Impolite Conversation: Everybody’s Body

Don’t be an ass.

There is a peculiar phenomenon that seems to be particular to me, and which has happened to me frequently at various times throughout my life, and it is when people insist to me that I have lost weight when I have not. Yes, I have lost significant weight at least twice in my life which may have attracted notice. These, however, are not those times that I am asked.

Here’s a recent example: A work colleague ran into me in the hallway and exclaimed, “You’ve really lost weight!” I had not – in fact I had just been weighed at the doctor’s and my weight had been rock solid for a year, and I was happy about this.

“Nope!” I said.

“No, REALLY! You’ve lost weight,” she insisted, as though somehow she were better acquainted with the recent workings of my body than I was.

“No, I haven’t. I just went to the doctor and…”

“Take the compliment!” she huffed, exasperated. I’m not a fan of this type of compliment, this sort of kindness-that-isn’t, in which the true message is, “You look better now that you are less fat.” Wouldn’t a simple “You look nice today” have sufficed?

It’s happened three more times since then. On the last turn, I said that I had not lost weight, I’m not interested in weight loss, and by the way, I’m fine with my body just the way it is. She was about to say something else on the subject when I blurted, kindly but with finality, “I don’t really want to discuss my body anymore.” Let me tell you, this does the trick of immediately halting any body talk you’re uncomfortable with!

This also happened to me at my thinner weight, with people who only knew me at that thinner weight, which I had maintained for eight years with little change. I used to wonder if people just imagined me fatter, as though they still saw the aura of my former fat self. Now I’m thinking it may have just been their way of trying to give me an awkward compliment.

I’m being generous, of course. A more paranoid translation might be that it was their way of insulting me, a little hint that I need to lose more weight. Which leads me to the whole point of this post: the weight of others is not really good, polite discussion material.

I get that in our fat-phobic society, telling someone they’ve lost weight is supposed to be a compliment. But think of all the possible outcomes of this misguided statement:

1. The person intended to lose weight and did lose weight and is happy about that, but since about 95% of people regain the lost weight and more, they might later feel bad about the fact that you said they looked better thin, and now they aren’t.
2. The person, like me, has not lost weight, and is left to wonder if you think they should lose weight.
3. The person might have an eating disorder and you’ve just reinforced the destructive motives to keep it going.
4. That person might have cancer. No joke, I’ve heard no end of mortifying stories of people who were being treated for cancer, lost a lot of weight unintentionally, and then friends and family told them how great they looked. Even as they battled a life-threatening disease, somehow their weight loss was supposed to make up for all that. That’s just fucked up. We should have learned this lesson with the indelicate question, “Are you pregnant?” but I guess we haven’t.

I’m not for banning any kind of speech – I value freedom of speech, it’s impossible to police, and frankly hearing the dumb-ass things that come out of some people’s mouths lets me know if I should avoid them or not – but let’s agree that there is such a thing as polite conversation. We don’t ask acquaintances how many times a day they poop, or what time of day/night they like to have sex and in what position (and if you do ask these questions of people you barely know and you’re not their therapist, you may want to rethink your boundaries). So how about we put questions about one’s body under the category of impolite conversation? If they don’t bring it up, you don’t bring it up.

And while we’re at it, how about we do that with people who aren’t in hearing distance too? This kind of body talk (“She’s lost/gained weight,” “She looks anorexic,” “Her boobs are enormous”) happens more toward women than men, and it’s high time women’s bodies stopped being a topic of casual catty discussion. It diminishes what we have or could accomplish apart from our bodies. It holds us back and it doesn’t do men any favors either as they get drawn further and further into the bodily perfection madness. No one feels good about this (and if this kind of conversation does make you feel good, please feel free to examine your own insecurities). I’m not proud to admit I used to participate in this kind of talk wholeheartedly, and it only served to make me more insecure about my own shortcomings and what was being said about them when I wasn’t in the room. The bottom line is, let’s stop talking about other people’s bottom lines.

By the way, I’m not talking about eliminating body talk as useful descriptors, e.g. she’s short, fat and has brown hair or he’s tall and thin. In these instances, body talk is neutral and non-judgmental. Similarly, if you want to tell someone they look beautiful or have a great sense of style, go for it – just make sure it’s occasion- and location-appropriate (i.e. “You’re a hot babe” may not fly well in your workplace with someone you’re not good friends with). I guess what I’m saying here is use your head and just ask yourself, “Is this polite?”

Also, if you want to talk about Joe Manganiello’s pecs in Magic Mike XXL, by all means go ahead because that’s what that movie is all about – people who display their bodies for a living and for your comment (It’s not about the dancing? But I really like the dancing!). Joe Blow’s body on the street is not your business to dissect.

So if you see me on the street or in the hallway at work, let’s talk about something else besides my weight. Like Magic Mike! Did you see that dancing?!?

Diving Deep Into Intuitive Eating

EATI have been reading Fiona Willer’s excellent book, The Non-Diet Approach Guidebook for Dietitians, which provides a structured approach for dietitians teaching normalized eating (aka attuned eating aka intuitive eating aka mindful eating). I can’t recommend it enough for dietitians who want to work from a Health At Every Size® perspective with their clients. I’m really enjoying the material and it made me think about how I teach this approach.

My shorthand for intuitive eating has always been, “Eat when you are hungry, stop when you are full.” But reading Willer’s book alerted me to something very important: there is a difference between full and satisfied. Satisfied is the absence of hunger that we need to pay attention to in our eating. The absence of hunger is actually the biological signal to stop eating – not feeling “full.” The difference may seem small, but it is in fact profound. It can be the difference between eating more than we need and eating just enough. Stopping when we are no longer hungry and waiting 10-15 minutes will take us to that comfortably full feeling, because it takes at least that long for our body to recognize fullness.

If I hadn’t given this a lot of thought before, I had to ask myself: Am I truly an intuitive eater?

When I first quit dieting, I decided to give myself a break and just eat. I hadn’t heard of intuitive eating yet, only HAES®, and was doing my best to figure out how to eat normally for the first time in my life. For the most part I didn’t binge – that was something I did when I was restricting – but I didn’t have a clue of how I wanted to feel before, during and after I ate a meal. I did become more of an intuitive eater as I learned more about it, but it’s a process that takes time and practice, especially after so many years of restrictive, regimented eating. Lately my efforts at eating well have concentrated around trying to find ways to get more vegetables into my day, but now I’d like to back up a bit and make sure my IE skills are where I want them to be.

So, because I will never ask my clients to do something I could not or would not do, last week I vowed to really start paying attention to my body’s signals around eating.

Hunger is not a problem for me – I recognize hunger like it was an old pal (although I as a dieter I considered it more of a frenemy). I generally do try to eat when I’m hungry but there are times when this is harder to do – like at work. I’m sometimes a poor planner around snacks, so I occasionally (all right, several times a week) find myself starving and without food at hand. Allowing my hunger to go on for so long – either because I am too busy or too lazy to get food – probably leads me to eat more than I need when lunch time rolls around. Thus, task number 1: make sure I have sufficient snacks throughout the day and access to a lunch I want in order to properly honor my hunger.

I realized last week that I have another hungry-habit that is a holdover from my dieting days. Never a morning exerciser, I like to work out (either at the gym, or by going for a walk) right after work and before dinner. But that means we sometimes don’t eat until almost 8 pm, some nights even later. No good – my significant other (S.O.) and I are both starving and miserable by then and a late dinner means trouble for my acid reflux problem. No to mention we tear into our meal like wild dogs at that late hour, sometimes holding our bellies in distress and dismay at how we ate more than we needed just because we were so hungry.

Task number 2, then: we’re going to eat dinner when we are hungry, which happens to be right after we get home from work. We don’t want snacks then, we want to make dinner because we still have the energy for it. I’ve avoided this because I didn’t like exercising on a “full” stomach after dinner…but exercising on a “satisfied” stomach should be fine…once I get there.

Which brings me to discovering my stopping point. The truth is, I’m often stressed and rushing when I eat, either at work because I’m busy or at home because I’ve waited too late to eat. I’ve also always been a fast eater, speeding through meals as though I’d had to compete with ten siblings for food growing up (I’m an only child). So I’m not actually sure at what point I am stopping these days. I have noticed lately that I feel fuller than I want to at times, and I’d like to remedy that.

(Incidentally, I asked my S.O., who is a very well-self-regulated eater, “Do you stop eating when you’re full, or when you’re no longer hungry?” He honestly didn’t know. He sometimes professes to be a member of the clean-plate-club, but nearly 10 years of watching him eat has allowed me the secret knowledge that he is not – quite often he’ll leave behind food that he is no longer interested in, even if it’s just a few bites. Now there’s an intuitive eater. Except when it comes to pizza, his personal kryptonite, and then all bets are off. Hey, we’ve all got something.)

Over the years I’ve participated in mindful eating exercises in which one bite of food is experienced with all the senses. The Non-Diet Approach… also has a script for this kind of exercise. As you eat slowly and with attention, your body and mind have time to recognize that magic moment when the food tastes suddenly less delicious, your hunger is gone, and you know you are done. While you do want to try to enjoy every bite of food, you probably wouldn’t want to eat quite so deliberately every single time; the idea is for you to practice recognizing the signals of hunger/satiety so that eventually, heeding them becomes automatic.

Again, I have to be honest; lately I’ve been eating at my desk, while working. It’s not the best environment for enjoying my food or recognizing body cues, so I’m determined to make eating a priority not only at home, but at work too. Task number 3: I will step away from the computer, I will put down the pen, and I will be one with my meal. I will eat slowly and mindfully and wait for “not hungry.”

I’ve been practicing all of this the last few days: enjoying my food, honoring my hunger and satiety signals, noting the difference between satisfied and full, eating slower. And I’ve been surprised to find that I am eating less than I thought I would at meals and avoiding that unpleasant, too-full feeling I often get when eating out. The whole point, however, is not to trick you into eating less. Eating with the intention to eat less is just another diet. Checking in often with your body means you get to decide if you want to eat more or not based on what your body is feeling, not a misguided sense of how much you think you should eat.

I’ve got my work cut out for me. But after several years of being diet-free, I finally feel ready to really listen to my body and let it be the boss of how I eat.

For more reading on how to normalize your eating, I recommend these books:
Intuitive Eating
Eat What You Love, Love What You Eat
The Diet Survivor’s Handbook
Overcoming Overeating

Down the Diet Rabbit Hole: A Story*

alice in the rabbit hole1
“Oh shit! How the f*ck did I get here?!”
It starts out with a simple declaration: “I really need to eat better. And I could shed a few pounds. It’s for my health.” So you join a weight loss group. You don’t really think of it as a diet because diets don’t work, everybody knows this. You’re just going to eat healthier and lose weight.

You measure and weigh out portions with the fancy food scale you bought and the measuring spoons that tell you exactly what one portion of everything is. At first this is easy and kind of fun, like a game. You’re a little bit hungry, but it tells you that your new diet eating plan is working, or at least that’s what someone in your weight loss group told you. You do frequently think about cookies and cupcakes, a lot more than you used to, but you’re not going to have any because this is for your health. Also, they don’t fit into your eating plan.

You love walking, so that becomes your main source of exercise. You walk almost every day and you love it.

You lose a few pounds pretty quickly and you think that all the weighing and measuring and avoiding of butter was worth it. People constantly tell you how great you look now that you’ve lost weight. That feels pretty good! Luckily, you barely hear the insult in the compliment.

After a few weeks, you have your first trip out to a restaurant with friends. You’ve been avoiding this for a while but you miss your friends and eating out. You scan the menu for something you can eat without breaking your diet new way of eating, but there is nothing. You heard about how restaurants will prepare food to your specifications if you ask. “Can I have a plain, skinless grilled chicken breast and steamed vegetables without any butter or oil?” The meal arrives and you are elated at how easy it was to ask and get what you wanted requested. Then you eye your friends’ meals and your mouth starts to water a little bit. However, you are also proud of how good you are being, and you revel in a mild sense of moral superiority at your eating austerity. You don’t even have a bite of the dessert your friends split. It looks delicious.

Soon you have lost several pounds. Somewhere along the way you decide on a number. What you have lost is great but you have not yet reached the number. You have reliably lost a little bit each week with your diet sensible eating that you think getting to the number will be easy. But then a funny thing happens. The number on the scale stops going down. For weeks. “You’re just on a plateau,” says the kindly weight loss counselor. “It happens to everyone. Just keep at it.”

Clearly things must change. You cut your portions down a bit more. Walking for exercise, you decide, is just not cutting it, so you join a gym and start moving very fast on cardio machines. You don’t like being inside instead of outside and you dread the sweaty, exhaustive pace, but hey, this is for your health.

A few weeks after you’ve made these restrictions changes, the scale breaks free and drops a pound. “Congratulations!” the lady says as she takes your weekly payment.

Even more diet changes: you switch to a very high fiber cereal that tastes like gravel and gives you painful gas cramps every afternoon. You eat massive quantities of low fat microwave popcorn (the kind you heard gives people who produce it “popcorn lung”) throughout the day to keep the now-constant gnawing hunger at bay. You make large quantities of steamed vegetables and low-fat, low-carb vegetable soup that you don’t want to eat after it’s made – but you do. Even with all those vegetables to fill you up, you are still hungry before you go to bed. You suck on a sugar free candy to fool the pangs away.

You lose a few more pounds but the scale stalls again. You have stopped eating out altogether – you can’t stand looking at others’ meals, can’t deal with the wonderful aromas of the foods you are afraid to eat. You’ve bought new clothes for your slimmer body but have nowhere to wear them because social outings usually involve food or drink, and right now you can’t have too much of either of those. It’s just not worth messing up all that work you’ve done on your weight health.

One day, you get tired of eating the same 10 safe foods and go out with friends. “What the hell!” you think, and order steak and mashed potatoes and sautéed vegetables. You think you deserve this because you’ve been good, but the fact is that you cannot stop yourself from eating the entire plate, well past your point of fullness. Even though your stomach hurts, you order dessert and eat it all yourself. You are not sure what came over you to make you eat that much.

You feel ashamed of your binge and determine to get back on the wagon. You do at first, but that meal opened the flood gates. You think of food 24 hours a day. You simultaneously lust for and fear your next meal. You double down on your exercise and diet (yes, yes, it’s a diet, you know it and can no longer deny this to yourself), but the number on the scale starts to move up a little anyway.

You hate everything you are doing to maintain this weight loss. You hate the gym and feeling like you have to go. You are so bored of your monotonous diet and also the lack of taste, and you are so so hungry. You dream of cheesecake one night and wake up in despair. You are not sure this is for your health anymore.

You keep gaining weight, even though you never really stopped dieting and exercising. So you start eating everything and anything you want. You know this is worse than how you ate before you dieted but you need to fill yourself, fill up the hollow feeling. You quit exercising, including walking, you haven’t done that in forever anyway and all the joy has gone out of it for you. Nobody compliments you on your weight gain.

When all is said and done, you have gained back all your weight plus a few more pounds. You don’t know that this is your body’s way of saving your life from another famine like the one it thinks you just went through. You also don’t know, yet, that you will go through this many more times, trying a different diet (Zone, Atkins, South Beach, Paleo, Volumetrics, Jenny Craig, Nutrisystem) each time, all with the same results. And in the end you’ll have gained an extra 40 (or 50, or 60, or 100) pounds and you will think it is all your fault.

Someday you will find out that there is another way. It’s a way to learn how to be healthy but without worrying about your weight. A way to live without fighting your body. You will find that revolutionary. It will be called Health at Every Size®.Will you choose it?

*This is a composite of many different diet experiences…including mine.

Scientists Find Miracle Weight Loss Cure! Or Not

This little gem showed up in my inbox this weekend: Cost-Effective Weight Loss Programs Help Shed Pounds And Keep Them Off.

The article reports on a study that examined a low-cost weight loss program, Taking Pounds Off Sensibly (TOPS), following 75,000 participants for seven years. The program cost about $92 a year.

Within their first year at TOPS, 50% of participants reached clinically significant weight loss. “Clinically significant weight loss” is defined as a mere 5% loss of body weight. It’s significant because it’s been found that even just a 5% weight loss results in vast improvements in “weight-related” conditions. We’ll talk more about this later. After seven years, 62% of those who lost weight maintained that weight loss. The cost of attending TOPS for seven years was roughly $644.

Well stop the presses, we’ve finally found a cure for obesity! It’s the miracle weight loss cure we’ve all been waiting for! Or so the title of the article would have us believe.

But let’s break it down, shall we? Of 75,000 people, 37,500 (50%) of them were able to lose 5% of their body weight. For a 200 pound person, that equates to 10 pounds, 15 pounds for a 300 pound person, etc. After seven years, 23,250 (62% of 37,500) managed to keep off that 5%. That amounts to 31% of total participants. So roughly one third of these folks were able to lose 10 to 15 pounds (slightly more for people who weighed more than 300 lb) for the mere price of $644. Having done my time in the weight loss industry – both as a customer and an employee – I know that most people don’t join these kinds of groups to lose just 5% of their starting body weight.

You know, I can give myself food poisoning and lose 10 pounds for free. I’ve done it before (by accident, obviously). I might not keep that weight off, but at least I’ll keep $644 in my pocket.

Meanwhile, 69% of the participants either could not lose any weight at all or regained the weight they lost. My guess is that they also spent $92 a year to find that out. Great. Did they get their money back, or were they just blamed for their lack of willpower? All 51,750 of them.

Now let’s talk about this clinically significant weight loss. The health authorities (the CDC, the NHLBI) have lightened up on the previously heralded 10% weight loss (likely having realized that even that is unattainable long term for most people) and now encourage a mere 5% weight loss. I won’t argue that some studies back this up – they do. But a 10 or 15 or even 20 pound weight loss for a 200, 300 or 400 pound person still leaves them fat. If the conditions that are “weight-related” are improved but the person remains fat, what does that say? It says that it might not be the weight loss at all that caused the improvements.

What do people who try to lose weight start out doing? They eat better and exercise. Gee, could it be the behavior changes and not the weight loss that caused the health improvements? We’ve already seen numerous studies that show that healthy behaviors make healthy people regardless of weight. Yet weight loss, a possible by-product of behavior changes, is touted as the supposed cure. Which would be great except it doesn’t seem to work for most people.

We’re smarter than this. This study does nothing but support the idea that we can’t turn fat people into thin ones, which is what people who buy into weight loss are being sold. Who plans to pay $644 to stay almost the same weight when you can do that for free? You don’t need to pay that much to make changes in your eating and exercise habits and become healthier (but not necessarily thinner), I promise you. You probably don’t need to pay anything at all.

It’s just a shame that the remaining 69% of the participants weren’t studied for the improvements they might have made in their health despite a lack of weight loss. Although my guess is that if they didn’t lose weight, they probably got discouraged and gave up any positive changes much quicker than those who did lose weight. And that, my friends, is the problem with a health intervention that focuses on weight loss.

Thanks but no thanks. A failure rate that high won’t see me giving away that kind of money. How about you?

Dieting Killed My Inner Foodie

Yum.
Yum.

Full disclosure: I was once a foodie. I loved trying new and unusual foods; I looked forward to meals out at fancy restaurants and holes-in-the-wall; I looked for recipes that challenged my burgeoning cooking skills – all while maintaining my love for grilled cheese sandwiches made with Kraft Singles (because it’s just best that way).

I grew up in a small town without a lot of culinary diversity (although I did first try Tibetan food there thanks to my friend’s enthusiastic siblings screaming “Try the momos! Try the momos!” at me from their booth at our town’s ethnic food festival), so when I moved to the huge Canadian city of Toronto at age 24, one of the first things I set out to do was taste everything.

A friend and I took the ethnic food listings from the local free paper and decided to conquer every cuisine listed. We started with a Moroccan restaurant (“A” for Africa – we were going alphabetically, at least at first). We ate earthy, spiced couscous and tender meat encased in a phyllo pastry crust. I’d never had anything like it. From there we tried food from Bolivia, Thailand, Indonesia, India, Sri Lanka, Peru, Portugal (and we abandoned alphabetical order). We brought friends with us and it was fun.

It wasn’t just ethnic cuisine I tackled; I also tried ostrich steak, boar, lamb, bison and sushi (“Raw fish?? EW!” and then found it immediately and completely addicting. Except for sea urchin. Still ew.) and more fusion combos than you can shake a ladle at. I found out what really amazing pizza tastes like. I was once on a date with a guy who didn’t know what avocado and sun-dried tomatoes were or what they were doing on his plate and I decided then and there it would probably be our last date. I was already in a committed and exciting relationship with food.

At home, I learned to cook fancy(ish) meals using exotic ingredients I could find in the various markets of Toronto: Chinatown, Kensington Market, St. Lawrence Market, Little India. My inner foodie flourished.

I was not dieting very restrictively at this time, despite having lost 30 pounds a few years earlier (perhaps I had just reached the lowest end of my natural weight range, as Traci Mann advocates but I’ll never know) although I do think that my lazy, halfhearted dieting left me hungry enough to crave very rich foods often and fueling my foodieness. It wasn’t until I began severely restricting my calories in the name of bodily perfection that my foodie self came into conflict with my dieting self.

To be thin, I simply could not afford the calories of a truly delicious meal – ever. I couldn’t even afford the calories of a very basic, average meal. By this time I was living in San Francisco, another great food town, but instead of enjoying it, I ate a half PBJ sandwich and fat free canned soup every day for lunch (I would have preferred the French cafe down the street) and hoovered bags of microwave popcorn to keep my stomach from growling. When I did eat out, I would starve myself all week and then binge till I was sick, followed up with a terrible guilt hangover. I don’t remember any of those meals fondly. Ironically, during this time I started telling people how much I lurved food, how obsessed I was by it. That obsession and preoccupation was even why I became a dietitian.

As you know, I eventually quit dieting because it was ruining my life. For a while, I ate everything again. I was in school and funds were limited but I still had fun not constantly worrying about what I was eating. I have since developed acid reflux which has recently limited my experimentation and even enjoyment of food. I know this is partly stress-related and I fully expect some improvement with upcoming life changes. But I’ve also likely inherited my mother’s delicate middle-aged stomach and will probably always have to be cautious around some foods (avoiding too much garlic, too much heat, too much fat or fried).

And part of me thinks I will never be quite that excited about food again because 1. I’ve tasted a LOT of foods, and the novelty of experimentation has worn off over the years and 2. I’m never starving enough to get into a food frenzy. Eating is generally pleasurable for me but I’ve got other things to do, and that’s a bit of a relief.

I still pine a bit for my former inner foodie, though. At the very least, I want to reclaim the joy I once had in cooking. I want to make bagels in my kitchen again because my bagels rock and it’s really fun. While writing this post, I slaved over an amazing pot of chicken posole. This weekend was jambalaya which I haven’t made in years. At the very least, I’m thrilled to be able to eat these foods without any diet anxiety. What I lost through dieting, I will reclaim through liberation.