Saturday, September 01, 2007

Why intuitive eating works

This just in from an article published in today's edition of the Journal of Physiology: ". . . during a reduction in energy stores or circulating nutrients, the brain initiates responses to restore and maintain energy and glucose homeostasis. In contrast, in times of nutrient abundance and excess energy storage, the brain promotes reduced food intake and increased energy expenditure."

In other words, deprivation makes your brain and body store fat. But having access to plenty of food can lead to eating less and moving around more.

This has always been my experience. When I give myself permission to eat what I'm truly hungry for--and stop eating when I'm satisfied--I eat less than when I go into deprivation mode.

It's interesting to know that there's neurobiology at work. The human body is a wonderful thing.

Friday, August 31, 2007

F as in Fat, K as in Knee-Jerk

On our last morning in Utah I picked up a copy of the Salt Lake City Tribne and was appalled (but not shocked, alas) to read an editorial based on the Robert Wood Johnson Foundation report mentioned a few days ago. Its concluding paragraph:

If you're "F" as in fat, you'll be "D" as in dead.

Talk about scare tactics. . . .

I haven't done a search, but I wonder how many other newspapers picked this up and ran with it.

Thursday, August 30, 2007

The good doctor

After reading fillyjonk's recent post over at Shapely Prose, and all the comments that followed, I realized it's time to say thanks to my wonderful internist.

So here's to you, Dr. Nancy Fuller, for being the kind of doctor who has never slapped the scarlet O on me. To you I am a patient, not an unacceptable number on the scale. I've brought all kinds of health issues to your office, from panic disorder to hot flashes to headaches, and never once have you said or implied that it's All Because I Need to Lose Some Weight.

Thank goodness you are not Dr. Sanjay Gupta, who writes in Time magazine, "Obesity, of course, means a higher risk of heart disease, diabetes, hospitalization and early death, so how come doctors are so lax about putting the scarlet O on the chart?"

How come indeed, Dr. Gupta?

Could it be that some doctors look beyond the numbers on the scale to a patient's true health? That they know all too well that putting a patient on a a diet through scare tactics will almost always backfire, winding up with the patient heavier than they already are? That shame is not a good motivator, and neither is fear?

Could it be that some doctors are not as egotistical as you, who seem to to believe that those who are fat don't really know it until it's pointed out by a doctor?

Could it be that some doctors have gone a little deeper into the subject, and know that fat does not always (or even usually) equal bad health? That fat can be fit and healthy, and thin can be unhealthy?

I far prefer my good doctor's approach. She takes time to talk with me, listen to me, guide me toward healthy choices in all ways. When I walk in the door she sees me, not just my measurements. And so I trust her.

And that's the basis of a healthy doctor-patient relationship.

Tuesday, August 28, 2007

Another missed opportunity

The Robert Wood Johnson Foundation has just come out with a report, "F as in Fat: How Obesity Policies Are Failing in America in 2007," in which it makes the same tired (and superficial) observations and beats the same dead horse some more. According to the report:

* Adult obesity rates rose in 31 states last year.
* Twenty-two states experienced an increase for the second year in a row; no states decreased.
* A new public opinion survey featured in the report finds 85 percent of Americans believe that obesity is an epidemic.

This last one made me laugh out loud. And this proves what, exactly? That most Americans will believe anything the media spoon-feeds them? Deep into George W. Bush's second term, we already knew that. But I digress.

* Rates of adult obesity now exceed 25 percent in 19 states, an increase from 14 states last year and 9 in 2005. In 1991, none of the states exceeded 20 percent.

Of course the report fails to mention the change in the BMI chart that created millions of new overweight and obese people overnight. Oops--I digress again.

* "There has been a breakthrough in terms of drawing attention to the obesity epidemic. Now, we need a breakthrough in terms of policies and results," said Jeff Levi, Ph.D., executive director of Trust for America's Health.

You got that right! You'd think that maybe this would be the moment to stop, take stock, and say, Wait a minute, maybe we're fucking up here. Could it be that we're actually making things worse by flailing around? But no. Levi went on to say, "Poor nutrition and physical inactivity are robbing America of our health and productivity."

Give me a break. He's just parroting the conventional lack of wisdom that says all fat people are couch potatoes eating junk food and watching TV.

The press release goes on to tout other "key findings":

* Twenty-two percent of American adults report that they do not engage in any physical activity.

But there's no context for this. Has this changed? I think people are more physically active now than they were 20 or 30 years ago. When my grandmother and mother were my age, they weren't out hiking the Utah mountains or dancing all night. They didn't go to the gym, jog, or play softball. And yet we're the ones who have the "obesity epidemic."

Once more, an opportunity for reflection and going beyond the conventional wisdom--sadly missed.

But the report does more than list problems. It proposed solutions. Solutions like this one, which tops the list:
* The federal government should develop and implement a National Strategy to Combat Obesity. This plan should involve every federal government agency, define clear roles and responsibilities for states and localities, and engage private industry and community groups.

I don't know whether to fall on the floor laughing or be truly frightened. And what about this:

* Federal, state, and local governments should work with private employers and insurers to ensure that every working American has access to a workplace wellness program.

I don't want a workplace wellness program, because what I know about them is that they're as much a joke as school wellness curricula. They exist to penalize workers who don't measure up to the approved guidelines, through surtaxes for those who are overweight, for instance. Unless they're paying for health club memberships for employees, and giving them an hour and a half lunch to go work out, I don't want to hear about it.

If RWJF has its way, our already eating-disordered culture would go beserk. Talk about obsession--they want to get the whole freaking government involved.

What a nightmare.

**Read the press release yourself at, which also has a link to the full tet of the report. Sorry I can't link it--still remote blogging.