weight loss

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‘Dietland': A Fat Heroine, And The Politics Of Weight

By Jean Fain

The heroine is the news in “Dietland,” the new novel by Sarai Walker. That’s because she’s got the rarest of qualities in a female protagonist: She’s fat.

Also, she has next to no sense of self, and expects to remain selfless until she can afford weight-loss surgery and find her true self as a thin person. In the meantime, Plum Kettle, our heroine, works as a ghostwriter for the slender, glamorous and self-absorbed editor of a teen magazine called Daisy Chain. In short, Plum’s got no life of her own.

Plum’s transformation from fat girl to full-bodied rebel with a cause is the narrative arc of Walker’s provocative and insightful book. Like “Alice in Wonderland,” Plum’s sense of self gets turned on its head by a cast of oddball characters, from the daughter of a famous diet guru and her feminist cohort to a murderous terrorist cell of women avenging crimes against women. When the daughter of the diet guru offers Plum $20,000 to postpone her surgery and confront the real costs of beauty, the plot and subplot blend and thicken.

dietlandDespite the rave reviews from my inner circle and the world at large, I didn’t expect to be drawn in by the writing. But, truth be told, it’s fresh, playful and sometimes hilarious: The parody of the diet industry is spot on. I also didn’t expect to be touched by the rejection and humiliation the 300+ pound Plum encounters along the way to finding herself.

Most unexpected of all: I kind of looked forward to spending my evenings with a fictional someone desperately seeking weight loss. Generally, if I’m desperate for anything at the end of the day with clients (I’m a therapist specializing in eating disorders and food issues), it’s non-diet-related downtime.

I can’t say I always loved reading “Dietland.” Violence, even when served as Walker serves it — with sarcasm and panache — isn’t my cup of tea. I also had trouble swallowing the meanness of the male characters, and the complete self-acceptance of the female ones. And yet, my curiosity kept me turning all 307 pages. I wanted to know if Plum would live more happily ever after. Plus, I wanted to discuss the book with members of my mindful eating support group. (“Dietland” is the group’s first unofficial book club selection.)

At the same time, I kept reading between the lines to learn the author’s story. From the book-jacket flap, I knew Walker writes from professional experience. Before she did her doctoral research on the feminist issue that is fat, she wrote about body image for “Our Bodies, Ourselves,” the feminist classic by the Boston Women’s Health Collective.

From the author photo, I also knew Walker is a fat woman. And yet, combing through the reviews and interviews, I could find very little about Walker’s personal experience with food and body image issues.

The therapist in me really wanted to know if Walker, like Plum, had tried and failed to lose weight over and again? If she’d been a victim of fat shaming and stigma? If she’d been discriminated against because of her appearance? What was Walker’s story?

My curiosity moved me to set up a Skype interview with the NYC-based author. What follows are questions and answers from that recent interview with Sarai (pronounced SUH-ray) Walker.

JF: You seem to know a lot about food and body image issues even though you’re not a medical person or scientist. What can you tell me about your personal experience in this arena?

SW: Well, I’m a fat woman, and so I think one of the reasons I wanted to write “Dietland” is I wanted to explore what it’s like to be a fat woman in our contemporary society because I think, while there are some novels with fat heroines, I feel like there aren’t any novels that explore the issue in a serious way. Continue reading

From The Eating Lab: Diets Don’t Work, But Why?

By Jean Fain
Guest Contributor

As soon as Traci Mann’s new book, “Secrets From The Eating Lab,” hit bookstores shelves, I ordered my copy. Not only because the University of Minnesota psychology professor is one of the leading researchers on the psychology of eating, dieting and self-control, but her 2007 Medicare study on effective obesity treatments was the irrefutable evidence I needed in writing about how diets don’t work — at least not as dieters expect — in my own book on eating with self-compassion.

Diets fail to facilitate significant or sustainable weight loss, Mann argues. What’s more, diets are unnecessary for optimal health.

Diets don’t work for a variety of reasons, from biology to psychology. After two decades of studying the scientific literature as well as her own diet subjects, Mann points the finger, first and foremost, at human biology. “Genes,” she argues, “play an indisputable role in regulating an individual’s weight: most of us have a genetically set weight range. When we try to live above or below that range, our body struggles mightily to adapt.”

Second to biology, Mann blames a combination of neuroscience and psychology. Our brains are hardwired to want food for survival, she explains, so restricting calories creates a psychological stress response, which facilitates weight gain, not loss. Also, she adds: “Studies show that willpower, the thing we all blame ourselves for not having enough of, is in many ways a mythical quality and certainly not something that can be relied upon for weight loss.”

Whether you’re interested in boosting your health or losing weight, Mann’s best advice is to ditch the diet and adopt her 12 “Smart Regulation Strategies,” her proven mental strategies for reaching your “leanest, livable weight.” Instead of counting calories, for example, she advocates penalizing yourself for succumbing to temptation as well as thinking about tempting foods in the abstract. So instead of thinking about the specific qualities of a glazed donut with chocolate icing, think of a donut as a generic dessert or just one of many breakfast foods.

Mann’s views come as no surprise to me, a therapist who specializes in eating disorders. The big surprise for me in her new book is that I only loved the first half — the half that pinpoints the problem with dieting. The other half, which focuses on her “no-diet” plan, well, I liked it only half as much. Turns out, a good bit of Mann’s plan calls for external changes, like using smaller plates and taking smaller portions, a la Brian Wansink’s Mindless Eating. Mann prescribes internal changes, too, but none are what I’d describe as truly mindful.

I was tempted to dismiss Mann’s plan as a collection of mental tricks, then I thought better of it. Instead, I set up a mini-interview via email with the professor turned author and I’m glad I did. Not only did Mann have some interesting things to say about dieting — her own experience and that of determined dieters –- but her answers reminded me that there’s no right way to address eating problems. In fact, there are many ways to go. To see if Mann’s way of reaching your leanest livable weight is a way you might want to go, read on.

JF: You’re pretty unusual in that you ditched dieting after just one diet. And yet, you’ve devoted your career to proving diets don’t work. Why is that?

TM: I ditched dieting because the diet I went on made me miserable, and I watched both of my parents cycle through diets and re-gain, diets and re-gain, ad nauseam. Continue reading

Weight Loss 2015: How To Get A Little Help From Your (New) Friends

feetonscale
If you made your resolution to lose weight in 2015 on New Year’s Eve, chances are you’re already feeling your initial determination start to flag. The dreary winter dusk calls for comfort food, and there’s slush between you and the gym.

So it’s time for a little help from your friends — only, maybe they should include new friends, not just the usual posse. Not the network that may have influenced you to over-indulge in the first place.

Dr. Sherry Pagoto, an associate professor of medicine at the University of Massachusetts Medical School and an obesity researcher, says studies show that social support is important for making lifestyle changes. “But just because you’ve decided to make a change, that doesn’t mean your friends or family members have. So what do you do? The best support comes from people who are on the same journey.” Social media lets you find people who are “exactly where you’re at, have the same interests and can support each other.”

“Maybe you don’t need everyone in your family to be as dedicated about the gym as you are,” she adds. “But if you can post to your online community — ‘I’m headed to the gym’ or ‘I just got back from the gym’ or ‘I’m on day 5 of my couch-to-5K’ — you’ll have someone who says, ‘Yay!'”

Here, Dr. Pagoto offers five top tips for using social media to help with weight loss:

1. Create a private Facebook group for friends interested in losing weight.

How? It’s easy: Post on Facebook asking if anyone wants to join a private weight loss group. Then create a group page (private, not public) and send invites to those interested. Identify a day when people report weight change from the last week, and a day to post goals for the coming week. Ask people to post helpful content, recipes, their exercise plans, questions, struggles and more throughout the week.

2. Find an existing weight loss community, such as those on Sparkpeople, Weight Watchers or MyFitnessPal websites.

Many are free. Just be sure they are promoting healthy lifestyle change, not a particular specialized diet.

3. Most commercial weight loss apps allow you to ‘friend’ other users. Connect with other serious users to increase your social support and motivation. Continue reading

Where Does Fat Go When You Lose Weight? Mostly Into Thin Air

(Phoney Nickle/Flickr)

(Phoney Nickle/Flickr)

By Richard Knox

A couple of years ago, Ruben Meerman took off 40 pounds. And that got him wondering: What exactly happened to all that fat?

Conventional wisdom was that he “burned” it off. Or sweated it off. Or excreted it. None of that satisfied Meerman, who has a physics degree and makes his living explaining science to schoolkids and for the Australian Broadcasting Corporation.

So Meerman tackled the problem and eventually came up with a surprising answer: Most of the lost fat disappears into thin air.

More specifically, 84 percent of those fat molecules get exhaled as colorless, odorless carbon dioxide. The other 16 percent departs the body as H-2-O — plain old water.

Meerman says the discovery “got me really excited because I’d stumbled onto a gap in the knowledge. It struck me as remarkable that no one had thought this was interesting enough to pursue.”

The British Medical Journal thought so too. It has published a paper, co-authored by biochemist Andrew Brown of the University of South Wales, in its annual Christmas issue, which features off-beat (but peer-reviewed) research.

Weight Loss Realism

Meerman hopes the work will dispel misconceptions held by health professionals as well as the general public. And, he hopes it will provide a helpful dose of realism to counter the impossible expectations millions have about weight loss.

If people understand where the fat goes (and how), they’ll get “why there’s a limit to how quickly you can lose weight,” Meerman said in a Skype interview from Sydney. “And if you understand the limit, you won’t be so quickly depressed if you don’t lose 20 pounds in the first two weeks.”

First, the misconceptions. Meerman and Brown surveyed 150 professionals — split equally among family doctors, dietitians and personal trainers — about where they think the fat goes during weight loss.

By far the most common answer was that the fat was transformed into energy or heat — that is, “burned off.” About two-thirds of doctors thought so. A slightly higher proportion of dietitians did too, and about 55 percent of personal trainers.

But that would violate the Law of Conservation of Mass. It’s a basic precept of chemistry, formulated in 1789 by the French scientist Antoine Lavoisier, which holds that mass is neither created nor destroyed in chemical reactions. The total mass at the end must equal the mass at the starting point — even if matter is quite transformed in the process, from solid to liquid or gas.

The Energy Of A Bomb

Meerman points out that if fat were transformed into pure energy during weight loss, the results would be cataclysmic. Continue reading

Senators Lambaste Dr. Oz For Sketchy Weight Loss Claims

Dr. Mehmet Oz testifies Tuesday before a U.S. Senate subcommittee. (Lauren Victoria Burke/AP)

Dr. Mehmet Oz testifies Tuesday before a U.S. Senate subcommittee. (Lauren Victoria Burke/AP)

At last, an antidote to some of the medical folderol that Dr. Mehmet Oz — “America’s doctor” — spouts on his popular television show.

Maggie Fox of NBC News reports here that Dr. Oz “got a harsh scolding from several senators on Tuesday at a hearing about bogus diet product ads.” (Raspberry ketones, anyone?)

“I don’t get why you need to say this stuff because you know it’s not true,” Missouri Sen. Claire McCaskill, a Democrat who chairs a Senate subcommittee on consumer protection, said at the hearing. “So why, when you have this amazing megaphone…why would you cheapen your show by saying things like that?”

(My personal answer: Dr. Oz is one giant metaphor for what is wrong with American health care: it’s a business. So money may sometimes get in the way of doing the right thing.)

Dr. Oz had a different response. NBC reports that he argued that his show had to “engage the viewer,” and “I actually do personally believe in the items I talk about on the show,” he added. “I recognize that oftentimes they don’t have the scientific muster to pass as fact. I have given my family these products.”

Not good enough for Sen. McCaskill. More from NBC: Continue reading

Make Lemonade: Study Finds Kids’ Active Video Games Boost Exercise, Weight Loss

Every time my kids hunker down for a long stretch of screen time, I get a tiny pang of guilt. The little good-parent-voice in my head says: They should be outside running around (or inside running around if you’re in New England, still praying for an end to this relentless winter). In any case, they should be active, not immobilized in front of a screen.

But maybe it’s OK for them to be active, and in front of a screen. A study published earlier this month in JAMA Pediatrics suggests that yes, those active video games do help overweight and obese kids boost their physical activity levels and lose weight too.

Chiew Pang/flickr

Chiew Pang/flickr

The study, with 75 kids between 8 and 12 years old, concluded that: “Incorporating active video gaming into an evidence-based pediatric weight management program had positive effects on physical activity and relative weight.”

Here’s more on the study from Reuters:

Both groups took part in the weight management program at local YMCAs and schools, but one group also received an Xbox game console and two active games.

The Xbox Kinect device captures the child’s body movements to operate the game. The games given to the kids in the active gaming group were Kinect Adventures! and Kinect Sports. (Children in the weight-loss program-only group received the same equipment and games at the end of the study).

All the children’s activity were recorded using an accelerometer, which measures movement, during the day.

At the start of the study, the children were between the ages of 8 and 12 years old and weighed between 123 and 132 pounds (lbs). About 67 percent of the kids had a body mass index (BMI), a measure of weight relative to height, that put them in the overweight category for their age groups. The rest of the children were in the obese category.

The researchers found that children in the group that received the active games added about seven minutes of moderate to vigorous activity and about three minutes of vigorous activity to their daily routines over the 16 weeks. Continue reading

I’m Finally Thin — But Is Living In A Crazymaking Food Prison Really Worth It?

(nataliej/Flickr)

(nataliej/Flickr)

I am not fat. At just over 5 feet tall and 101 pounds, I’m actually closer to thin. It shocks me to even write this, but after a zaftig childhood and a curvy-bordering-on-chunky early adulthood, I find myself, in middle age, after two kids, to have reached my “ideal” weight.

But lately I wonder if it’s really worth it.

From the outside, thin is surely better. Other moms tell me I look great. I can consider bikinis. I appear far younger than my actual age and, with a perky, teen-sounding BMI of 19.9, I fit in my daughter’s Forever 21 tops.

But peek inside my brain: it’s alarming.

(Rachel Zimmerman/WBUR)

(Rachel Zimmerman/WBUR)

I spend an inordinate, and frankly embarrassing amount of time thinking about food, planning meals and strategizing about how to control my weight. It’s on my mind pretty much every waking hour of every day and the details are painfully banal: how many pumpkin seeds in my nonfat yogurt; will a green smoothie pack on an extra ounce or two; can I eat dinner early so my weight the next morning will be optimally low?

If I don’t exercise (Every. Single. Day.) I get depressed. If I stray from my short list of accepted foods, I can spiral out of control. My life is bound by a strict system of controls and rigid rules (maintained with a pack-a-day gum-chewing habit) that keep my weight in line. These include daily digital scale checks that set my mood each morning: 102.9 is bad news; 100.4 gets me high. Trivial? Yes. A shamefully first-world problem? Absolutely. But, sadly, true.

And widespread. A new report on women and body image conducted by eating disorder experts at the University of North Carolina makes clear the scope of the problem: a mere 12 percent of middle-aged women are “satisfied” with their body size. (An earlier study put the number at 11 percent.) What’s worse, perhaps, is that even those relatively content ladies are troubled by specific body parts: 56 percent, for instance, don’t like their stomachs. Many dislike their skin (79 percent unsatisfied) or faces (54 percent unsatisfied) or any other parts that suggest, in Nora-Ephron-neck-hating-fashion, they are aging.

The author as a not-quite-svelte child, in an undated photo from the 1970s.

The author as a not-quite-svelte child, in an undated photo from the 1970s.

The very first sentence of the study, published in the highly un-sexily titled Journal of Women and Aging, makes clear that women who are happy in their own skin are a rare, exotic breed; specimen worthy of study by a crack team of anthropologists. The report begins:

We know strikingly little about the intriguing minority of women who are satisfied with their body size. Defined as having a current body size equal to their ideal size, body satisfaction is endorsed by only about 11% of adult American women aged 45–74 years.

If you dig a little deeper into the study you’ll find that this “body satisfaction” is fragile. Women were asked if they’d remain satisfied if they gained five pounds. The answer (duh): “No.”

And these so-called “satisfied” women seem to spend a huge amount of energy maintaining. Continue reading

‘Thigh Gap': Reflections On Teenage Girls’ Latest Obsession

By Sylvia Pagan Westphal
Guest Contributor

A few weeks ago, my 13-year-old daughter brought up the issue of the “thigh gap.”

A thigh-what? I thought. I Googled it and was appalled by the latest teenage girl obsession: having ultra-skinny thighs, so much so that one can see a space in between them when feet are touching (hence, the gap) is a trait many teenagers now covet. Of course, for many, this idealized gap is physically impossible to attain. (Still, I must admit to checking in the closet mirror to see if I had one.)

topgold/flickr, creative commons

topgold/flickr, creative commons

I was relieved when my daughter said she found the trend unhealthy. At the same time, she said, it’s unavoidable.

“You hear about it from your friends, it just travels,” she says. “Usually when you first find out about the thigh gap, the normal instinct is to Google it and one of the things that comes up is Tumblr and you get these crazy blogs on how to get a thigh gap and how to diet so you get it.”

(It’s true, some of these sites are a parent’s nightmare, from Cara’s Thigh Gap on twitter, which I’m not even linking to it because of the inappropriate content, to less-bad-but-still-troubling Operation Thigh Gap. Even this level-headed wiki-how is anxiety-producing, in that it confirms the ubiquity of the trend.)

It’s a tough world out there for our teens. We bombard them with conflicting messages to stay fit and be healthy (see Michelle Obama) while at the same time asking them not to get too neurotic about their body image. Some of us mothers send mixed messages too. What matters is how beautiful you are on the inside, we tell them, yet we work out and order salads for dinner Continue reading

After Losing 322 Pounds, One Man’s Thoughts On Christie Surgery

Russ Hannagan before and after losing 322 pounds (Courtesy)

Russ Hannagan before and after losing 322 pounds. (Courtesy)

As a man who formerly weighed over 500 pounds, I’ve been thinking a lot about New Jersey Governor Chris Christie’s recent announcement that he had lap band surgery. And I’m not alone: The governor’s surgery has also been a hot topic among many of my weight-loss friends on Facebook and Twitter, and my fellow diet workshop participants in Newton.

As a “New Jersey Boy” myself (born and raised in Carteret, Exit 12 on the Turnpike), and because I still have many friends who live in the Garden State, I like to keep tabs on what’s happening there. At first my friends and I felt Mr. Christie was in a state of denial. I believe he was once quoted as saying he was the healthiest “overweight” man you’d ever meet. Many of us who attend diet workshops know this feeling. You are overweight but still feel it’s not a problem. Like an alcoholic who claims they can stop at any time.

We would love to sit down with him and talk with him about “The Good, The Bad, and The Ugly” of weight loss. I mention this because back in November of 2011 I weighed over 533 pounds. In a little over a year, I have lost 322 pounds. I now weigh 210. My goal weight is 200 pounds, so I am only 10 pounds away from reaching it. But it took a great deal of hard work to get to where I am now.

I know this sounds like every other Cinderella story out there but through the years I have tried every diet in the book. From counting calories, to getting food shipped to me, to attending overeaters classes; you name it and I have tried it. Sure, I would lose the weight for a while and I would be healthy, but then it would all come back with a vengeance and I would be even worse then I was before.

Russ Hannagan celebrates his 50th birthday, a year after his surgery. (Courtesy)

Russ Hannagan celebrates his 50th birthday, a year after his surgery. (Courtesy)

My epiphany came when I met a friend I had not seen in a long time. I literally did not recognize her because she’d lost so much weight. I asked her what she’d done to transform herself. That’s when she told me about bariatric weight-loss surgery.

There are two main types of this surgery (and I’m not counting lap band surgery here). With the bariatric procedure they surgically alter your stomach into a small pouch (Roux-en-Y) or a gastric by pass sleeve. I won’t go into all the details — but suffice it to say I got the pouch.

Each month at Newton Wellesley Hospital, I attend these free diet workshops with other patients who are having or have had the surgery. The nurses, nutritionists, doctors, and fellow patients teach each other how to eat right and exercise properly. We all continue to attend the workshops to stay current on what types of vitamins are available and how stay healthy. The surgery is a tool — not a cure and not a goal. In the right hands and used in the correct way this tool can make your life so much better. I am proof of that. Used incorrectly it can be as useless as any other fad diet out there. Continue reading

Weight-Loss Surgeon: Christie-Style Secrecy Common, Stigma Lingers

New Jersey Gov. Chris Christie is surrounded by security and journalists in 2012. (Getty Images via NPR)

New Jersey Gov. Chris Christie is surrounded by security and journalists in 2012. (Getty Images via NPR)

 

I’m not sure which is grabbier news: That New Jersey Governor Chris Christie underwent weight-loss surgery in February or that he felt compelled to keep the operation secret until The New York Post was about to publish a story about it.

I asked Dr. Daniel B. Jones, director of the Weight Loss Surgery Center at Beth Israel Deaconess Medical Center and a Harvard professor of Surgery, for his perspective. He began by emphasizing that all patients are entitled to privacy about their health care, including a governor. He went on:

That said, it is not uncommon for patients, when they have weight loss surgery, to say, ‘I don’t want anyone to know about this.’ We try to get patients over that hump as part of the pre-operative evaluation.

As physicians, we really want patients to identify: Who’s your support group? Who’s your champion? If your spouse doesn’t know what you’re doing, they’ll bring junk food into the house; if family members don’t know, they may think you’re not eating enough. So we really want some core people to know what’s going on. That said, most people do have a core group but don’t want other people to know.

Dr. Daniel B. Jones (BIDMC)

Dr. Daniel B. Jones (BIDMC)

We don’t know the reason but we think there’s still sort of a stigma to having weight-loss surgery. So even though we’re doing 150,000 weight-loss operations a year [in the United States], there’s the idea that if you have a weight-loss operation you’re somehow ‘taking the easy way out.’ You’re kind of ‘cheating.’ You’re just not tough enough to do the diet and exercise required for weight loss. You’re somehow ‘weak,’ right?

We even see this with gastric bypass patients who, six months after surgery, when they’ve lost 100 pounds and they’re healthier and more mobile, they still ask themselves, ‘Should I have done this without an operation?’

So this is sort of normal. In fact, I had a nurse — this was a real clandestine operation. She came in with a separate name, only a bare-minimum number of people got to know who it was. It was done in complete secrecy, but three to four months later, after her lap band was working, the whole hospital knew she’d had it. So what happens is, you reach a point of ‘Everyone can know.’

I quote people a 40-percent chance that the band over their lifetime will need to be repaired, revised or removed.

The other part of it is a concern that you might fail. And the pressure’s kind of high. So once you’re winning, everyone likes to share success. Not everyone knows whether they’re going to achieve it. You have to remember, everyone who’s had a weight loss operation has, by definition, already been on multiple diets — that’s a requirement for any operation in an accredited bariatric program. It’s very common for people to have lost 15 or 50 or 100 pounds, and for one reason or another they’ve gained back even more. It has to do with our physiology. It’s not about willpower.

The body has a set point and whether you like it nor not, your body hovers there. So if you diet in the traditional sense and knock the weight down, your body thinks you’re somehow starving it. And the first chance it gets, it fires off chemicals that not only push you back to where you started, it sets your new set point higher. We call this yo-yo-ing.

Whether it’s the band or the sleeve or the bypass, [weight-loss operations] do things that make it possible for people to get the weight off and keep it off. Continue reading