Hey Sailor! Watch Your Weight

Thousands of sailors wearing their summer dress whites hit the streets of New York City today, the start of Fleet Week. You’d think I’d be over the uniform by now, having worked as a cocktail waitress in the enlisted man’s club back in the day when the Navy was in Newport, Rhode Island. But, no, I’m still captivated by that costume, unchanged since the late 1800s. It is a uniform is build on tradition: bell bottom trousers are easy to roll for deck work, the neckerchief functions as a sweat band, the jumper’s collar keeps tar spots off the shirt, and the indestructible “Dixie Cup” hat is comfortable and easy to make and clean.

The Future of the Fleet

Here’s hoping our shores stay safe because we don’t have the men to defend them. Of all military applicants, 25 percent are declared unfit to serve and rejected because they are overweight or obese. CDC data shows, in 1960, the average American man was 5’8” tall and weighed 166 pounds; by 2004, he was 5’9” tall and weighed-in at 191. The military only accepts candidates who fall into a specific height and weight range. A fighting man’s height is between 5’0” to 6’6” and the Navy’s maximum allowable weight is around BMI 25.5, which translates to 174 pounds at 5’9.” If an applicant exceeds the weight on the chart, then his body fat is measured and the goal is 23 percent or less, a realistic number. I’m not worried because those young guys can get fit fast when they try, and in a Star Wars defense system, unfit sailors can sit at computers. But what about those cute sailor suits? They won’t look nearly so fine.

Your thoughts: Is weight threatening national defense? How ’bout that sailor suit?

Light Treatment for a Heavy Matter

Have you heard about the documentary, Weight of the Nation™, on HBO in four parts starting on May 14th? The show is so important that HBO is airing it for free! It coincides with a conference in Washington this week also called, Weight of the Nation, hosted by the Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity, and Obesity. (What a mouthful!) The conference showcased the Institute of Medicine’s (IOM) new report, Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation.

The IOM evaluated prior obesity prevention strategies and identified recommendations to accelerate progress. They say:

  • Integrate physical activity every day in every way (e.g. make more green space)
  • Make healthy foods and beverages available everywhere (e.g. health vending machines)
  • Market what matters for a healthy life (e.g. industry-wide guidelines on food and drinks marketed to kids)
  • Activate employers and health care professionals (e.g. more worksite wellness programs – yawn)
  • Strengthen schools as the heart of health (e.g. 60 minutes of physical activity in schools every day! That’s after you lay-off the teachers and teach to the test.)

Do you remember last November when the IOM recommended ways to made school lunch healthier? Congress sold out to Big Food in the “pizza as a vegetable” fiasco. I wrote about it for Diets In Review, Congress Denies All Changes to School Lunch Throwing Children’s Health Under the Bus.

Sorry, but I’ve been following this issue going on 40 years, and don’t think this will make a difference. I see the ultimate solution (to all things) as coming from the people. Kids who were practically born fat and sick will find their indignation and provide the critical mass needed to turn the tide toward all things healthy.  Alternately, a good famine could save the day. In the end, only the obese will survive!

Read all of the IOM’s recommendations here.

Your thoughts: What will it take to fix the obesity crisis?

My Intuitive Eating “Aha” Moment

On LinkedIn, I am a member of the Intuitive Eating Professionals Group, where Evelyn Tribole, MS, RD, group founder, asks us to “share something…that is not included in your profile, perhaps an “aha” moment in your career.”  I am inspired to share my “aha” moment after attending the BEDA (Binge Eating Disorder Association) national conference on Saturday, where I learned that, treatment-wise, not much has changed over the years.

In 1985, I worked in a large gastroenterology practice affiliated with a teaching hospital. I saw lots of eating disordered patients because one of the docs did medical evaluations of patients with bulimia and AN. At the same time, another gastroenterologist performed a procedure with a device called the Garren-Edwards Gastric Bubble. A deflated ‘bubble’ made of stretchable plastic (like a pool toy) was placed by endoscopy in the stomach of a severely overweight patient.  With the pull of a cannula, the bubble was inflated and left in place to fill the stomach while the patient followed a low-calorie diet. That’s where I came in. The bubble was developed by a team at Johns Hopkins. It was all above the board. The hospital asked us to do the procedure, but we stopped after a patient got a small bowel obstruction from the bubble. Those were interesting days. My patients’ eating patterns were all over the map.

But my “aha’ moment came by way of a patient referred by an internist for a simple weight loss diet.  She was a favorite patient, a young woman of my age, overweight but far from obese, with my mother’s maiden name. We were doing the balanced, flexible diet thing with a focus on behaviors when one day, she looked at me and said, “Mary, you don’t understand. I peek behind the curtain, and when my husband drives away, I make a batch of scalloped potatoes, and I eat the whole thing.” Aha! I thought, “they didn’t teach us this in school.” And then I thought, “this is really real.”

I was lucky because psychologists who specialized in EDs would stop into  the office. They turned me on to Susie Orbach, Fat Is a Feminist Issue (1978); Geneen Roth, Feeding the Hungry Heart (1982) and Breaking Free from Compulsive Eating (1986) and, of course, Hilde Bruch. Evelyn’s book, Intuitive Eating (1995), wasn’t published yet and there was no Gurze catalogue. But, I read and read and saw lots of patients, and attended Geneen’s workshops,  consulted with therapists, and taught others how to do it. And now it’s wonderful to see so many dietitians espouse the non-diet approach. But, after all those years, the pills, shakes, meals, stomach stapling (but not swallowing pool toys) are all still here.

Your thoughts: Why don’t more people give up dieting and follow a non-diet approach?

Tweet What You Intuitively Eat

There are people who “Tweet what they eat.”  I follow one, and I saw an entry on his/her Twitter stream that bothered me. To me it said that, despite losing 90 pounds, I’m at risk for weight regain because I do not think like an Intuitive Eater. The Tweet (not the actual words) was “three donuts with a mea culpa.”  My tip off was the apology. An Intuitive Eater has no reason to apologize.

How to Approach Donuts from an Intuitive Eating Mindset

The Tweeter sees donuts, and asks “Am I hungry?”
If YES:  “Do I want donuts now?
-> YES: Eat donuts, enjoy, stop when satisfied, skip ‘my bad’
-> NO:   Eat different food, enjoy, stop when satisfied, skip ‘my bad’
If NO:  “Do I want donuts now?
-> NO:   Walk away; enjoy, skip ‘my bad’
-> YES:  Ask, “What am I feeling?”  Walk away, soul-search, process feelings.
Ask again, “Do I want donuts now?
-> NO:   Walk away; enjoy, skip ‘my bad’
-> YES: Eat donuts, enjoy, stop when satisfied; skip ‘my bad’

There are lots of tricky questions: Am I hungry? Am I satisfied? What do I feel? Why do I feel bad? What do I want?  Also worth noting is that (1) formerly starved people – through natural circumstances or intentional dieting – tend to hoard food, (2) really hungry people usually prefer wholesome food, and (3) emotionally healthy people – who have the knowledge and have not dieted – tend to value nutritious food and learn to prefer it.

Your thoughts: Does this make sense?