming than of proving any kind of point.

Of course, the next line is pretty over the top, too:

Whether it's the war with Iraq, hard decisions abut college, or troubles with friends, some of us use food to provide the good feelings we're missing.

I don't know about you, but I often reach for the Oreos when I think of the Iraq War. Doritos, on the other hand, are my comfort food of choice when I think of Vietnam. The Korean War takes me straight to the freezer for some Ben & Jerry's. World War II? Gotta be those Jello pudding cups!

It's more than just fodder for satire, though. The site goes on to suggest 9 ways for girls to improve their eating habits, including:

1. At the moment you grab for something to eat, tell yourself you can have it if you still want it but you have to wait 30 minutes. The craving may pass, you might get distracted, you might become wise enough in that half hour to find a more life affirming way of getting rid of that creepy stress.

2. Write down everything you eat. Icky, we know, but we also know there's no better substitute (except looking at yourself in the mirror naked), that's better than tracking what goes into your mouth to get you into the habit of thinking before you eat.

I remember strategies like these from Weight Watchers. And from my own daughter's spiral into anorexia.

One of the worst parts of the site (created by Proctor & Gamble) is an unmoderated discussion for girls. Some of the comments on the site made me want to weep.

To tell P&G what you think of its site, click here. (You have to give a birthday to send feedback; I always type in a fake birth date.)

I've been reviewed by someone named Calamity

And the news was pretty good. :-)

Off-topic but irresistible

It's good to know that leaving Wisconsin for New York will not reduce my opportunities for being cynical about our Fearless Leaders.

Everyone knows who's doing what here. But these darn midwesterners don't blab it to the New York Times. I guess.

Distracted

Apologies to regular readers for not posting much the last week or two. I've been in negotiations for a new job, and I'm delighted to say that beginning this fall I will be an assistant professor in magazine journalism at the Newhouse School of Journalism at Syracuse University.

Big changes for me and the family, including a move back east from the wilds of Wisconsin.

My head should be back in the blogworld pretty soon. :-)

Progress on parity

According to a press release from the Eating Disorders Coalition, eating disorders "were front and center" in the debate that ended with the House passing its own version of a mental health parity bill, 268 to 148. The House version is much better than the Senate version passed last year, but it's unlikely to be the one passed in the end.

Still, the fact that we're even talking about having a mental health parity bill in this country just blows my mind. It's about goddamn time.

I love this quote from EDC executive director Marc Lerro: “We made our points so often that members of Congress started making our points for us. In committee meetings, Republicans and Democrats alike described how parity could affect people with eating disorders.”

Now that's activism at work.

Another good quote comes from David Wellstone, son of the late Senator Paul Wellstone of Minnesota. He felt the Senate bill didn't go far enough and refused to let it be named after his father, saying, “My dad always believed that you can’t leave people out." The Senate version would not protect people with eating disorders to the same degree as the House version.

But it's a start.

SOTD: Anti-depressants don't work?

Today's Study of the Day comes to us courtesy of the U.K.'s Hull University, where an analysis of 47 separate trials purportedly showed that most treatment with SSRIs is little better than a placebo.

Here's the paragraph that caught my eye:

The study has credibility because it has included data which drug companies had chosen not to publicise possibly because it was less favourable than they would like, and it suggests that millions are needlessly taking powerful and potentially dangerous drugs.

I don't know if this is true, but it's a hell of a story if it is. Would it surprise anyone to know that drug companies withhold information?

On the other hand, I know people whose lives have been saved, literally, by meds for depression. I would hate to see a wholesale rush to drop them.

What do you think?

What will it take to change the system?

This is a question I ask myself a lot. What will it take to create a health care system that truly cares for all people, sick and well, young and old, healthy and not?

It seems self-evident to me what we need. But my eyes were opened a bit about the way the rest of the world sees it when I sat in on a class at the Center for Patient Partnerships here in Madison.

The guest speaker was a woman who's worked in health care policy at the national and state levels. She explained that in order to change policy, there must first be some shared perception of a problem. And she pointed out that for those who have great health care (say, our elected officials), there is no perception of a problem and so no incentive to work toward change.

Which makes it all the more clear to me that we need to raise our voices around inequities in the health care system. Add your story here if it's appropriate. If it's not, please send it to me. I think maybe we need another blog where we can collect stories of the inequities of the health care system--and then send them to every member of Congress as often as possible.

Make a call for mental health parity

Last week I learned, to my shock and horror, that because my daughter had anorexia, we cannot get health insurance, except through a large group plan (i.e., through an employer). We can't become freelancers and buy our own health insurance because, as our agent said, "You'll never pass underwriting."

What we need in this country is real true health care reform, not some bullshit foisted on us by the greedy health insurance companies. And I hope to God I live to see the day it finally happens. In the meantime, we can do something now by helping to pass a federal mental health parity law. The U.S. Senate has already passed its version; now the House of Representatives is getting ready to debate its version.

Please take a few minutes to call your Representative and advocate for passage of H.R. 1424, coming up for debate this Wednesday. The Eating Disorders Coalition--one of the most effective advocacy groups in the eating disorders world--suggests saying something like this:

I am a constituent of Representative ______ and a supporter of the Eating Disorders Coalition. I am calling to ask that the Representative vote for H.R. 1424, the Paul Wellstone Mental Health & Addiction Equity Act. Parity is a fair and affordable solution to insurance discrimination against people with eating disorders and other mental disorders. It will save lives and families.

But you can say whatever you want. Just make the call. Please. In this era of pressure politics it really makes a difference for the folks in Washington to hear from the little people.

The number to call is 866-727-4894.

(Not sure who your Representative is? Go to this site, click on the little hand on the upper left hand side of the page, and enter your zip code to find out.)

All of us who have found ourselves in DSM at one time or another thank you kindly.

What, if anything, can you say?

That's the question raised by Kate in the previous thread:

If we think intervening is good, maybe even if the person we see struggling with eating is a stranger, how are we supposed to approach it?

She's wondering about what to say or do when you see someone who is obviously struggling with anorexia, whether it's a stranger, an acquaintance, or a friend.

I can't imagine anything anyone could have said to my daughter when she did have it that would have made a difference. But she was 14 when she was ill. Is it different if you're older?

I would really like to hear from those of you who have struggled with anorexia. Was there anything that anyone said that made a difference to you? What was it? What advice would you give someone like Kate?

Anorexia: a portrait

WARNING: THIS POST MAY BE TRIGGERING.




You’re standing in a bakery. Not just any bakery—-let's say it's the best bakery in Paris. It’s warm, and the room is full of so many wonderful smells: cinnamon rolls, sourdough bread, pain au chocolate. Flaky Napoleons decorated with real gold leaf, the chocolate custard oozing from between flaky layers. Gateau, petits fours, elephant ears, all of them buttery and sweet and warm.

And you’re hungry. Not just a little hungry, not just wanting to eat. You’re starving. Your hunger is a hurricane blowing through you like a thousand fists, battering your insides. It’s a tiger clawing you, its claws sharpening on your insides. As you stand in front of the glass cases filled with beautiful pastries and cakes and breads, the tiger swipes at you again and again. Your stomach clenches and contracts. You swallow again and again.

More than anything you want what’s in those glass cases. You want to sink your teeth into one of those pastries, let almond filling ooze from the corners of your mouth, lick raspberry jam from your lips. You want to bite into an éclair, taste the rich custard, hold the chocolate against your tongue until it fills your mouth with sweetness. You know just how good everything would taste because you’ve been dreaming about it, night and day, for months. Other people come in and out of the bakery, buying white paper bags full of warm cakes. Other people reach into those bags, break off a piece of croissant, pop it into their mouths. But not you. Never you.

Because you are not allowed to eat. Though your stomach grinds against your backbone and your cheeks are hollow, though that familiar wind howls inside you all day long, you cannot eat. When you do, when you manage half of a fat-free yogurt, a pretzel, two grapes, the voice in your head starts up again. It hisses in your ear—how weak you are, how stupid and lazy and gluttonous. It shouts at you all day long: You’re a fat pig. You’re disgusting. You don’t deserve to eat. You don’t deserve to live. You don’t remember when that voice began. You can’t remember a time when it wasn’t inside you, always watching, making you suffer. The voice takes you inside your worst nightmare, to the scariest place you’ve ever been, a place you’d do anything to stay out of. So you don’t eat, even though food is all you think about, all that matters. Even though all day long, wherever you are—doing homework, sitting with friends, trying to sleep—part of you is standing in this bakery, watching, smelling, longing to eat, paralyzed with fear.

And you can’t leave the bakery, either. You have to stand here, breathing in those buttery, delicious smells, the voice growling softly in your ear. You have to stand here, longing for the pastries, terrified and alone. You have to stand in this bakery, shivering now, getting colder and colder and more alone while the rest of the world goes on, full of light and laughter and good things to eat.

You wish someone else could sweep into the bakery, cry, “Here you are!,” hand you a warm roll straight from the oven, and protect you while you take that first bite, the buttery taste of relief. You wish there was someone, anyone, who could shout down the voice, who could keep you safe. But there isn’t. There will be no rolls for you, no pastries, no feeling of relief and safety. There’s only the voice and its torments, and you, more alone than you’ve ever been. You, growing smaller and thinner and frailer. You can't bear the suffering. You want to die.

This is what it feels like to have anorexia.

Tapeworms, anyone?

You couldn't make this stuff up if you tried.

**Link from Asylum, courtesy of Abigail Saguy.

A little exercise for National Eeating Disorders Awareness Week

As I was reading this article on the "global obesity epidemic," I couldn't help thinking that it was in fact a blueprint for creating an eating disorder.

Let's take a closer look.

Wherever we read the words weight gain let's substitute the words weight loss. Wherever we read the word obesity, let's substitute the word anorexia. Instead of weight maintenance, let's go with weight loss. For prevent we'll say cause. For less, more.

Now let's look at the section of the article that talks about strategies for weight maintenance--I mean weight loss.

[The researcher] will argue that small daily changes, say using the stairs, are enough to cause incremental weight loss that can lead to anorexia. [The researcher], however, will make the case that much larger life-style changes - say exercising 60 to 90 minutes a day - are needed to cause weight loss.

"Our data from the National Weight Control Registry suggests strategies associated with successful weight loss include high levels of physical activity and conscious control of eating habits," said [the researcher]. "Dieters who remain diligent about diet and exercise are much more likely to gain weight back."

Examples of conscious control include frequent weighing, following a consistent dietary regimen across the weekdays and weekends, and taking fast action if small weight gains are observed. . . .



Actually you don't even have to change a lot of the language here, because the basic idea in maintaining weight loss is the same in inspiring weight loss. You've got to make changes in your life--in other words, you've got to behave in eating-disordered ways--in order to lose weight.

Frequent weighing, rigid eating behaviors, obsessive attention to dietary details. Yup. Sounds like an eating disorder to me.

And since this is, after all, a week when we are supposed to become more aware of eating disorders, I encourage you to go out and eat something and then not write it down. Have a second helping. Don't weigh yourself. Eat what you feel like. Stop when you're done.

In other words, eat normally--if we can even remember what that means.

A health insurer gets its comeuppance

in this story, sent by a friend, about a judge who ordered punitive damages for an insurance company that dropped a breast cancer patient in the middle of chemotherapy.

I'm particularly obsessed with health insurance stories right now, having just heard that our family would not make it through medical underwriting now because our daughter had anorexia. This story has nothing to do with food, eating, or eating disorders, but it's just so damn gratifying to see a health insurance company get called on one of its many out-and-out exploitative practices.

I'm always amazed at how self-serving these companies are--and how they get away with it. So yay! for the good guys. And a big thank you to judge Sam Cianchetti, who did the Right Thing and who I hope will be rewarded for his good judgment somewhere, sometime.

Now if we could just send the CEOs of companies like Health Net to jail for doing stuff like this, I'd be a happy girl.

In honor of National Eating Disorders Awareness Week . . .

. . . which starts tomorrow, why not treat yourself to one of Carrie Arnold's "Fork You, Eddie!" necklaces?

All profits go to the National Eating Disorders Association.

C'mon. You know you want to tell good ol' ED to fork off. Here's your chance to do it in style.

Now this is scary

I get a lot of e-newsletters these days from folks who work in the eating disorders field. And I like seeing what "the field" is up to.

The one that arrived in my mailbox yesterday, though, is so egregious that I must share, because I think it typifies so much of what's wrong with the way we think about food and eating these days.

First off, the newsletter came with a title that suggests that its goal is to empower parents to help heal eating disorders. Naturally that got my attention. It opens with a couple of abstracts of recent studies on eating disorders. That part was good. Then there's a plug for the writer's new book. Fair enough. All of us authors do that stuff.

But then--now remember this is all going out under the aegis of eating disorders--there's a list of "10 Healthy Eating Tips for Your Child." And here's where things get ugly.

1. Encourage your child to drink water. Lots of it. Drinking water is essential to losing weight as it keeps the metabolism healthy and functional. Plus, lots of kids feel the urge to eat when, in fact, they are not experiencing hunger, but thirst. Are you aware that drinking soda pop leeches the calcium from your child’s bones? Water is undoubtedly the better way to go!

Note the assumption* here: That "healthy eating" involves losing weight. For a child. Children should never be put on diets and should rarely if ever be encouraged to lose weight. This woman knows nothing about healthy eating. Or feeding children.

Plus, drinking lots and lots of water to feel full is a classic eating disorder strategy. I thought we were trying to heal eating disorders here, not cause them.

2. Is your child not crazy about drinking water? Why not stir in small spoonfuls of his or her favorite jam? Or squeeze in a bit of lemon with honey and you have made lemonade. You can make it festive with a mint leaf tucked on the side of the glass.

Have you ever known a child who wanted to drink water with a little bit of jam in it? Again, this is a strategy designed to fool the child into feeling like s/he has actually eaten something with calories in it. A big no-no in my book. You can't fool Mother Nature and you sure as hell can't fool the body.

I could go on here, people, but you get the idea.

* And you remember what Felix Unger said about assumptions: They make an ASS out of U and ME.

Now THIS is fat activism

If you haven't heard about Kimberly Brittingham's in-your-face (literally) fativism project in New York City, check it out here. I love this woman's chutzpah! She created a fake book cover for a book called Fat Is Contagious: How Sitting Next to a Fat Person Can Make YOU Fat. Then she took her book on the New York City buses, opened it, and observed what happened. Which was, of course, both hilarious, poignant, and ultimately heartwarming. Take a look for yourself.

I'd love to hear about other fativism projects like this. Remember the Guerilla Grrls, anyone?

The Bobaraba

That's a dance craze sweeping the Ivory Coast, and a tribute to the natural shape of many African women.

Ironically, the craze has spawned something of a black market in injections and creams designed to, um, increase the size of your bobaraba.

Which just goes to show that the U.S. has no corner on the personal transformation fantasy. Still, you've gotta love a dance that celebrates the tush.

Kitty

This month we celebrated Kitty's birthday. She was bummed because she got a lot of homework on the actual day, but she handled it well. We had one of her favorite dinners--takeout Indian, because our kitchen is in the midst of a renovation project and we have no kitchen sink, which makes washing up difficult. We had ice cream cake for dessert, by her request, and opened presents.

I couldn't help thinking back to her birthday two years ago, when we were in the midst of re-feeding. And that led me to thinking about where we would be today if we hadn't done what we did, if we'd followed a more conventional treatment plan for Kitty's anorexia. Would she be happy and healthy and as fully recovered as she is now? Would she be in a hospital or residential care program somewhere? Would she be at home, struggling and tormented as she was when she was ill? What would her life be like? What would our family's lives be like?

I looked at her younger sister, Lulu, her face shining with vicarious pleasure at the celebration (and also digging that cake). I looked at my husband, saw the lines at his eyes, the kind of lines that come from both laughing and crying. I looked into the mirrror and saw my own gray hairs, the new lines etched in my face.

And I smiled. I smiled into the mirror, and then I went back into the dining room and smiled at my family. At my beloved, imperfect family. We make lots of mistakes. We mess up. We say the wrong things. But at the end of the day we love one another. We fight for one another. We are stubborn and stupid and persistent as hell.

And our daughter is well.

Happy birthday, Kitty.

Cognitive dissonance

In response to another post, twistie wrote this about a Thanksgiving meal with her family:

I wanted to cry and my stomach rebelled at the cognitive dissonance.

The meal in question was one of those faux dieting meals--you know the kind, I'm sure. Where the "mashed potatoes" were really pureed cauliflower. Where the "lasagna" was really zucchini cooked in butter.

II can't count the number of faux dieting meals I've eaten in my life. I still remember some of those old Weight Watchers recipes, like the one for bread pudding that consisted of cottage cheese, almond extract, cinnamon mixed with Sweet 'N Low, and "lite" bread, mushed into, well, mush. You get the idea. It gives me the willies just thinking about it.**

At some point I simply could not eat another one of those meals. Could not. It's not because I'm such a gourmand that I couldn't bring myself to eat fake food. It's because, as twistie says, of the cognitive dissonance.

Lovely concept, cognitive dissonance. It refers to the mind-blowing distance between what is and what should be. In this case, food should be substantive. It should have enough calories to make you feel satisfied. It should taste good. It should look appealing. Faux diet meals do none of the above. Hence, they trip you right into cognitive dissonance.

So now I have an intelligent-sounding answer to offer the next time I am sitting at a potluck table and neighbors start whipping out the Weight Watchers "brownies," made with applesauce, cocoa powder, and aspartame: "No thanks, I'm allergic to the cognitive dissonance."


**If you're a veteran of 1970s and 80s WW and haven't seen Wendy McClure's hilarious take on those recipes, you are missing the laugh of a lifetime. Check it out.

Taking an SSRI? Read this

SOTD (study of the day):

Antidepressants of the future may work not on boosting serotonin, as SSRIs do, but on blocking a substance called GSK3ß in the brain. (OK, I had to copy and paste to get that funny little symbol at the end of the string of letters and numbers. I know it's Greek, but what is it?)

Pretty cool to think there's lots of room for improvement on the mental health front.

It's the real thing, baby

One of the first lessons I learned in intuitive eating was that substitutions are unsatisfying. That is, if what I really, really want to eat is a baked potato with butter on it, then a baked potato with margarine or olive oil probably isn't going to cut it. Neither is a pretzel. Or an eclair. Or air-popped popcorn. When you're tuned in to your appetite, you can't pretend you want something else.

That holds true whether what you want is a hot fudge sundae or a bowl of kale with sesame seeds, both of which I find delicious at various times. And if you give me the sundae when I want the kale, I'm probably going to keep on eating until I'm either overly full or I find a bowlful of kale.

Now a new study done by Susan Swithers and Terry Davidson at Purdue University now supports the notion that certain kinds of substitutions just make you eat more. (Scroll down the link page for a free PDF of the study.) They found that rats given yogurt sweetened with saccharin ate more, gained more weight, and developed more body fat than rats who ate yogurt with sugar.

In other words, you can trick your mind, but you can't trick your body. Any food is unsatisfying when it's not what you really want, and fake crap like saccharin, aspartame, etc. is especially unsatisfying. Unless what you really want is a mouthful of chemical aftertaste.

I'm sticking with sugar, myself.

The "Piggy You" diet doll

Just in case you thought you'd seen everything, take a look at this dinosaur: the "Piggy You" diet doll, patented in 1991.

The doll attaches to your refrigerator with magnets along its tush. The charming caption underneath it is meant as instructions, I guess. Instructions for self-flagellation.

I really don't think I can express my thoughts about this any better than Elizabeth Valeri already did. Except to say thank God this doll never made it past the conceptual stage. At least I don't think it did.

One reader's description of the war on obesity

"It's as if an anal retentive ED is running the world."

So well said, by Mary, that I thought it deserved its very own post.

Thanks, Mary.

Some of the right moves (maybe) for all the wrong reasons (definitely)

That was my initial reaction to the news that a British ban on marketing "unhealthy" foods during children's television programming is now being looked to as a model by other European countries.

The rationale behind the ban was that it would--can you guess?--help fight obesity in British children. It's a testament to the pervasiveness of fatphobia: Only the O word could be a strong enough incentive to go up against the powerful free-market forces that throw commercials at kids.

Under normal circumstances, to suggest that maybe we don't need to turn kids into little consumers is something like saying you're a commie pinko who doesn't believe in capitalism. (Which I don't, but that's another story.) But when you brandish the O word, it seems, even the junk food marketers hang their putative heads in shame and back off. A little.

That this comes in the context of a British government ad campaign to fight obesity that has no idea what it's doing is hardly surprising. In fact, the ad campaign is a perfect microcosm of everything that's wrong with the war on obesity in the first place.

Conflicts over how exactly to execute this campaign abound. As the New York Times reported yesterday,

The government, for instance, wanted to be able to keep junk food brands from using the [newly developed anti-obesity] logo, but the food industry wanted to leave that decision to marketers.

Already we're landed smack in the midst of the debate over what, exactly, constitutes healthy and unhealthy food. Which, I need hardly add, the British government is not going to resolve, because, as we keep saying here, there are no unhealthy foods. There may be patterns of eating that aren't so good for you, but we know what happens when you demonize certain foods as "unhealthy": They become ever more appealing and powerful.

This is just one example of the kind of ridiculousness the British government is about to get into. Some of the suggestions in its plan to reduce childhood obesity seem positive, like promoting bicycle riding (great!) and offering cooking lessons in schools (also great, if we're talking about real cooking and not what passes for school cooking, which is opening packets and boxes).

But I find it very telling indeed that it takes the dreaded O word to go up against the monied powers that be. Marketing to children is just plain wrong, folks, whether you're selling Barbie dolls, candy bars, or educational computer games. It's wrong because all advertising is a form of manipulation, and our cultural values didn't use to support manipulating young children. And they still shouldn't.

Meanwhile, the Brits are busy fighting over what the logo for this new anti-obesity campaign should be. I'd love to see what's on the table: A headless fattie with a red line through him/her? A piece of chocolate cake with a red line through it? How about a cutesy marketing jingle about not stuffing your face? Really, the mind boggles at the possibilities.

If only all this energy could be used for good. For making the lives of children and adults truly better, and not just a knee-jerk response to the latest hysteria.

If I ruled the world . . .

No one, including me, would spend any of their precious time in the world thinking about whether they were fat or thin.

Food would just be food--sometimes sensual pleasure, sometimes just fuel for going on with.

Obesity would carry no moral disgrace. Thinness would carry no moral virtue.

No one would diet.

Because no one would diet, few people would develop anorexia.

Those who did show the first signs of anorexia would be treated promptly, effectively, and compassionately--with food. They would bounce back quickly.

Families would be supported in supporting their children, whatever their issues.

Of course there would be no war. There would be good schools for all children and good health care for everyone.

Everyone would learn to dance.

Art would be just as important as math in school curricula and in the world.

Now how about you?

If I had a (smaller) hammer . . .

To a hammer, everything looks like a nail. And the proverbial hammer we often talk about is the BMI, a simple height/weight ratio that's more and more being used to identify and punish everyone from schoolchildren to the lederly for being fat.

Of course, BMI is a crude tool, a hammer, if you will, because it doesn't take into account muscle mass, or percentage of body fat, or anything beyond height and weight. So most athletes fall into the overweight if not obese category, according to BMI charts. Tom Cruise's BMI makes him obese, because he's short and densely muscled.

Now, finally, someone somewhere is paying attention. In a study published in Nutrition Journal, researchers at the University of Pavia in Italy did a small study looking at how weight loss recommendations would change for a group of people when they applied different measures of overweight:

The researchers obtained each person's BMI as well as body-fat measurements including waist circumference and total percent body fat. The also calculated a measurement similar to BMI that identifies fat mass called body fat mass index. The investigators then compared the percentage of the study group that would be told to lose weight according to each calculation.

BMI calculations, they found, identified 11 percent of the group as needing strong recommendations to lose weight and 41 percent as needing basic recommendations to lose weight. By contrast, waist circumference measurements indicated about 25 percent would need strong recommendations to shed pounds and 36 percent would need basic weight loss recommendations, Colombo said.

Moreover, 29 percent and 48 percent would have received similar weight loss recommendations according to total percent body fat measurements, while 21 percent and 54 percent would receive the same, according to body fat mass index.

The lead researcher, Dr. Ottavio Columbo, concluded, "Using criteria based on body adiposity (fatness) rather than body weight would result in a much greater proportion of the study population receiving recommendations for weight loss."

Yeah. We coulda told you that. But hey, it's a start.

Under-reporting eating disorders?

This study, just out from Rhode Island Hospital and Brown University, is not only interesting, it's important. And timely. And has implications for the way eating disorders are both diagnosed and treated.

Researchers went back through data collected from some 2500 psychiatric patients and looked at the incidence rates of various diagnoses of eating disorders. They found--unsurprising to anyone familiar with eating disorders--that the vast majority of diagnoses were for ED-NOS, or "eating disorders not otherwise specified."

This is a catch-all diagnosis for those who don't meet the strict diagnostic criteria for anorexia or bulimia. The study authors intelligently suggest that the fact that ED-NOS is the most common e.d. diagnosis (at least in their sample)

suggests that there is a problem with the clinical applicability of the diagnostic criteria in the DSM-IV eating disorder category.

Yes! Too true. Why does it matter? Let me tell you a story.

When my daughter became ill, at age 14, our pediatrician diagnosed anorexia. It was clear to all of us that that's what she had. Her weight was down to 75% of what it was supposed to be; she was in ketosis, she was afraid of all food and drink, she'd withdrawn socially--in short, she had a classic case.

Following good medical procedure, the pediatrician referred my daughter to a psychiatrist. Our insurance would cover only a shrink-in-training, a very nice woman without a lot of experience. My daughter spent our first visit, and most subsequent visits, with her head in my lap, sobbing.

I'm not sure which of the diagnostic criteria for anorexia the psychiatrist felt my daughter did not meet:

DSM-IV Criteria for Anorexia Nervosa

1. Refusal to maintain body weight at or above a minimally normal weight for age and height (eg, weight loss leading to maintenance of body weight less than 85% of that expected or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).
2. Intense fear of gaining weight or becoming fat, even though underweight.
3. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
4. In postmenarchal females, amenorrhea ie, the absence of at least three consecutive cycles. (A woman is considered to have amenorrhea if her periods occur only following hormone, eg, estrogen administration.)

My daughter definitely had #1 and #2 (though more on the wording of #1 in another post). She wasn't expressing #3, partly because by then she wasn't expressing much of anything, other than intense anxiety and fear. And she hadn't begun menstrual cycles yet, so #4 wasn't applicable.

In any case, the psychiatric fellow diagnosed her with ED-NOS--and you will be surprised to learn, as I was, that because they're classified as mental health disorders and appear in DSM-IV, only a psychiatrist can truly diagnose an eating disorder. The pediatrician's word counted for nothing.

The diagnosis informed our daughter's entire treatment with the psychiatrist, most of which consisted of useless attempts at anti depressants. The psych was convinced that if we treated the depression, my daughter's eating "issues" would magically improve or even resolve.

Why does it matter? Because we wasted a lot of time, and most of our precious mental health benefits, dicking around with this stuff. If the diagnosis had been anorexia, the psych could have looked up research showing that antidepressants are ineffective during acute malnutrition, and that depression is a symptom of anorexia, not a cause. She probably could have looked this stuff up anyway, but since she was never convinced my daughter had anorexia, I assume she just didn't go there. I don't know for sure what she was thinking, and it stopped mattering after a while.

Back to the study, which hypothesizes that many of the ED-NOS diagnoses are true cases of anorexia or bulimia that for one reason or another don't meet 100% of the clinical criteria. And that psychiatrists should take another look at the criteria and the cases.

I agree. And there's another implication, too: I'm convinced that the low incidence rates are one reason so few research dollars have been spent on anorexia and bulimia. Where are you going to spend your money, on a disease that affects 2 percent of the population or on one that affects 30 percent?*

So three cheers for the Rhode Island researchers, whose work, if somewhat obvious, is long overdue. I look forward to seeing how it might begin to change the clinical picture in eating disorders.



*I refer, somewhat sarcastically, to the proposal that obesity be classified as a psychiatric illness in DSM-V.

It is too genetic

Check out this new study, just published in the American Journal of Clinical Nutrition, in which British researchers looked at more than 5,000 pairs of identical twins and determined that

genes account for about three-quarters of the differences in a child's waistline and weight.

Here's the quote of the day:

"Contrary to the widespread assumption that family environment is the key factor in determining weight gain, we found this was not the case," said Jane Wardle, director of Cancer Research UK's Health Behavior Centre, who led the study.

So what does this mean? It means that maybe we can stop obsessing over children's BMI and focus instead on their OH--their overall health. It means that families can go back to making sure their children are healthy without all the woohoohoo about them being fat. Most important, it means that maybe, just maybe, we can start ditching some of the blame and shame about fat and pay attention to what really matters.

As the Dressing Room Project folks like to say, Worry about the size of your heart, not the size of your body. Amen, sisters.

Here's a PDF of the entire study. Have fun with it.

News flash: Oprah's gaining weight

Though I despise the culture of celebrity obsession, I found this story from the Orlando Sentinel to be of interest (well, most of it) because it raises in a public and visceral way the question at the heart of the weight-loss "debate."

To wit: If Oprah Winfrey, with all her money and personal chef and personal trainer, can't keep the weight off, who can?

According to the story,

Oprah, by her own admission, has tried everything.She tried the Atkins diet, she tried diet pills. She tried the Scarsdale diet, the banana, hot dog and egg diet. She tried a 1,000 calorie a day diet. She tried Weight Watchers, Diet Work Shop and Diet Center. She tried Nutri-System.

Yep, and still her weight goes up and down.

The story quotes a dietitian who says, "The longer you do this over the years and get into this classic yo-yo dieting syndrome, the more likely you are to end up with metabolic chaos." Thank you, thank you. It's nice to see the truth in print occasionally.

The reporter goes on to say

But the key to losing weight permanently, experts say, is to figure out why you overeat. Do you eat junk food when you're depressed? When you're stressed out from work? When you break up with a boyfriend or girlfriend? To figure out what triggers your overeating, keep a journal.

(For the record, Oprah has kept a journal for years -- and opined publicly about how you need to understand how emotions play into your eating habits. It's not clear how much it has helped.)

Maybe that's because fat people are no different from thin people when it comes to emotional eating. Show me a thin person who never takes comfort from a plate of warm mac and cheese or a slice of chocolate cake, and I'll show you someone who's lying--to themselves or to you.

Emotional eating is no different from emotional sex, emotional TV watching, emotional long-talks-with-a-friend. They're all part of life.

There's a difference between emotional eating and binge eating. I know, because I've done both. It's been about 10 years since I binge-ate, and in that time my weight has come down maybe 25 or 30 pounds. But I'd still be considered obese by the BMI charts.

It would have been nice if the reporter followed up on the ideas she raised--that very few people can lose a lot of weight and keep it off, that dieting is part of the reason. It would have been nice if the word genetics was mentioned anywhere in the story.

But it's a start. Of sorts.

Mississippi 282, RIP

From ClarionLedger.com:

A state lawmaker on Monday promised a quick death for a bill that would prohibit Mississippi restaurants from serving obese people.

House Public Health and Human Services Committee Chairman Steve Holland announced his intention to kill House Bill 282. The proposed legislation has outraged advocacy groups critical of the legislation and intrigued the national media.
"It's dead on arrival at my desk," Holland, D-Plantersville, said in a news release. "While I appreciate the efforts of my fellow House members to help curb the obesity problem in Mississippi, this is totally the wrong approach."

The bill filed by State Reps. Ted Mayhall, R-Southaven, John Read, R-Gautier, and Bobby Shows, D-Ellisville, would make it illegal for restaurants with more than five seats to serve people who are obese. The criteria for obesity would be set by the state Department of Health, and restaurants that do not comply would have their permits revoked.

The legislation has been referred to a subcommittee, where Holland said he will use a "pocket veto" to kill it. It would have advanced to his committee if it had survived.

Mayhall said Monday he wouldn't vote for the bill. He said he and his colleagues filed it to bring attention to the state's obesity problem, but he never expected to hear from so many people. Media from New York, Australia, London and Ireland have called him since The Clarion-Ledger reported on the bill Sunday, he said.

"You take food away from fat people ... my gosh," Mayhall said.

Obesity makes people more susceptible to diabetes, which puts a further strain on the state's financially-challenged Medicaid program, he said.

A 2007 report put the state's obesity rate at 30.6 percent - the worst in the nation.

Dr. Ed Thompson, state health officer, has previously said Mississippi's obesity rate cost Medicaid alone $221 million each year.

But the National Association to Advance Fat Acceptance issued a news release Monday blasting the bill as "a clear and shameless violation of (Mississippians') human and civil rights."

The group described itself as a "nonprofit human rights organization dedicated to improving the quality of life for fat people," and urged voters to boot the lawmakers who filed the legislation.

"These men are wasting their time, which is your money, and could potentially bankrupt your state. Are these the kind of men you want to continue to represent you?" the news release said.

In a separate news release, the Coalition of Fat Rights Activists president Paul McAleer said the bill would "have substantial and negative side effects on Mississippi's economy and health."

"Anyone who supports human rights and freedoms should be opposing this bill - and any subsequent bill," he added.

Cheryle Evans of Clinton said the legislation is "very short-sighted." She said restaurants should be required to provide details of calories, fat grams and carbohydrates on their menus instead. Evans also said more bike paths and sidewalks should be made available.

Holland, who has described himself as obese, said, "I am working on my own health issues, and I need to do that. I think (Gov. Haley Barbour's) take on this is a good idea. Let's all go walking instead of trying to tell restaurants who they can serve."

Barbour appears in television commercials that promote physical activity. Last session, state lawmakers mandated exercise and health education for students in kindergarten through middle school.

One Reason I'm not Voting for Obama

"Reducing obesity to 1980 levels will save Medicare $1 trillion." -- Barack Obama

Now a new study, as reported by Junkfood Science, calculates that reducing obesity actually costs governments more money in the long run.

What the study really points out, says JS, is the ridiculousness of coming up with such estimates in the first place. And I would add, the moral sledgehammer of using them in sound bytes, to make points that truly do not exist.

We've already had a president who fudges with spectacular ease and seeks to impose his own moral code on all of us. Please, let's not have another.**


**Oh, wait, do any of the candidates pass this test?

Quote of the Day

The "serious problem" [House bill 282] clearly calls attention to is the erosion of basic civil and human rights as war is continually waged against a segment of our population.


From the Association for Size Diversity and Health, in a response to Mississippi House Bill 282, which seeks to bar restaurants from serving food to anyone considered obese by the Mississippi state department of Health. For more, visit ASDAH's website.

For God's sake, repeat after me: There are no bad foods

That's what I feel like saying to the idiots who now want to "salvage" the ridiculous Mississippi bill that would prohibit restaurants from serving food to people considered obese.

Who will be labeled obese, and by whom? Let's not even go there. For now, let's stick with a higher power of absurdity, worthy of Beckett, and talk about the latest twist on this bill: Use it to Save the Children.

Forget about saving the adult fatties, according to this latest spin; let's stick to saving the innocent children. Under the new provisions, children would not be allowed to eat in certain fast food restaurants without a parent present. (Sounds like the concept behind R-rated movies, doesn't it? Do you know the danger you child is able to be exposed to?)

According to John Banzhaf, the idiot behind this new spin,

obese children would still be permitted to order most of the items on a fast food menu. "For example, at McDonald's, even a Double Cheeseburger and Quarterpounder, or a Filet-O-Fish or McChicken, has fewer than 500 calories. Those food items the child should not be served include: the Double Quarter Pounder With Cheese (740 calories), Premium Crispy Chicken Club Sandwich (660 calories), several deserts [sic], etc.

What's the cutoff here? 500 calories = OK, 600 calories = instant obesity?

Banzhaf, a professor of public interest law at George Washington University, needs a lesson in psychology. Actually he needs lessons in a whole lot of other fields, but let's start with psychology. Does the term forbidden fruit hold any meaning? How about banned books? See, we humans are constructed to always want what we cannot have.

And when it comes to food, that goes double. The biggest reason why 95% of diets do not work is that depriving yourself leads to later cycles of binging. You tell your body it can't have chocolate, and watch your chocolate cravings soar. Whereas if you tell your body, Chocolate's fine, no big deal, work it into your day if you really want it, well, your chocolate consumption will over the long term drop. A lot.

Do we really want a double quarter pounder with cheese to become the Holy Grail of a generation of children? Cause that's what will happen should your ridiculous plan come to fruition.

Here's another pearl of wisdom: The more we try to micromanage our metabolisms, the more badly we fuck them up. Dieting leads to eating disorders and even more weight gain. How about, instead of banning foods like they were chapters of Lady Chatterley's Lover, we invest in teaching children the joys of intuitive eating?

Oh, yeah, that would take a complete cultural paradigm shift. And it wouldn't make for such a great sound byte.


P.S. I don't eat at McDonald's; I don't like their food. My kids have never eaten there. I'm not a shill for the fast-food industry. I'm a reasonable human being who believes that people come in all shapes and sizes, that you can be fat and healthy, and that discriminating against and humiliating fat people seems to be the new national sport. Whatever happened to baseball?

And now, a word from NAAFA

Oakland, CA – The National Association to Advance Fat Acceptance, a civil rights organization fighting discrimination against people of
size strongly opposes the Mississippi House Bill 282. This bill
introduced by Representative W.T. Mayhall, Jr., a retired
pharmaceutical salesman with DuPont-Merk, and co-authored by Bobby
Shows, a businessman, and John Read, a pharmacist, would prohibit
restaurants with more than 5 seats from serving people who are
determined to be obese by standards set forth by the Department of
Health. Said restaurant owners who choose to ignore this bill if
passed into law would be subject to fines and/or closure. NAAFA calls upon the union leaders of the food service and hospitality industries to use your influence to stop this bill before it or others like it take your businesses down. If in fact
two-thirds of Mississippians are obese, such a bill could potentially eliminate two-thirds of your customer base, bankrupting an untold number of businesses and potentially impacting a high percentage of your union members/food service employees. NAAFA calls upon the restaurant lobby, gaming lobby and tourism lobby to
exercise your influence in stopping this disastrous bill.

NAAFA calls upon the people of Mississippi to stand up and make your voice heard. This is a clear and shameless violation of your human and civil rights. Flood your governor's office with letters, faxes and phone calls demanding that this bill be stopped in its tracks: Haley Barbour - Governor of MS - 1-877-405-0733 or 601.359.3150, or by mail at: P.O. Box 139, Jackson, Mississippi 39205.

Citizens of Mississippi, these state representatives are supported by your tax dollars. The 2000 Census says 16.2% of your state's residents make under $10,000 a year. The state poverty rate is around 20%. Wouldn't your tax dollars be better spent on representatives who are working to improve the income level of Mississippians? Your state consistently ranks in the bottom three in terms of public school successes. Wouldn't your tax dollars be better spent on representatives who are working to improve the educational system in Mississippi? Who do you think would have to pay for the enforcement of this bill if ratified? The very people who are no longer allowed to eat in restaurants! These men are wasting their time which is your money and could potentially bankrupt your state. Are these the kind of men you want to continue
to represent you?

Our own federal government recognizes that 95% - 98% of diets fail. Weight loss surgeons have admitted that only 5% of people undergoing weight loss surgery ever reach and maintain their weight loss goals. Depriving people of food does not cause them to lose weight in the long term and only increases the risk of ill health. Is our end goal good health and increased longevity or superficial appearance?

NAAFA calls upon every Mississippi citizen above the age of 18 to register to vote and remove these officials from office. Take a lesson from your own state's history. Demonstrate your distaste for prejudice and your disgust with discrimination by denouncing this bill.

Founded in 1969, NAAFA is a non-profit human rights organization dedicated to improving the quality of life for fat people. NAAFA works to eliminate discrimination based on body size and provide fat people with the tools for self-empowerment through public education, advocacy, and member support.

For more information: naafa_pr@yahoo.com

It's not how fat you are--it's how thin you think you should be

At least that's the gist of an interesting new study that's just out in the American Journal of Public Health.

Lead researcher Peter Muennig, of the Mailman School of Public Health at Columbia University, set out to examine the relationship between stress over being fat and physical and mental health, and found that

the difference between actual and desired body weight was a stronger predictor than was body mass index (BMI) of mental and physical health.

He and his team concluded that

some of the health effects of the obesity epidemic are related to way we see our bodies.


I'll forgo commenting on the assumption that obesity = unhealthiness and will instead applaud Dr. Muennig and his team for at least asking the question.

And I'll pose them another question: What if it's not just internal stress, but external stress? What if judgment and discrimination from the rest of the world affects the health of people who are fat?

We already know that it does, of course, judging by these firsthand accounts.

Might make a good next study for someone. I hope.

Meanwhile, here's more from the Conclusions section of the paper:

If our findings are correct, the policy implications may be counterintuitive. Foremost, if more of the association between BMI is perceptual, some public health messages that advocate idealized body types may be harming their target audience.

Ya got that right.

Concerted efforts to disassociate health messages, such as encouragement of exercise, from obesity stigmatization may circumvent the paradox.

Tell it to Rep. W.T. Mayhall, Jr., who introduced this lovely bill to the Mississippi legislature this week.

I wonder why fat people might feel stressed?

The Dressing Room Project

Thanks to Beth Kanell for tuning me in to this fabulous project, which describes itself as "a girl-powered rebellion to free girls & women
from the bonds of media-imposed standards of beauty."

My favorite one of their quotes, distributed on postcards and buttons:

Worry about the size of your heart, not the size of your body.

It's a little bit of guerilla grrls action. Check it out.

Fat and the law

Clearly I'm naive. I had no idea that it is legal in most places in the U.S. to discriminate against people because of their size or weight.

One reader kindly sent me the text of Wisconsin's discrimination law, as an example:

Prohibited bases of discrimination. Subject to ss. 111.33 to 111.36, no employer, labor organization, employment agency, licensing agency or other person may engage in any act of employment discrimination as specified in s. 111.322 against any individual on the basis of age, race, creed, color, disability, marital status, sex, national origin, ancestry, arrest record, conviction record, membership in the national guard, state defense force or any reserve component of the military forces of the United States or this state or use or nonuse of lawful products off the employer's premises during nonworking hours.

Nothing in there about size or weight, which makes it one of those little discriminatory loopholes we'd love to close up.

As a child of the 1960s, my first impulse is to stage a sit-in. Luckily, there are already folks working on this in much more sophisticated ways. Paul over at Big Fat Blog reminds me about COFRA's Fat Fifty project, which will aim, once it's up and running, to put every state's discrimination statutes, fat-related court cases, and other info on record as a first step toward changing them.

What a great project. And it means I don't have to reinvent the wheel or picket the Wisconson state capitol. Yet.

Y'all get involved now.

Follow-up

Thanks to everyone who posted advice for our anonymous reader. I got this email from her today, and post it here with her permission:

I have great news! I went into the meeting today with my girlfriend (not having the opportunity to have read any of the blogs on your site yet) and the rehab counselor was so sweet. She really focused on making up for the past Counselor's actions. Which was awesome for me. I didn't want to revisit that traumatic day at all.

My girlfriend and I felt no homophobia at all. I went in as my confident self and it seems like she approved me for their services. Because from how she was talking, she talked about the future. Not using the word "if," she used the word "when" repeatedly: When we work down the line together, or when you receive future correspondence, do this and do that. She's mailing me my plan. Wheeeeeee!

I am so so so happy. I can get past all of it and not have to deal with the trauma so much. No lawyer would take it because it's not illegal to deny based on size or weight. Which really is wrong because it's my disability that took away my active life and the weight poured on. I felt I had to fight and fight and that's something I can't do now, I'm fighting three other discrimination situations. I am a bubbly person, I am a fighter, but a person can only handle so much in life before you lose the happiness or time for family. I feel like my own Erin Brockovich. It's hard to encounter so much daily hatred for being fat, lesbian and in a wheelchair. I can handle hatred, it took me from being bitter, to making me stronger, it isn't right or humane, but it is what it is. I can only pray to God for strength and remember The Serenity Prayer everyday.

My goal in life is to help people. I am not in it for me, I want to do social work. Well, I guess feeling great about helping others is in it for me. I did on my own get my local post office to widen their doors and they did a whole reconstruct for disabled people. It took me half a year, but the disabled can feel like everyone else and buy stamps or conduct business. Woohooo!

I really love people and I try daily to be kind, generous and loving to people and that teenager or that old person who looks at me and laughs, snickers, or rolls their eyes, I thank God for, because it makes me thankful to be alive! To feel. To appreciate the people who do love me and accept me. Thank you, bless all of you, and I will keep you posted.

A happy ending, at least for now.

But tell me, the lawyers among us, is it truly legal to discriminate based on size and weight?

Advice for a reader? Please weigh in

I got the following email from one of my readers. Names have been changed or omitted to protect her privacy. Any advice for her?

I live in [state name removed]. I am fat and lesbian. I am disabled and use a power wheelchair for assisted mobility for my daily needs. I have been able to get myself enough courage to apply for city college courses, but I didn't get enough funding from financial aid, so I was directed to go to the Deptartment of Rehab by my local Center for Independent Living Advocate.

I called Rehab and made the appointment. I met with the counselor last October. My girlfriend was with me and from the moment the counselor laid eyes upon me, he gave me this disgusted look. He made his decision to deny me services in his mind but invited me into the office. He took five minutes interrogating me, belittling me and then said you're too fat, too disabled and no one will ever hire you in a wheelchair. He said the only way I could get help from Rehab was to get gastric bypass surgery and lose the weight first. He continued to cut me down by saying I was no better than a criminal who gets out of prison and asks him to buy his clothes, shoes and socks.

My girlfriend was there to get help too, but he scared her so badly she was afraid to say one word to this militant gatekeeper. I am so traumatized still by how he was to me. I immediately complained to The Center for Independent Living and I was told to complain to their CAP Advocate. I complained to him and he has yet to help me. I feel discriminated against because of being fat and lesbian. Since October the CAP Advocate has been playing games with me; I went to his supervisor and he too won't call me back or do anything.

I called Rehab, complained, and got a new counselor, a woman. I am supposed to meet up with her tomorrow and I don't know what to expect. That denial of services in Oct. 07 caused me not to be able to start school Jan. 08. Now, I want to start college in the Fall 2008 and this replacement Counselor can do the same and ruin my chances based on my weight, disability and sexual orientation.

I refuse to get down and depressed. I am going to stand up for what I know is right. I've worked all my life being fat, it never affected my work. I excelled at anything I did. Just because I'm in a wheelchair shouldn't matter with non manual labor.

What do you think I should do?

--Worried and Upset


Anyone out there know the law on discrimination or have any practical advice for this reader?

And while we're on the subject of mixed messages . . .

Read this story from a news station in Tennessee.

They can't quite get the story straight, can they? Is it the scary overweight teens, or is it the scary eating-disordered teens?

Oh, and P.S.: By the time you notice changes to someone's hair, nails, and teeth, they're deep in an eating disorder. If you want to be helpful to parents, give them some earlier warning signs to look for, like preoccupation with cooking, excuses for not eating, cutting out whole categories of food, using the bathroom after every meal, etc.

Miss America

Kirsten Haglund, just crowned the new Miss America, talks movingly about her recovery from anorexia at age 16 here.

She doesn't talk about how much she weighs, to avoid triggering other teens. She does talk about having curves, and liking them. She alludes to the horror of anorexia without going into other details.

I'm no fan of the whole Miss America pageant thing. Still, I'm with her right up until the line where she's quoted as saying that while she isn't about to "let myself go," she won't be skipping any meals.

Kirsten, you have the chance to do a lot of good as an emissary from the hellish lands of eating disorders. Please, next time, skip judgments like this. Remember that bodies come in all shapes and sizes, and that many of the young women you'll come into contact with this year will never, can never look like you. And that that doesn't mean they've "let themselves go."

Use your powers for good.

An incredibly sad story

This interview with a nun who's been anorexic for 50 years is one of the saddest things I've ever read. Sad because of Sister Marie Therese's childhood experiences, which no one's child should ever have to go through. Sad because of her tormented young adulthood.

Most of all, sad because of these lines:

Anorexia has been a part of my life for more than 50 of my 61 years. It has been a friend really. Having it is like being with somebody who takes away your feelings.

For parents whose children are struggling with anorexia right now, this is what's at stake. This is the reason to tackle the demon of an eating disorder head-on, right now, while your child is still in his/her teens, while s/he can still recover and go on with a normal life.

This is what no parent wants for their child.