Smorgasborg of weight in television

Sometimes, I get so tired of all the weight loss shows on television. Though the shows all claim that it is about health, there is always a focus on numbers.

We'd all agree that the The Biggest Loser finale certainly focused on numbers. Many bloggers, including myself, have talked about this show and the misappropriate message it is sending to the public. Last night was the season 7 finale. Helen Phillips, a 48-year old woman from Michigan, took the prize of $250,000 after losing a percentage of more than half her body weight. Looking at those finale photos, my eyebrows raise, reminding me just how much someone will do for a cash incentive. Of course, I cannot say this was her sole motivation, but clearly, there wasn't much of an appearance of "health." This also included the at-home winner, Jerry, the oldest contestant, who looked like he had aged 20 years.

So this begs the question, does the Biggest Loser finale cause eating disorders as the tvsquad suggests.

The sad thing about all this is 1) I couldn't believe I kept thinking, "well, crap, she weighs less than me" and 2) The Biggest Loser is slated for another season next year.

Since the Biggest Loser has become popular, another new show coming to the Oxygen network is hoping to prove to be just as successful. Dance your ass off combines both the aspects of the Biggest Loser and Dancing with the Stars. In this show, contestants are paired with a professional dancer and nutritionist. Each week, they perform a dance and receive scores from judges. Combing the judges' scores with how much weight loss they had during that week, determines elimination. Hmm, I just don't think this is sending the greatest message either to a general audience who craves weight loss.

On a positive note here, I caught a few episodes of the Wetv show, I want to save your life with Charles Stuart Platkin, aka the "Diet Detective." Platkin, a nutrition and public health advocate, performs health interventions on various individuals/couples each week. Platkin spends a week with the individuals, educating them on nutrition, exercise, and general well being. He leaves it up to them, and then returns 3-4 months later to see how they have progressed.

What I liked about this show was that there was a general less overall emphasis on weight. It did seem to be more geared towards a healthy lifestyle. In the show, he did not advocate for 6-8 hours of exercise a day but a much more reasonable amount for weight loss. There was more a realistic approach to getting exercise any way you could then simply hours in the gym. With eating, there wasn't an extremist ideology, but instead making health conscious choices. I wish more people watched this show, as there was much more of a realistic approach to weight loss.

Lastly, today's Dr,. Phil had an episode on eating disorders. I didn't see the entire episode, but did read through the show. In general, Dr. Phil did seem to have a little of an understanding on the plight of eating disorders. This specific show focused on a set of twins, one of whom had an eating disorder. Cynthia Bulik, researcher and author of Crave, was also in the audience to help both the eating disorder individual and the family with informative, helpful insights.

Thoughts on any of these shows?

Anti-junk food law in Korea

As most of us know, reports of obesity in children have risen worldwide, and it seems more and more countries are placing stipulations on foods, especially "junk" foods. In 2006, there was a big push to eliminate sodas from schools in the US.

A year later, Korea followed suit with similar measures in banning sodas in schools. And now, according to KoreaBeat , the blog for Korean news in English translation, an anti-junk food law went into effect 21 days ago. The purpose of the law is to prevent the selling of high calorie, low nutrition "junk" food, like sodas, hamburgers, and ice cream sold near schools. The government hopes this will help children to curb their "junk" food eating habits. Unfortunately, this has backfired since the nutrition regulations are not very standardized and have been delayed for some food items, causing much confusion within the vendors.

According to one middle school girl whose school ejected vendors last year, there has not been change in students snacking habits between meals. Another girl said there was an increase in students bringing instant ramen noodles from home or just buying sodas and snacks at a convenience store.

I find this interesting since you really don't hear much about what other countries are doing to stymie the "obesity" epidemic in their countries. It seems everywhere, the same notion is implied--junk food is bad, soda is bad, greasy foods are bad, sugar is bad, fat is bad, etc. This just breeds children who will begin to fear everything, and that is not a healthy view to give. I wonder if Korea and other countries will follow suit with posting calories on menus like several cities in the US (UK has as well) have or propose an "obesity" tax on non-diet sodas, or ban trans fats, etc.

In the end, I don't know how much any of these measures really solve the overall problem. This is not to say that some of these efforts aren't made with good intentions, it's just that they do not seem to be properly thought through, creating many other problems to occur.

Note:--*It's a bit ironic, but a small study suggests that junk food make make kids fatter but happier
*Removing sodas in schools was stickier than thought in some places.

Horrible headline

A headline from Reuters reads: Stay slim to save the planet.

The brief article goes on to say how overweight people eat and travel by car more frequently, therefore are further contributing to the worsening environment.

According to British researchers, Phil Edwards and Ian Roberts who published a study on this in the International Journal of Epidemiology, "We need to be doing a lot more to reverse the global trend toward fatness, and recognize it as a key factor in the battle to reduce (carbon) emissions and slow climate change."

While I agree we all need to be doing things, like driving less (and yes even thin people do drive a lot) to save the planet, playing the blame game is not necessary nor cool in my opinion. I hate when articles pull this kind of crap.

Anyway, if you are interested in saving the environment (think early Earth Day post), here is a list of 50 simple things to do to stop global warming and a global warming survival guide from Time.

Note: *some of these are repetitious but still good reads

Obesity "epidemic" may be overstated

It's nice to read every once in awhile that people need to rethink the obesity epidemic as so many of us have already stated. In this article, sociologist Samantha Kwan of the University of Houston says the obesity epidemic may be overstated and is more of a moral panic. Kwan says:

"This epidemic has been constructed to the benefit of the medical industry that has in part medicalized the treatment of obesity over the years. While there may be a rise in 'obesity,' the BMI is not always accurate. Some scholars describe this epidemic more as a moral panic. While there may be some truths to rising rates, they have been overstated."

Unfortunately, you don't hear this much but rather just how significant the obesity rate is. I still often wonder if this obesity hysteria would not have been so dramatic had the BMI cut offs for branding someone "overweight" been lowered. To me, there was a correlation between that and the mass thinking of the obesity epidemic.

Schools and calorie boards

Within the last few years, there has been a big push to put calories on menus to fight the "obesity" epidemic. I'm sure most of us have heard about it. In mid-February, a Federal Appeals court in New York upheld the ruling of posting calories on menus. Though some chain restaurants have already been doing this, it is now required if there are 15 or more outlets. California and Philadelphia have taken similar regulations with effects occurring next year. Even the UK has gotten in on this bandwagon.

With large states taking this action, it seems like it is happening everywhere. Posted calorie menus have been seen on college campuses (though Harvard removed theirs) and now even in school districts. Case in point, in North Carolina, some districts are going high tech in presenting nutrition information, including some with calorie and fat numbers. Amy Harkey of the CMS Child Nutrition Services says, "Food can be fun for kids, and I think that message needs to come across. We don't want to burden them with too much."

While it's true that food can be fun and should be, how would presenting a blaring neon-type board with calorie counts not be burdening to children? This only emphasizes dieting, a pre-cursor to eating disorders and unhealthy body image. Though I think it is is important to have some general information, like ingredients of wheat, soy, seafood, peanut for those with allergies, I think listing calories is unwise. Schools need to figure out an alternative way of passing along nutrition information. I can guarantee that this will only cause more harm than good on an already vulnerable population.

Future dietitians and weight bias

I came across this disturbing article the other day about weight bias among future dietitians. A new study in the Journal of the American Dietetic Association showed only two percent of future dietitians have positive or neutral attitudes towards obese individuals with the rest moderately biased.

Dietetic students were asked questions about both a normal weight male and female as well as an obese male and female with the same health characteristics other than weight. The results indicated that the majority of the 182 students who participated viewed obese patients' self control, attractiveness, eating habits, compliance to treatment, self-esteem, and insecurity negatively.

Although this may show that dietitians are not immune to weight bias, this can impact treatment negatively. What patient wants insensitivity by a professional? How can a patient learn to trust her/his dietitian and get though the treatment plan?

This makes me wonder what dietitians think of eating disorder patients as first impressions. Do they think we are all stubborn, non-compliant? Do they feel some of us are too thin or too fat to be there? Whatever stereotype a dietitian or any other professional may hold affects both the patient relationship and treatment in the long run. No one needs stigma held over them. Perhaps, stigma reduction classes, similar to medical students compassion training classes, should be implemented into in the class curriculum, as well as positive role models and mentors who do not reflect weight bias.

Note--this is only a small study with a mostly Caucasian group, so there might be differences in ethnicity attitudes. This also can obviously not be a clear generalization, as with any profession, there are always the good apples and the bad.

Obese toys?

Dr. Deb recently posted about the Active Life Movement, a Texas-based non-profit organization, encouraging healthy, active lifestyles for children. Their current campaign, entitled "Keep obesity away from your child" uses obese toys like this to promote their message.

While I can understand the message this group may be attempting to send, I think there are more educational ways in showing it. Why does everything have to be about the negative, including their awful tagline?

What's your opinion? Is this the right way to go to encourage healthy lifestyles for children?

Other toys used can be seen here: pirates and superman

Preventing youth smoking: tell them they could become fat

stock.xchng
This article caught my eye today. Now, we all know the effects of smoking on one's health. There are a number of illnesses that can cause damage later in life, including a variety of cancers and heart disease. Experts are always trying to find ways to prevent youth from starting the smoking habit. The latest now is that by smoking in adolescence, there is an increased risk of being fat later in life. They feel this may be more effective than mentioning the risks about heart disease, diabetes, and lung cancer.

This thinking is all based on an upcoming article in the American Journal of Public Health of a long-term Finnish study of 4300 twins. The study looked at their smoking habits as adolescents and their body shape in young adulthood. Of the 12 percent who smoked during adolescence, 24 percent of men and 11 percent of women were overweight in their early 20s. These results were independent of health habits, participants' body weights, and genetics. Females who also smoked at least 10 cigarettes daily during adolescence had double the risk of becoming overweight as their non-smoking counterparts, according to this study.

While it is true that teenagers certainly feel as though they are invincible, I don't know that telling them they could be fat later in life is a better alternative for the prevention of smoking. This is yet another reminder how fat phobic we are as a society and this only provides a mere scare tactic.

Toddler gym equipment?

image: dailymail

I came across a blog entry in the RW Daily about toddler treadmills. Yes, treadmills for those little tykes to combat childhood obesity. These treadmills first came out in 2006, made by the British company, Gymkids. This company also makes toddler and junior bikes, rowers, steppers, riders, etc. for kids ages 3-11. According to this Canadian article, the bikes even have read outs of time, distance travelled, and amount of energy expended! What young child needs to know that? Better yet, how is this going to help children develop good exercising habits?

This is when I think people need to be reminded of playgrounds, parks, fields to run in, all those sorts of things for young children, not exercise equipment. Children need to be children, not mini adults.

Is there harm in telling parents their children's weight?

I read this article today, published in Pediatrics about how there was little harm in telling parents their children were overweight. The article was from a survey in the UK looking at the National Child Measurement Program in which parents are told their children's weight upon request. While it may be true that a small percentage of parents and children were not upset about their weight feedback, I still question the repercussions of the children.

The study says that 96% of the children (ages 6-7 years and ages 10-11 years) said being weighed was "okay" or enjoyable and about the same percentage said they would be measured again in a year. Of those, 10% of healthy weight and overweight children did not like being weighed. 15% of healthy and overweight children did not want to be measured again in a year. And most of the ones who responded negatively were older which would be about right at the beginning of puberty for some.

The article also says that there was only a slight increase in restriction of food by parents of overweight girls, but that it wasn't apparent that parents were becoming overly vigilant about their eating habits after feedback.

There's a lot missing in this survey. Even if about half of the parents of overweight children changed their dietary and physical habits after feedback was given of their children's weight, there is no indication of how they did this, how they told their children, and whether it was merely to be "healthier" or to just lose weight. I think these are all important questions to ask. There's a lot to be said for how parents and other professionals talk to someone about weight. And I think with children, the utmost of care ought to be given with little emphasis on BMI or a number on a scale.

BDNF and onset of obesity

In this week's New England Journal of Medicine, there is an interesting study looking at the brain-derived neurotrophic factor (BDNF) and its relation to obesity. BDNF is a protein encoded by the BDNF gene. BDNF's role in the brain is to help with learning, higher thinking, and memory, especially long-term memory. Studies have looked at the role of BDNF in energy homeostasis in animals but never in humans.

This study looked at a subset group of individuals with WAGR syndrome, a rare genetic disorder which puts people at risk for eye disorders (Aniridia), certain types of cancers (Wilms tumor based in the kidney), genitourinary anomalies, and mental retardation. In normal people, there are two copies for the BDNF gene, however, those with WAGR syndrome have a deletion in one of the copies, therefore having a lower BDNF. The results showed that all of them with this deletion had onset childhood obesity by age ten and had a strong tendency towards overeating.

The importance of this study is not only looking at genetics but also the role of BDNF on obesity and appetite control. Also to note, BDNF may be indirectly controlled by leptin.

Abstract

FYI: There is a prospective article in this week's New England Journal of Medicine that may be useful to some readers who are interested in dispelling the myth that obesity is only based on lifestyle choices. The title of the article is "The power of the extreme in elucidating obesity" by Philippe Froguel and Alexandra Blakemore. I just read the first 100 words, and it sounds like an interesting article.

Perceptions and our pets

I'm on a roll with thinking about body perceptions and how we perceive them. This next post is about how we view body image in our four-legged friends. Yes, I know this may sound odd, but again, I'm wondering if those of us with body image issues have a different ideal for our pets than the rest of the population. Are we able to distinguish between thin, normal, overweight, obese in our pets? Are we more vigilant about our pets' health even though we compromise our own? I'm seriously not trying to dumb anyone down, so I hope these questions aren't offensive. They really do have a point.

Recently, my boss loaned me her back issues of BARk magazine, a magazine of modern dog culture. It's actually a fairly interesting magazine with a wide variety of topics. In this 2006 issue, it discussed canine obesity and how it was mostly a human perception problem. According to this article, 34 percent of dogs are overweight but only 30 to 40 percent of their human caretakers realize it. This 2005 study about the prevalence and risk factors for obesity in dogs and cats (may have been the same one the article used) also said how vet practitioners commonly underreported animals who were overweight or obese.

So how are pets assessed for obesity? Well, since there isn't a BMI calculation, it becomes more individualistic. At times, it is obvious to see the body condition of an animal and tell whether it is too thin or overweight. However, if there is a lot of fur, this can easily deceive the pet owner. The standard measurement is to check their bodies around the ribs. An ideal pet has a small layer of fat over the rib bones, however, the rib bones are sufficiently felt. Usually , a "waist" is also easily visible. Pets who on the thin side can have rib, spine, or hip bones easily felt since there is no fat. Pets who are overweight or obese, none of these can be felt without some pressure.

Like humans, there are various reasons why pets gain weight. Genetics of certain breeds, reproductive status (spayed and neutered), hormones, and their human/canine lifestyle (think lack of exercise for many companion animals) are all reasons for weight gain. In reality, it's quite amazing how much our four-legged friends resemble many of the same characteristics as humans, including similar diseases like diabetes type 1 and 2, cancer, hypothyroidism, Cushings's, disease, etc. In animals who are overweight or obese, problems such as osteoarthritis, respiratory, cardiovascular, and dermatological can occur. Some studies have also shown a correlation with high body fat mass and longevity in dogs. (AVMA collections of obesity)

As the reports of obesity in pets has risen over the years, new weight loss products have come onto the market. Slentrol which debuted in 2007 was the first to be approved by the FDA. The key mechanisms are reduced appetite and fat absorption. Though this is the only actual medication for dogs and obesity, there are other products labeled as "natural" to help your pet. lose weight. I'm sure, just like humans, there will be other drugs researched as well. Although I have not heard of gastric by-pass surgery for pets, there are people who have actually asked about it! It's kind of a scary thought.

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Now, that I've given some background information, let's look at human perception versus dog perception. Something funny that Dr. Marty Becker, a well known veterinarian, said in an article for The Whole Pet was,

"No pet is going to catch sight of himself in the mirror and see that hairy derriere and say 'That's it! No more Scooby snacks for me!' There is no canine bikini season, and they don't try to get into last year's jeans and find they don't fit."

Animals for the most part do not have an image problem like humans do.One question I've seen asked is if animals can be anorexic? Yes, anorexic in the medical sense of losing appetite. The nervosa part, however, is not obtainable.

In most cases in terms of eating, it's about survival. There's the line, "dogs eat to live not live to eat." For the most part, it's true, although sometimes I question it as some dog sand cats do appear to live to eat. For some if they could have as much food as they wanted sitting right in front of them, they would eat it in a heartbeat and not think about it or have "guilt-associated" feelings with it. For many, the time elapsed between eating too much and an actual ill event is too long to make an associative cause since they do not have a "conscience." Whenever I think about this, I am reminded of one of my own dogs who ate five pounds of chicken in a sitting or two pounds of organ meat in less than five minutes or the dog I knew who ate over a pound of candy, then suffered an allergic reaction, only to still eat its dinner twenty minutes later. All of them looked like they had a "guilty" feeling, but in reality, it was only because they didn't feel well, or they reacted to their human. In the case of my own dogs, I was pretty upset with them.

So where am I going with this? As I posed the question earlier about whether those of us with body image issues are more vigilant about our pets' health, do we perceive the same thing as the average, normal dog/cat owners? Are we different? Are we more sympathetic to an animal who may be underweight or overweight? I guess I'm asking these questions, because I think of myself and how I perceive my own dogs and the animals I have cared for over the years.

In the almost eight years now that I've worked in a kennel environment, there have been a variety of sizes, breeds, and ages that I've seen. Many have been normal weight, well taken care of, some underweight, and others overweight. In the cases where dogs were underweight and overweight, I do ask their owners whether they realize this (it's of course in a polite way) and how much food they are giving their dogs. Some owners do realize this, say they've tried getting them to lose weight/gain weight to no avail, others have tried different foods, and still others are truly oblivious to the problem or dare I say it, they will tell me their vet said the dog looked fine. I've seen it where you can practically count the number of vertebrae on the spine, or where there is no "waist" in a dog, and that is okay? I've often asked myself how a professional could not see that? But then again, I question my perception at times since my view tends to be skewed.

I remember another case of a dog who hadn't been boarded in three or so months. When she came, I was absolutely shocked at her appearance. This was a dog who normally was about five or so pounds overweight and supposed to be a show dog even though she was already six years old. The dog had probably lost a good twenty to twenty five pounds. She was so thin it aged her in that amount of time. Her face was sunken, her ribs and spine could be counted, and she was so cold, needing a sweater in the fall, typically the season most dogs enjoy. I did inquire about what happened, and the owners only said that she was being trained some place in FL, and that they were being more strict with her food, not giving table scraps and such. I told them my concern and thought she needed labs run. I honestly don't know whether they had the labs run or not. I do think that they maybe realized there really was a problem. Now, she is at the appropriate weight where she should be at which is a good thing.

Another case on the opposite spectrum is my dad's wife's dog. C. is a shih tzu-poo. He weighs in at something like 35 or so pounds. He is by standards way overweight. After realizing that the early influence of his weight was their own fault--many many treats were given, they cut back and gave healthier options. They also realized his weight was a problem when he could no longer enjoy long walks with them and his stamina was much lowered. They tried reducing his meals, they took him to an endocrinologist to have labs run as well as their vet. His thyroid was borderline, the Cushing's Test turned out negative, he had some liver problems, and he had arthritis in his knees. One specialist said he just had a "fat economic" gene, so he couldn't lose weight. They also tried swimming, but everything was to no avail and now they've just given up. Sure, he's a happy dog, but it is obvious he can't keep up with his two housemates.

Another case is with one my mom's dog who is a king charles cavalier spaniel. L. turn three this December I believe. Last year she had some knee issues. It turned out to be a luxating patella (kneecap moves in and out of place) which was more than likely genetic. The vet wanted to do surgery, but L. weighed in at somewhere between 22-25 pounds. She wasn't grossly overweight, but enough that the vet did not want to do surgery until she got her weight lower. He decided to put her on slentrol. The first few months, she didn't lose weight but probably gained instead. My mother said it was more due to the fact that she received so many treats. The treats were a way for her to stop barking at her dad when he wanted to play a computer game instead (similar to the kid who wants something, and in the end the parent gives in and gets them the item). L. also likes food a lot and will shove her way past the other 3 cavaliers to try to eat their share as well as intimidate one while she eats her food. An additional few months later, L. did lose some weight. My mom, however, said she was really wasn't sure whether it was the medication or just the fact that they had reduced her treat intake. She did notice that L. felt better, and they are now adding some exercise.

None of these people have eating disorders, though a few do have body image concerns, and one I'd say has BED. Still though, many didn't perceive their pets to have a problem whereas I noticed these things right away. Is it the fact I work with dogs everyday or that I'm more attuned to what a dog should look like? Or are my perceptions clouded by my own experiences?

I do remember one client who actually mentioned she had recovered from an eating disorder and had taken in a stray dog. She was concerned about her eating, saying she once knew what it felt like to starve and didn't want the poor dog to feel that. The dog was in no way overweight, but could it have been if her fear of not letting the dog starve got in the way of what was healthy for the dog?

I hope this post doesn't offend. It's just something I've thought about through my observations of dogs and their people. I think for the most part humans love their pets. There are countless things our four-legged companions do for us., but we, as their caretakers, do need to ensure their safety, health, and well being on all levels physically and emotionally.

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On a completely different note, this story recently surfaced with a man being charged on cruelty for allowing his dog to become obese.
Another case last week showed a cat, now dubbed "Prince Chunk" who was found homeless in NJ. (owner's house was being foreclosed) The cat is obese weighing just short of 2 pound on the Guiness Book of World records. The cat has been vet checked and is okay and will be adopted out. The sad thing is that so many people want to adopt the cat since seeing it on television, forgetting about all the other homeless pets out there that need a home.

Perceptions and body image

I've been thinking about body image and perceptions lately. We all know that many of us who have/had eating disorders more or less have a skewed perception of ourselves. Much of the time we can't see how others perceive us. Someone may say we are thin when we think/feel the complete opposite. Or maybe not even think fat but that we need to lose weight, etc.

I've often wondered how/if our perceptions of what is thin/fat has changed compared to other people who have not had eating disorders. Is our definition different? Do we tend to think that someone is too thin whom others would consider "normal?" Or someone whose definition of fat we consider "normal?" Are we just more sensitive to the rest of the general population biased by our own experiences?

In a recent BBC article, it said that adults (Britons) misjudge weight problems. According to the article, just over half (53%) were overweight or obese with only 75% identifying themselves as overweight. This was opposed to 1999 when 43% were classified as overweight or obese and 81% identified themselves that way.

One of the researchers in this article made a few interesting points in that the idea of "normal" for what is considered overweight may have changed. Another factor was that the media often showed those who had very high BMI, thus making people think only if they reached this size were they overweight. Hmm, does this all sound familiar but switch overweight to "thin" and high BMI to "very low BMI?"

I guess I'm just wondering what other people's thoughts are about their perceptions of themselves and other people in terms of body image. For me, I do think having dealt with eating disorders has changed my definitions of the various spectrum of sizes of people. I know I'm more sensitive to any type of body image talk whether it be someone who is too skinny to someone who is obese.

However, yet, at the same time, I can also see the viewpoint of healthcare professionals, though they have unfortunately exaggerated the "epidemic." My opinion is that this would not have been considered had the BMI guidelines remained the same. This article in the Washington Post discussed the possible repercussions when the changes were first made to lower the overweight threshold from 27.8 to 25. I guess I wonder what would have happened if things had been left alone. Would we really be talking about this "obesity epidemic?" And again, how would that have changed how we perceived what is thin/normal/overweight?

The latest obesity prediction

A new article out today by the Johns Hopkins School of Public Health, predicts that 86% of the population will be overweight or obese by the year 2030.

Hmm, that's a pretty "weighty" statistic. I guess this might also mean that the rate of eating disorders would increase as well?

thoughts? Far-fetched number? Exaggeration or accurate?

Alarming article on the increase of obesity-related medications for children

I read this article in the NY Times as well as my local paper about the increase of prescription obesity-related medications for children and was quite alarmed. These were medications for high cholesterol, type 2 diabetes, acid reflux, and high blood pressure being given to children as young as 6 years of age! After one 13 year old girl visited her doctor for high blood pressure, high cholesterol, and high blood sugar, she went home with five different medications. Gosh, how scary is that?

One of the biggest problems I see with this besides the fact that our society and insurance companies continue to push a "quick fix" approach to solving health ailments is the fact that not enough information is out there on the effects of these drugs on children. Any prescription medication for an adult is going to be different for a child.. You can't just halve a medication and give that dosage to a child. It is never a one size fits all approach.The fact that there are no real long term studies worries me (or at least none that I've seen). These children could have some major health issues from being on these types of drugs (not that they should be on them anyway) in the future. And some physicians proclaim that children who start them early in life will wind up having to rely on them in the future.

The phamaceutical companies are also jumping on this bandwagon with developing new flavors and liquid forms for these medications.

The other issue I see is the pressure physicians feel to do something about the problem. Some physicians say they have recommended exercise and diet and only turn to medications as a last resort. Some of them also say that changing the child's lifestyle is difficult depending on their location (low income, no grocery store locales) and lack of physical education in the school system, so they have to turn to pharmacotherapy.

I think this article is a good case in point about just how far the whole idea of obesity among our children has gotten a bit out of control in my opinion. It's also indicative of how so many, including parents and doctors alike, seem hurried into the "here and now" that they're not even questioning what they are doing. I think the "here and now" approach is relevant to many things, but in terms of medications, a lot can happen in the future. It's important that we think about these consequences, because otherwise, then the whole idea of "saving" on healthcare will wind up just the opposite anyway with having to undo the mistake that have been made in the sake of "saving" these children from obesity-related problems.

I don't know the solutions to all these problems, but I don't believe it's about pill popping.

Just what we need--another new diet book

A new book is out called The Pen and Paper Diet The website touts that this diet plan will allow adults to maintain their desired weight for the rest of their life, using scientific principles and common sense. Apparently, this diet plan accounts for height, age, weight, activity level, and gender and can be applied to ages 19-84 years old. The catch is that you have to continuously count calories throughout the day. Hmmm, is that really healthy?

The line that really sticks out for me the most seen in this press release is:

"This diet will be ideal for those that struggle with anorexia and bulimia because it can enable these individuals to maintain their weight at the low end of BMI like they would prefer while digesting their food," Dow says.

I should note that Dow and his wife are not medical experts but two people who wanted to lose weight. I think I'm astonished that someone would even say this. Sure, many with anorexia and bulimia don't want to gain weight. Even when weight is gained, many want to hover at the minimal range of ideal which just puts that person at risk to fall back into old patterns. This can also lead to living like a "functional" eating disorder individual, making that seem okay. But really, it is not okay. It's not okay to be married to your calorie counter or your scale. :sigh:

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Besides this new book coming out, I've also been seeing the trend in weight loss by a few of my clients. One is a woman who recently got back from Hawaii. She and her husband have a condo there and go every year for several weeks. I knew she had been on Weight Watchers and was attending meetings and such, but I was surprised at her weight loss. She said she thinks that most people had only seen her when she had gained weight and not the weight she was most of her adult life. I don't know whether things could get out of control or not, but it is a little worrisome.

Then I saw my good friend last week out of the blue. I had left a number of messages for her but didn't hear back. When I saw her, I could tell she had lost weight. She said she was on the "CNS diet, ie "caffeine, nicotine, and stress" diet. Most of her life, she has been big and losing weight was always a tough battle for her. However, I do not think this is the way to go. She said it's mostly stemming from personal problems. I do worry since she is a good friend.

The last client is a married couple. When I last saw them, it was noticeable that they too had lost weight. Neither were what I'd call overweight, just more on the average. They talked about their weight loss saying it was mostly due to drinking more water, some exercising, and eating healthier. I do know the woman has been doing more exercise since her job position changed. I guess I hope that it was a healthy approach for them.

Sometimes I wonder if I'm more sensitive to people losing weight. I can understand losing some weight for health, but I always have this fear it will go overboard for them. Maybe I'm just too clouded by my own experiences. I keep wondering if these people are married to their calorie counting books or their points systems or whether they have just embraced healthy living. The latter is my hope.

Satire or rude commentary?

June 26, 2008
Non-Runner Dies While Not Running

A Mississippi man died yesterday while not running in a local marathon.

Les Actiff, 43, of Jackson, Miss., collapsed while watching television in his Hattiesburg home. Attempts to revive him failed, and paramedics pronounced him dead at the scene.

He was still clutching a bucket of fried chicken.

Like 25% of the U.S. population, Actiff was obese. Federal statistics show that nearly a third of U.S. adults 20 years and older are obese; about two-thirds are overweight. Actiff had been a non-runner for more than 20 years, according to his family and friends.

Family members were stunned.

"I don't get it," said his wife, Bess. "He didn't run all his life. He was always so inactive. And now, this. You just never know, I guess."

"At least he died doing what he loved," she added. "Not running."

Spectators gathered outside Actiff's home were similarly shocked.

"I'll never not run," said one woman. "It's too dangerous."

A large man on a scooter, out walking his dog, was more fatalistic: "If you can avoid doing a single positive thing for your health your whole life, just sit around like a lump and eat poorly and then still drop dead... Well, I just don't know. I guess when it's your time, it's your time."

Actiff appears to have died from atherosclerotic heart disease, according to Lamar County Coroner Paul Caste.

A memorial service is planned for Saturday, at the Pizza Hut off of I-59.

First off, I did not write this piece. It is from a blog entry in Runnersworld. If you haven't gathered, it is supposed to be a satire. However, is it really? Many in the running community have been upset that when an athlete dies suddenly in a running event, headlines asking whether running is safe appear everywhere.

It's interesting reading the comments from this entry. Some people found this incredibly hilarious, in the same liking as the satirical Onion. Others found it not funny, in poor taste, and felt like it was being critical of obese people.

There is no doubt good satire is funny with proper taste. However, weight, obesity, personal lifestyle tends to tread on a fine line. Maybe I'm a bit sensitive when it comes to these topics. I know I've preached this before but I truly do believe education, awareness, and helpful strategies have a better chance at providing lasting change in any avenue of life.

Weights among the Japanese

I think I about wanted to fall on the floor after reading this article about how the 58cm (22 inches) waist is the ideal "norm" for Japanese women. Like in the US advertising is emphasized on weight loss with thin, beautiful models. This completely contraindicates the fact that Japanese women in their 30s weigh 12% less than they did 20 years ago, and that almost a quarter of women in their 20s and 40s are medically underweight. I guess they are now catching up to this ideal. How scary is that?

Then on the men's side, there is apparently an "obesity epidemic" occurring, especially men over 40. Companies are trying to off shoot this with "flab checks" and give penalties for those who do not get their employees' weight under control. According to this article in the Guardian, men who have above 33.5 inch waists will be given diet and exercise plans. This article also says that women are 6% heavier. Hmm.

There is also an obesity epidemic among Japanese children. Authorities feel that this is due to the shift away from more traditional Japanese foods to a more western diet. Apparently, they've instituted a sports program for overweight children.

The ironic thing about all this is that the percentage of Japanese whoa re overweight is very low compared to world standards.

I just think how scary all this is. To have an entire country literally have distorted body views is quite astonishing. Yes, the US and other parts of the world do as well, but we haven't instituted flab checks in the workplace (at least not to my knowledge, sports arenas and such is a different story) or penalties (maybe discrimination of sorts which isn't any better unfortunately).

This just goes to show how far and wide (no pun intended) the whole weight debate/crisis occurs cross culturally.

Fat and health care costs

The title of the article is "Fat people cheaper to treat." After reading the article, it kind of makes you feel bad if you are thin and healthy, because you cost more in the long run. The government has continued to say that by preventing obesity, it will cost less. This study basically counters that whole theory. Researchers looked at three groups: obese, smokers, and healthy-living subjects (thin and non-smoker). They found that the obese and smoking groups had higher health care costs from age 20 to 56. However, because both these groups die earlier than their healthy counterparts, they cost less in the long run. And if you have lung cancer, the only cancer incidence which was the same in all three groups, you are really cheap to treat. Gee, that's good to know. However, if you have Alzheimer's, you may live longer and cost more.

Does anyone see the irony in all this? It is a reminder how much health care has become a business. In the end, we all need to strive to be healthy individuals no matter the size. Obviously, those with eating disorders were not looked at, but if it had been, it would have been interesting to see the comparison of costs of complications and treatments. Oh right but then again, they don't live as long, so it may have wound up cheaper overall compared to all three groups. Okay, I'm in a little bit of a sarcastic mood today.

Obesity as a brain disorder

As the new year has begun and many people have vowed to lose weight as their resolution, the topic of weight loss and obesity are up there. But then again, do they ever go away? I can't count how many ads I've heard on the television and radio about joining this gym or that gym, trying this weight loss plan, etc. However, on a completely different slant, I came across an interesting editorial in The American Journal of Psychiatry, entitled "Should obesity be included as a brain disorder" by Drs. Nora Volkow and Charles O'Brien. They were addressing this question as an inclusion into the new DSM-V proposed to be published in 2011.

Drs. Volkow and O'Brien propose "that some forms of obesity are driven by an excessive motivational drive for food and should be included as a mental disorder in DSM-V. DSM-IV recognizes eating disorders such as anorexia and bulimia as mental disorders with severe impairments and serious adverse outcomes but does not recognize obesity despite its devastating medical and psychological consequences. Obesity is characterized by compulsive consumption of food and the inability to restrain from eating despite the desire to do so. These symptoms are remarkably parallel to those described in DSM-IV for substance abuse and drug dependence (Table 1), which has led some to suggest that obesity may be considered a "food addiction" (5).

They go on to talk about the similarities of the brain regions of those with obesity and substance abuse dependency which is essentially the drive for rewarding properties. That in effect affects dopamine, though in different ways from the substance abuser. They also point out how the medications used for both substance and obesity often overlap.

In their conclusion, they do point out that this classification is a component at looking at obesity as a mental health disorder which is not completely inclusive to everyone.

I think this is an interesting take on obesity and could be true for some people. Dr. Volkow is likely to take this approach since she is an addictions specialist. She was featured in the excellent HBO documentary "Addiction." I thought her explanation about how addiction works was very educational. If you haven't seen this, I highly recommend it.

This editorial was written last May, and in the current issue a psychologist rebutted her thoughts. She also had some interesting things to say, including how from her experience the "health at every size approach" has worked in her practice. This approach is about not dieting, tuning in to your hunger signals, and accepting your size. Drs. Volkow's and O'Brien's also addressed the psychologist and defended their editorial in this issue.

Personally, I think it is an interesting way to look at obesity. I do not think all people who are obese would fall into this category as Dr. Volkow suggests, but it does give explanations into the "drive to eat" just as those with anorexia nervosa have a drive to restrict their food intake or not to find food as pleasurable as some recent studies have proposed. I think with addiction, there is a lot of overlap whether it is to food to illegal substances to an eating disorder if you believe an eating disorder can also be classified as an addiction, etc.

My only issue with so much studying of the brain going on and different illnesses is that people will just blame their brain and forget accountability and responsibility. Don't get me wrong, science is really in its infancy of studying the brain and how it works, but there has to be balance. But the more information we have, the more society can be helped educationally.

Just to point out, there is also an article about binge eating disorder and treatment as well in this current issue.