I Speak for the Fat People-last part

Jan18

I heard a heartening story about a man and his joy-spreading tactic. Essentially, he spends half of his time acquiring special little chocolates and the other half, gifting them to people as morsels of universal love. I am either becoming a very cynical nutritionist or a very empathic human being. The collective psyche is longing for the morsel of joy even at the expense of the perfect waistline. The truth is that we have appetites and hungers because we are merely human, not because we are bad people. However, when all of these human tendencies accumulate into extra pounds, getting rid of that weight is very difficult.

A few years ago, I attended a conference on an obesity-related topic. During one of the workshops, the speaker, a physician and researcher at a major university, presented a case study of a postpartum woman with a body mass index (BMI) of 30–thus classified as borderline obese. He instructed the audience of professionals to brainstorm how to counsel this woman. The exercise had me squirming from the get-go. As the attendees were dead-ending in their attempts to describe a reasonable approach, the presenter intervened. He said, “Let me offer this idea. I am often in my office at my desk and on the phone. I could just sit there and talk on the phone, but instead I stand and pace as I am talking.” My agitated brain said, “Yes, let’s file that idea to use.” Not with my clients but in this article. I could picture Homer Simpson stuffing one more donut in his face while muttering “Ah, vigorous pacing. That’s the ticket.” I wondered when was the last time this guy got out of his office and realized the experiences of real people, including real fat people and real postpartum women.

TARTA DECORADA HOMER Y BART SIMPSON

TARTA DECORADA HOMER Y BART SIMPSON (Photo credit: YOCUNA ARTE EN AZUCAR)

Hardly are all designated cases of overweight problematic. Some in the field maintain that the goal is for all individuals to attain an “appropriate” BMI.  Short of that, they will be at risk for various health problems. My intuition and much science beg to differ. Many people are fine–if not perhaps better off–with a little extra weight on them. Pavarotti once said, “The reason fat people are happy is that their nerves are well protected.” My own observations reveal that the neurotically thin tend to be more frayed than their rounder counterparts. Besides, BMI is just a tool. At times it is a cruel tool—or at least a not very nice one. It makes no allowance for age, fitness, or even natural body type–nor pregnancy-related metabolic changes. Whether we like it or not, our bodies will shift and change as we age. Nature, with no ill intent, seems to want to round us out a bit as we mature. That is how we get to be grandpas and grandmas. Appropriate BMI does not necessarily confer lack of health risks–only ones of a particular nature.

Do not get me wrong. I am not undermining the seriousness of the obesity crisis that we are facing. I understand its consequences perhaps more than most. I see the implications of weight that people struggle with on a daily basis and I strive to alleviate the challenges through educational, lifestyle and nutritional support. I bemoan the forces that are propelling our society into ever-expanding levels of girth, especially those that are now affecting our children.

Still, I feel a need to call TIME OUT! To stop the madness that makes those who are the statistics speechless. To stop pointing the finger merely at the individual without an understanding of the deeper forces that are at play.  There are multi-factorial causes that lie at the root of the weight gain epidemic. Many are so abstract or insidious that it is very difficult for the experts—let alone an ordinary individual–to understand what is going on. Though overeating, bad eating, food addiction, and poor lifestyle choices are definitely a part of it, the magnitude of the communal weight gain doesn’t seem to make sense based on calories alone. In the causative mix lie politics, hormones, pharmaceuticals, poverty, nutrition misinformation, dieting, food sensitivities, sensory science, profits, changes in the components of our food, environmental toxins, personal and spiritual alienation and lifestyles spinning out of control.  There are strange bedfellows in each and every fat cell.

Now, back to our friend the Lorax. For the record, the Lorax, our venerable spokesperson, was rather portly himself.  Based on his picture, I’d put him at a BMI of about 27. I’d describe him as neither apple nor pear-shaped but rather pickle-shaped.  According to Dr. Seuss, “He was shortish. And oldish. And brownish and mossy.” The final message of the Lorax in his plea to save the environment was UNLESS. “Unless someone like you cares a whole awful lot, nothing is going to get better.  It’s not.”

I too am rather shortish. Oldish, brownish and mossy may someday also describe me.  For now, my intention is not to imply an ultimatum. It is, however, to bring a greater sense of compassion and understanding–and a broader lens to the discussion and to the approaches to care.

I do not intend to deny the role of personal responsibility—be that for everyone. It is a big piece of the puzzle. Though it is critical that we address the current weight epidemic–we should not do it with an assault on the fat people. We must not slap everyone silly in an attempt to squeeze them into a size six dress or Speedo swimsuit. Besides, who would be left to sing the blues? And though I’d have been happy to find my grandmother at the gym, it could not replace the experience of cuddling up on her big, warm lap with wonderful smells wafting in from the kitchen.

Thank you for listening, sharing, following, and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.

Related Posts:  I Speak for the Fat People: First Part and I Speak for the Fat People: Middle Part

In health, Elyn

my plate

my plate

My Plate Haiku

Hunger tiptoes in

From bellies, hearts or minds

Feed me now she calls.

by Eva

I Speak for the Fat People: middle part

Jan14

Let’s put the issue of overweight into perspective. If we look at weight historically, I’m pretty certain that from the beginning of time, there have been fat people. We have all seen the pictures of early Cro-Magnon and Neanderthal men. Even those quintessential hunters and gatherers seemed capable of packing on a few pounds. After them came Confucius, King Henry the Eighth, Mamie in Gone with the Wind, Jackie Gleason, Pavarotti, Aunt Bea, and my grandmother. Chances are your grandmother was fat, too.

English: Luciano Pavarotti in Vélodrome Stadiu...

Pavarotti Image via Wikipedia

Since our early beginnings, human beings have come in varying shapes and sizes and large-size was not necessarily an aberration of medium-size. It is good that there are large-sized people. A world without them would mean a world with fewer great opera singers, chefs, women of ample bosom, football players, construction workers, and cuddly grandmothers.

It is not very difficult to become fat. You do not have to go out of your way to try.  If Chinese youth can become fat, then anyone can. Only about 4% of the population has naturally model-thin bodies. That means that many models are starving themselves in order to be models. It also means that the rest of the size 2 wannabes are expending a lot of physical and mental energy in the pursuit of thinness. Carolyn Knapp, in her book Appetites, tells the story of a woman who describes the angst she feels putting on her stockings every morning. She wonders what she could have accomplished in her life with the time she has spent worrying about her weight.

There are the naturally skinny–and then there are the neurotically and pathologically skinny; and the metabolically hyper-activated skinny–those who sustain themselves on a steady diet of excessive caffeine and nicotine—or maybe extensive exercise. For the rest of us, the possibility of becoming overweight is just around the corner. We are physiologically and neurologically wired to pack it on. The ability to store fat came in pretty handy a time or two during our multi-millenial evolution. We have about 107 compensatory mechanisms that prevent us from starving to death.  A bunch of those certainly kicked in to save our forefathers when they were unable to kill a bison. In people who attempt to starve themselves toward thinness, the body fights back–it regains the lost weight plus more, and then absolutely refuses to budge.

In addition, we are wired for comfort. Research shows that the food habits that sustain us are those that we developed while still wrapped in the loving veil of early childhood.  Whether that happened to be gazelle, chicken soup, mashed potatoes or cheeseburgers, you will probably turn to those foods as an adult. Believe me, the corporate world certainly knows this.  The Happy Meal ensures that today’s toddlers will become tomorrow’s adult fast-food consumers.  The concept of comfort foods is one I hear a lot about during my spy missions. Women have confessed to me that they would choose a good loaf of bread over sex. The quality of the sex is not indicated in this context.

Then, of course, there are our natural temperaments as well as good old genetics.  I listened once to the tender story of a woman who was adopted as a child.  She never met her birth mother, but she possessed a very old, poor quality home movie that she believes is of her mother. Though she struggles to see the face better in search of subtle resemblances, it is the woman’s thighs that confirm her finding.  She states, “Look at the thighs. Those are my thighs.”

On top of all this, let’s sprinkle on a life change, or just daily, chronic stress. Take your pick. Break-ups, abuse, graduate school, poverty, working long hours, caregiving, depression or menopause are possible choices. And, God forbid you should simply possess a deep sensuous life-affirming passion for cooking and eating.**  Throw any of these on your plate and if your primal wiring wasn’t enough to enlist you, then current circumstances will. Even the once-thins can become the now-fat–especially in this current milieu where food is literally out to get ya. Not even the high school cheerleader is immune. Any emotional state that is heightened, increases for many, the desire to seek food for a reward. When one is working their way up the weight chart, it is because they are possessed by physical or emotional hunger or physiological changes that they can neither understand nor control.

I can hear you begin to protest that it has to be more than just this. Aren’t we soooo bad?  We ate the piece of chocolate cake (and we loved it). How could we? How dare we?  That translates into four hours of floor mopping according to the calorie expenditure charts.  That must be fair penance for the crime. As a spy, my days are peppered with the monologues and dialogues of self-hate and recrimination that people utter like a mantra before and/or after each foray into eating. The guilt is palpable. We must have all been ____________ in a previous lifetime. (insert your own response.)

(one more segment to follow)

Thank you for listening, sharing, following, and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.

Related Posts:  I Speak for the Fat People: First Part and I Speak for the Fat People: Last Part

In health, Elyn

Related Resources 2010: The end of overeating. Taking Control of the Insatiable American Appetite (David A. Kessler, MD); Born Round:  A Story of Family, Food and a Ferocious Appetite (Frank Bruni)

 

I Speak for the Fat People: first part

Jan12

I speak for the fat people. Like Dr. Seuss’ Lorax who spoke for the trees, someone must speak for the fat people. Unlike the trees who needed a spokesperson because they had no tongues, you would think that the fat people would be able to speak for themselves. Of course, fat people have tongues. If they did not have that taste bud laden sensory organ, they would not be fat.  Given the current weight of the world, this group should not be particularly hard to hear. However, in the huge public dialogue about weight and obesity, the fat people are merely statistics. There are no real people behind the statistics, and this is where they have lost their voice.  Therefore, they are stripped of any ability to speak with authority on the topic.

I am not a statistic. Though I have had some years where I toed the chubby line, for the most part, I have done my part in tipping the scales toward societal svelteness. Besides my obligation as a citizen to keep the fat numbers down, as a nutritionist, it is my professional responsibility to pull people out of the fat pool and to keep them from falling in at all.

It is no big secret that the medical and nutritional community has not done a great job in their role as bariatric (the science of obesity) lifeguards. I myself do not have a great track record of turning people into mere shadows of their former selves. But, I have spent my career as a nutritionist hearing the stories and struggles of the fat people and observing the ways of food and eating that define this turn of the century. I am a spy in the house of girth.

The fat community does, in fact, have some spokespeople. There are magazines, journals, and websites edited by those (mainly women) who have spent one day too many in the deprived and depraved world of dieting. There are professionals and individuals who are doing incredible and poetic work about re-informing and re-educating on misconceptions about weight and health and respectful self-care. Still, many of these efforts are marginalized or featured in venues that only topic-obsessed people like myself pay attention to. Even Roseanne Barr once said, “It’s OK to be fat. So you’re fat. Just be fat and shut up about it.” For every individual or undertaking that sings the praises of fat, there are thousands of counter-voices screaming the imperative to whip it away.

Therefore, I believe I must use my credentials to speak out. I hope that the fat people can accept me, a thin person–who is often cold and prone to osteoporosis–and an ex-stress and emotional eater to be their voice. Born of thin mother and fat father, I will try to do the cause justice.

Thank you for listening, sharing, following and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.

(to be continued)

In health, Elyn

Related Posts: I Speak for the Fat People: Middle Part and I Speak for the Fat People: Last Part

Related Resources (2010): (Frances M. Berg); Intuitive Eating  (Evelyn Tribole and Elyse Resch); Health at Every Size (Dr. Bacon); Dances with Fat(Ragen Chastain)

 

feeding things

Jan5
Sunflower Seed Kaleidoscope

Sunflower Seed Kaleidoscope Image by Tobyotter via Flickr

Why are the birds at my feeder giving me attitude about the milo, millet, cracked seed with oil sunflower seed food, squawking that they will only eat plain oil sunflower seed? Picky, picky, juvenile, ungrateful little peckers. Sure, I’ll get out the ladder in the freezing cold and go change it–which I did.

Chico, the cat, is never satisfied. How can it be that after so many years together, his humans cannot understand his hearty appetites and food preferences? Why must he always settle for such mundane fare as cat food? He knows that I know he enjoys cantaloupe served diced on a plate at the table, so what’s up with this dry crap in the cracked bowl on the floor?

Last week, after our usual morning argument about breakfast, I left the kitchen in a huff, saying, sorry, Chico, this is not a restaurant, and that is what I am serving today. He followed me into the living room, and as I bent over to put my shoes on, he head-butted me in the butt. Lucky for him he is the most amazing, adorable and hysterical cat in the world.

dmc-g1 015

Chico

Luna, the other cat, will only drink out of the bathroom sink. A trip to the toilet is never a solitary experience. If you’ve not tripped over her as she comes careening out of nowhere to leap onto the sink from the toilet bowl, you must then negotiate the faucet flow, your own flow, and the toilet paper roll, all simultaneously as she tends to her hydration.

My daughter scoffs at the most important meal of the day and today, I watched as my dear husband tried to mix his whey protein powder into his bowl of oatmeal–trying to kill two dietary imperatives with one spoon. Why must this all be so difficult?

Meanwhile, the fire belly newt, Everest, that we have had for nine years is without complaint, happily chowing down on his Freshwater Flakes from the first and only 2.2-ounce container that we ever bought. I am trying to read from the label but some of it has already faded. It contains a natural something or other formula and is made ONLY with Fresh Seafood. Seriously, he is only two-thirds through this small canister–in nine years! The price sticker is still on it. The bottle cost $5.89. Every few days I say, “Oh, the newt!”, and sprinkle a few flakes into his grungy tank. Don’t misread this. He and I have a very special bond. Today as a treat, I gave him a couple of Newt and Salamander Bites. My he loves those. That 1.2 oz container is only half empty and says on the label–soft sinking pellet diet.

There is just so much meowing, barking, whining, chirping, oinking, mooing, hissing and howling going on these days about all this food and eating stuff. Can’t all species just get over it and agree to this simple amphibian flake and pellet diet?

Ah, well. Time to go make myself some lunch. Please comment if you love Chico (he does have quite the following) or any other finicky mammal.

Thank you for listening, sharing, following, and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.

In health, Elyn

Related Post: Still Feeding Things

a cinderella story

Dec31

Yesterday, at 2:00, I had my last client guest of the year. I was visited by the young Haitian princess Atabei. I have had the pleasure of working with her over the course of the past year. I was granted permission to be in her highness’s presence because her royally endowed figure put her by age sixteen very close to 300 lbs. Now, she is almost eighteen. She is not the heaviest of my young clients but I do particularly worry about her because she has Type 2 diabetes.

HISTORY | Her Serene Highness Princess Olive, Daughter of Emperor Soulouque. Haiti C. 1858

Haitian Princess

As we know from many fairy tales, life is not always easy for the crown-wearing crowd. Atabei has had a not so rosy past and has been fending for herself for a very long time. She has a queen mother and an older prince brother who love her–but who are caught up in their own problems to have much time for her. She navigates most of her medical care essentially on her own. Unfortunately, Medicaid doesn’t pay physicians for castle calls.

Like many royals and commoners alike, Atabei was used to eating in a bacchanalian fashion and was not subscribing to my pedestrian nutritional guidebook. She mainly craved and consumed foods that in her own giggly adolescent words were magically delicious. For those of you who may not know what that means, Lucky Charms, Toaster Strudels, and Dunkin’ Donut Munchkins are magically delicious, while whole wheat bread and oatmeal are not.

Progress was very slow, but she got a lot of credit for what we call just showing up–despite multiple challenges and limited ability to change her food environment; and she was succeeding at what I like to refer to as weight gain stabilization–she wasn’t losing weight but she wasn’t gaining either. Being evicted from the castle and landing in a motel does not usually lend itself to being able to focus on one’s eating habits and feeling good about oneself. Still, despite a few missed appointments here and there, she kept coming and she kept journaling. She was never too shy to hide her utter disgust at some of my suggestions and held tight to the foods that comforted her.

Eventually, I began to encourage her to get over to the local YMCA, where I have a partner in crime–Ben. Ben’s a little wiry guy, but as the wellness director responsible for youth programming and as a trainer, he is deeply committed to catching any kid–no matter how big- I can throw his way. Patiently, he serves to help re-knit the self-esteem that has been unraveled from so many through the art of attention and physical activity.

After a few failed attempts, Atabei gathered her horses, got in her coach, and proceeded over to the Y. Yesterday was the first time I had seen her in a while. She arrived in her radiant beauty, sans tiara, more alert and positive than I have ever seen her. She has only been going to the Y for a month, but she is already enjoying that her endurance and strength have increased. She is drinking a lot more water, is less obsessed and possessed by her old magically delicious foods, and is shocked to realize she can now choose to leave food behind. Gradually, she has made some significant diet changes which will help heal her insulin resistance. I had to almost stand on my desk and shout for her to acknowledge this. But, when the scale confirmed what I already had, her beautiful princess smile widened even more.

At the end of the session, I helped her set some of her goals for the new year. She had never before been able to even imagine that there was a possibility for change that she could empower herself. Now she finally could. What did I ask of her? That she keeps really listening to her body and seeing what it actually needs; and that she does not give up on herself. She will try–she does like to humor me.

When the clock struck three and she stepped off the curb in front of the building, she may have looked like just another poor, black, fat kid– but things are not always as they appear in the kingdom. Blessed be. Tres Bonne Annee, Atabei!

Please acknowledge the health and dietary impacts resultant from our huge cultural and environmental challenges and inequities–and honor your own small victories. Cheers.

Thank you for listening, sharing, following, and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.

In health, Elyn

culture clash

Dec26

A new client arrived at my office. She was an Iraqi woman–a refugee of the war in her country. She had made it to my little corner of the planet by some grace and the help of her three adult sons who she was lucky to still have in her embrace. One of her sons was present with her for the appointment and served as our interpreter.

The woman was about my age–mid-fifties. She was referred to me for high cholesterol–which is a usual raison d’etre for getting put on my schedule. Though there are so many things the human heart can suffer from that may affect our health and hardiness, there are only a few we can measure easily and then neatly deem abnormal. Cholesterol and blood pressure levels are of course the most common. One spin of the sphygmomanometer or a few fatty drops in the blood is the determinant of our health risks. The regulation and control of these resultant measurements become the pressing story, while the real matters of the heart get deeply lost in the sauce.

My client with warm shining eyes beaming at me from under her headscarf had been treated for breast cancer a few years ago while still in Iraq and had not had much follow-up care since her odyssey had begun. She had only been in the United States for a few months. She was dressed in full Muslim garb, ensconced in a lot of fabric. Awkwardly, she adjusted her clothing to reveal to me some loosely wrapped gauze lying limply around her upper arm to contain the swelling of lymphedema. The consult contained fragments of conversation as I tried to piece together some semblance of her health history and her saga of survival.A Picture Of One Of The Doors Of Al-Kadhimiya Mosque, It ...

As I was engaged in my own fact-finding mission, and trying to figure out how I could best assist her in the short time I had, she was gesturing toward me while speaking in Arabic. While I was simultaneously trying to stay very present and yet trying to search for contact numbers of local resources, her son was gently interpreting her words for me. She was apparently commenting on my seemingly well-behaved body that has obediently stayed within the confines of acceptable shape and form. She referred to her own, rounder, body with shame and regret.

As her meaning crystallized before me, the tears welled behind my eyes. This beautiful woman inhabited a body that manifested the pain of many inflictions. She had traveled half the globe to find a tiny sanctum of political refuge and safety. While living in the midst of unbelievable violence I am sure she lost a lot more besides her girlish figure. How dare she not tend to her weight and diet like I had while my government had torn her country asunder and bombed it to pieces. I beseeched her not to compare and mumbled my apologies while the irony of our human vanities swept over me.

With this turning of the year, as I pray for peace on earth, I will carry her story with me and wish her the very best.

Thank you for listening, sharing, following and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.

To all of you, A  Happy and Healthy New Year.

Photo Credit: Al-Kadhimiya Mosque  rasoulali/123RH.com

In health, Elyn

Bamia: Stewed Meat with Okra

Okra stew served in a bowl

Iraqi MyPlate by Amina hungrypaprikas.com/okra-stew

My Plate Poem

As we walked away from our grandparents’ houses

Away from the places we knew as children, changes of state and state and state

To stumble across a stony desert, or to brave the deep waters

While food and friends, home, a bed

Even a blanket become just memories.

by Neil (Gaiman)

you ain’t necessarily misbehavin’-part 1

Dec16

Why is this question of nourishing ourselves so difficult? We all know there are some basic concepts surrounding the care and feeding of the human being, but unfortunately, we are not equipped with an owner’s manual. Therefore, as we move through our lives requiring food for both emotional and physical survival, we respond to our needs with some twist based on our own experience; and clearly, some confusion often occurs along the way.

Looking at this question might enable us to have more compassion for ourselves and others in this realm where there is so much self-loathing and self-recrimination. There is probably no other activity that we do with so much community and yet such isolation as feeding ourselves. In the emotional terrain of eating, no feeding decision is made because we are a bad, weak or disgusting person. I use those words because that is how people feel and describe themselves.Image result for mom diner sign images

As a nutritionist, I sit in small rooms hearing people’s stories about their relationship with food, eating and their bodies. These stories are spilling over into the “street buzz” of daily conversation as people are being increasingly consumed by a fear of food and shame and loathing of their bodies. In workshops, I lead an exercise asking people to write down a negative thought they have had about their body that day. I then ask them to write a good quality about themselves that is not related to body image. Reconciling the two is hard to do. Realizing that such wonderful people could be feeling so badly about themselves is enough to make anyone cry.

The power and capacity for these feelings to diminish the human experience is profound and insidious, yet we rarely consider how complicated is the source of the issues. However, such consideration provides an important perspective and may shift where we point the finger. By separating out those aspects related to self-nourishment that we have control over, from those that we don’t, we can perhaps alleviate some of this suffering and can enhance prevention efforts which may be more effective than current remedial strategies.

To understand the distinctions, and to get just a glimpse of how many factors there are, entails a look at human development. Much of our food tendencies begin while we are still pickling in the brine of our mothers’ wombs. Our chromosomal template influences not only our adult body size and shape but more subtle biological processes as well. How efficiently our metabolisms will burn, how our brains will interpret satiety, and how and where we will store fat is all rather pre-programmed on one’s personal dance card—imprinted essentially when sperm meets egg. Our ability to resist a piece of chocolate cake is apparently even coded in our DNA. Some individuals are genetically better “resisters” than others. Who knew, right?

Likewise, women have more sensitive taste buds than men. That second X chromosome can translate into a tendency for food distaste and picky eating that is formed before we are even born. Other aspects of the maternal milieu–or in other words, our intrauterine environment–including our mother’s diet, blood sugar regulation, and calorie availability also will have an effect on our own taste inclinations and feeding behaviors after we are born. Our first eating experience really happens at Mom’s Diner. Pretty crazy.

And that is just the beginning. For now, just chew on this, and in the spirit of loving ourselves, consider how such an appreciation of how we have arrived where we are through very little fault of our own, can translate into some gentle acceptance instead of the usual flagellation with figurative wet noodles–be they whole wheat, gluten-free or basic semolina.

I do not intend to suggest that we absolve ourselves of responsibility for our health and eating behaviors, or that we should just throw in the towel, but perhaps such a reflection can help us to accept ourselves more for who we are and to put a lid on the negative self speak about our bodies. Such scolding and negative reinforcements will never lead to positive change.

Let us return food to its own natural place and let us reclaim our birthright of health. Remember that there is a beautiful light that shines in all of us. Believe that it is there.  Keep trying. We can create a new reality for ourselves.

Thank you for listening, sharing, following and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.

Related Post: you ain’t necessarily misbehavin’-part 2

In health, Elyn

by george, i think he’s got it!

Dec11

Thorazine, Seroquel, Paroxetine and Lipitor. It looked like a good case of schizophrenia with a touch of high cholesterol. Unless I am very busy, I usually get a glimpse of my client’s history on the electronic medical record before I call them in. This is usually a good idea.

There is a set of double doors and a short hallway separating my office from the waiting room area where patients wait. As I pushed through the doors, a tall gentleman was anxiously waiting right at the other side, surprising me. James? I ventured. Yes, indeed.  Well, that was touching. Not all my clients are quite so eager to see me.

baked bread on plate near mug with coffee

Photo by Sarah Boudreau on Unsplash

James began excitedly talking before we even made it back to my office. Persons with mental health problems are no strangers on my schedule. Often the powerful medications they are on have high side effect profiles–most of which include weight gain. In addition to this, many in this population cannot work and live on the very limited fixed incomes provided by their disability payments. The capacity to access and prepare good food is pretty low–and coping behaviors like cigarette smoking, coffee drinking, and pastry eating are high.

I admit that sometimes, as I am doing my ritualistic walk from office to waiting room, premature assumptions rotate my eyeballs upward and I internally utter something like, Dear Lord, really? Is my job as a nutritionist not already hard enough? Couldn’t you have made me a psychiatrist or neurosurgeon or something easy like that instead? This was one of those times.

James is 45-years-old. He lives in a studio apartment by himself. His meager kitchen consists of a refrigerator, microwave, and hot plate. He smokes close to a pack of cigarettes a day. And, he is a baker at a local cafe and bakery. So, every morning, James is at the bakery, not only surrounded by but preparing mouth-watering temptations–and an always fresh pot of brewed coffee. Together, that popular combination has been the foundation of his diet for many years. He confides that he loves his Folgers and has 2-3 big cups per day with sugar and powdered creamer.

About three weeks ago, James’ doctor informed him that his cholesterol levels were high and prescribed the usual statin Lipitor. Of course, that scenario is exceedingly common.  Most people are generally just told to take the medication; some are given lip service on eating a low-fat diet; and a few who may be fortunate to have a doctor who knows of a nutritionist a few doors down, are told, “Go see the nutritionist”.

James says he doesn’t want to have health problems like this and that he has already made some changes. He’s not really sure if what he is doing is right though, and he’d like some input. He proceeds to tell me that instead of just having coffee and a sweet in the morning, he is now eating a bowl of instant oatmeal at home; leaving the pastries alone and waits till late morning when the head cook prepares for him a bowl of her well-regarded freshly made soup. Also, he has stopped going to McDonald’s; has cut down his coffee intake and is drinking more water. And, when he wants to snack at night he is having some peanuts. Impressively, he is trying some new vegetables which he admits is hard for him. Almost apologetically, he explains he never ate any of that kind of stuff when he was growing up.

I am praising, affirming and singing hallelujah. Then, he says that with his next paycheck he is planning on buying a steamer and a countertop grill. He imagines that he has room for those and they wouldn’t be that expensive. He asks if I think that is a good idea.  Suddenly, he is the Eliza Doolittle to me, Professor Higgins, and though I haven’t done anything, I could not be more proud.

By these simple changes, James has already cut his consumption of dangerous refined sugars and carbohydrates,  increased soluble fibers, decreased trans fats and improved his hydration status. When I weigh him he is already down three pounds. This pleases him. But, most incredibly, he says that he already feels a little better– not just physically, but mentally as well. Yes. This is a very profound statement for someone who has been medicated for most of his adult life. James has gleaned what most have never considered–the relationship between nutrition and emotional and behavioral health.  As we finish, he acknowledges that he is not ready to address his smoking, but he is really thinking about it. Though there are changes I will still recommend–and some things that I will not be able to change–James is on his way.

This story is typical of instances I am privileged to encounter on most days and which really keep me going– people like James, who despite very difficult circumstances, find some way to respond to an inner impulse to find a better way. As often as I may wish for easier work, I do look upward and say thanks for some incredible inspiration and beautiful encounters in the name of health. Now that wasn’t so hard, was it?

Thank you for listening, sharing, following and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.

In health, Elyn

Stopping Traffic

Dec7

“The public is silent when young women die.” charges Naomi Wolf, author of The Beauty Myth.

I have just returned from an annual conference that I attend on Eating Disorders. The conference, in its eleventh year, is sponsored by The Nutrition Clinic and Sol Stone (Update 2020: Upstate New York Eating Disorder Service); Clearpath Healing Arts Center; and Ophelia’s Place who work together to form a strong, sensitive and progressive treatment network in central New York.

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Image by Mystic Art Design at Pixabay   

Each year, near the end of the conference, a handful of individuals in the recovery stage of their eating disorder are invited up to share some part of their story. This is, of course, the most enlightening and always most emotional part of the day. The wisdom acquired in overcoming such a strong opponent is very deep and these very intelligent women articulate it beautifully.

This day, a young woman in her mid-twenties, stood before the two hundred or more attendees and shared that in the darkest days of her eating disorder, she almost walked into traffic–but only stopped herself because she felt it would be immoral to place such a horrible burden on whoever might have killed her. To witness someone so young describe such a depth of despair was both bone-chilling and deeply heart-opening.  

On some level, we know that there are people who are suffering from eating disorders, but essentially they are invisible. However, when one is privy to the stories of those who have had one of these crippling conditions; and you couple that with statistics like one in 100 individuals has an eating disorder—it is imaginable that there are truly some “walking dead” amongst us.

To offer some response to this young woman who had the courage to expose her pain and vulnerability and who has found the strength to persevere and to heal, I bring to this conversation– about the realities of eaters and eating– a discussion about eating disorders. I know that it does not do justice to the topic. It is a contorted and rather incomplete version of something I have written before. But, it seems a fitting time for me to introduce this part of the story. In honor of that woman and the four others who stood before me a few days ago, please consider the following.

We may have seen or heard about someone who is nibbling on only lettuce and carrots at mealtimes; wearing heavy clothing in moderate temperatures; exhibiting extreme weight loss; exercising excessively or appearing listless at a team practice or dance class.  But, to the inexperienced eye, even extreme physical changes or behaviors can be overlooked or ignored. We may have even encountered someone who we suspected was suffering from an eating disorder, but we did not know what to do or say.

Most definitely, we have all had dealings with eating disordered individuals whose behaviors escaped our radar screen. The very nature of eating disorders is secretive and manipulative. Average-weight or over-weight individuals may be suffering as much as their noticeably underweight counterparts; older persons as well as younger ones; and men as well as women. Compounding the issue is that in certain environments like high schools and college campuses—but in the larger world as well—there is a “culture of thinness”. In such environments, underweight individuals can appear almost normal looking. Responses to eating disorders can include, “Oh, I wish I had that problem”, or “Why don’t they just eat?”

Even when we are cognizant and concerned about eating disorders, it is impossible to consider or measure the loss of potential and achievement, the degree of nutrient deficiencies, the magnitude of depression and anxiety, the potential for long-term health problems, and the possibility of sudden death from complications or suicide that eating disorders engender.

Eating disorders tend to leave people feeling frustrated, confused and helpless. Despite this normal reaction, it is really important that our society and our public health policymakers begin to better acknowledge, support and treat those with these disorders.  Without intervention, chances for a full recovery are slim for those with severe conditions.

I have discussed my concern about the panicked way in which we are “battling” obesity.  For many, overeating is an eating disorder–as deserving of a very sensitive and holistic approach to care as does “undereating”. We have the opportunity, and perhaps the obligation, to create an environment and dialogue that challenges the attitudes that make individuals feel bad about their bodies and that feed the medium in which all eating disorders thrive.

We can only hear the wisdom of those who have confronted an eating disorder if we are very quiet. If we can move the lens away from the obesity issue and reframe the disgust we harbor about fat, we may realize there is a gentler and more important conversation to be had about feeding, eating, and nourishment.

Frances Berg writes, “Our children, our daughters, and sons, are growing up afraid to eat, afraid to gain weight, afraid to grow and mature in normal ways. They are desperate to have the right bodies, obsessed with the need to be thin and fearful they won’t be loved until they reach perfection. This is the point to which our weight-obsessed culture has brought us. Our children are innocent victims.”

Thank you for listening, sharing, following and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings always welcome.

Related Resources: Bulimia.com; Becky Henry, Hope Network; Moonshadow’s Spirit

In health, Elyn

Related Posts: Dolls with Faith, Muse of the Girl, Nourish Thyself Well Day, A Meteorological Change of Plans, Size Me Down

Related Resources: Bulimia.com; Becky Henry, Hope Network; Moonshadow’s Spirit

Are you the 1 in 4?

Dec1

Some serious news has crossed this nutritionist’s desk. A new study published in Obstetrics and Gynecology and reported by Science Daily shows that 25% of overweight women do not know they are overweight! C’mon. I can see maybe not knowing if you have high blood pressure or an obnoxious personality, but I am pretty sure overweight women are not walking around too delusional.

Image from Pinterest

Of course, once again it is those Black and Hispanic women who seem to be most in the dark about their weight status, along with women who hang with other fat women. But, it could happen to anyone–even you. Do you know your body mass index (BMI)? If not, it is quite possible that you too are a misinformed blob.

This type of media messaging drives me insane. The study involved asking ‘childbearing-aged women’ (oddly, only those aged 18-25) some objective and out-of-context multiple-choice type questions about a very subjective issue. The responses were matched to the (once again) imperfect BMI and the results were interpreted to show that 25% of overweight and obese women didn’t realize they were fat. The study authors conclude from this that this misperception will “lead women to continue to eat poorly, to gain more weight and to eventually develop the complications of obesity”. As opposed to those who are fully aware of their corpulence? If you didn’t deem your body ugly and problematic and its BMI was any higher than a 25–the threshold of gluttony–you clearly have had your head in the ice cream freezer for too long. Tell me, who gets these research dollars? I want some.

The study authors say that they were not surprised by the results based on their belief system that “as the nation’s obesity rate grows, it becomes more socially acceptable to be overweight and the truth becomes obscured.” Those who can no longer see their toes must now be mightily perplexed.

The lead study author says, “people compare themselves to those closest to themselves”. I am not really sure what that means. I presume she is reiterating this other new belief, that if all your friends are fat, and if you are fat, you think that is normal. I thought I was a “normal” weight woman, but, now I’m wondering if maybe I just think I’m “normal” because I spend my days with high-weight people–and can no longer assess my own size.

I work with some real heavyweights. My clients have BMIs in the thirties, forties, and fifties. I realize the privilege and responsibility I have in talking to people about the very intimate topic of weight and body size. Having done this work for many years, I think I have a deep respect for the territory, but on occasion, I too may overstep the boundaries. Sometimes, I am compelled to inform someone that their health may be at risk when it is my conjecture and not their truth.

My days are filled with having very insightful and meaningful conversations with very reality-based individuals–each with their own profound story about eating, diet, and self-care. And all that has influenced these. Most usually, my clients seem to appreciate having an opportunity to safely talk about these sensitive issues. Most are interested in change not because they suddenly realized they were fat, but because something else is impacting their physical or emotional experience. Some have had previous efforts trying to melt away their fat–others, are trying to figure out where to even start.

When they are with me, my clients are very nice, but for all I know, behind my back, they are probably calling me skinny, undernourished, or bony. Perhaps it is time for fat people to reclaim normal and to expand the derogatory language used to describe skinny people. I offer hyperactive, self-absorbed, or neurotic. However, mind you, many are just genetically under-endowed. Overlooked in the dialogue about appropriate weight is that the vigilance, self-scrutinizing. attaining and maintaining required is much more of a privilege associated with socioeconomic status than is acknowledged generally or by the study’s authors.

I would like to advance the Peter Paul Rubens standard of sensual Rubenesque beauty and health. A standard that allows people to feel comfortable in their bodies in the way that much classical art portrays. It’s likely that when we were created in the great creator’s image, a little pudge was part of the package. The correlation between weight and health is not a black-and-white issue as we have been led to believe. Some fat reserves may even be protective.

It should be noted that some of the subjects included in this study were indicated to be postpartum, a particularly complicated, specific, and weight-shifting metabolic period. This mix of non-post-partum and post-partum women, along with other aspects of the study design and its assumptions, makes me leery of its conclusions. Particularly when it also states that “normal weight misperceivers”, or those whose BMI fell within the normal range but perceived that they were overweight, were more likely to engage in unhealthy behaviors including dieting, meal skipping, smoking, and carbohydrate restricting than the overweight subjects.

I am not dismissing that there are serious health issues associated with excessive weight. But, at this point in the game, I would expect a more sophisticated and nuanced understanding of the situation such as that presented by Cara Kulciwki in The Curvature. Based on studies like these, I am just praying that car mechanics don’t start handing out a questionnaire to childbearing-aged women about auto maintenance beliefs and behaviors. When that happens, watch out suburban white women, for we will be royally humiliated. I bet at least 1 in 4 of us mistakenly believes that our tires are properly inflated and that our oil crankcase is full.

Thank you for listening, sharing, following, and supporting my writing. Please subscribe in the sidebar to receive notice of new posts. Comments and greetings are always welcome.

In health, Elyn