Exercise in Our Lives

Much of our learning about health and exercise has stemmed from large changes in lifestyle since the industrial revolution and especially in the last fifty years. Job opportunities in the first world have become increasingly sedentary. The human experiment of life with minimal movement and exercise has forced the medical world to explore the ways in which moving our bodies improves overall health and well being. 

However, clinical understanding of the health benefits of exercise has lagged behind the powerful food, diet and exercise industries. Capitalizing on the lack of information, big business took advantage of an opening to create a new narrative, and that storyline is much more compelling and powerful. 

Rather than explore how activity can enhance our daily routine in today's world, these for-profit businesses have used another convincing but ultimately cynical tack. The bottom line is a subtle attempt to place blame and responsibility for the lack of exercise on the individual.

Using guilt as the ultimate subtext for a business model has been very successful. Education about the type of useful exercise and the many ways to create opportunities to be active is much less profitable than convincing the public that exercise is essential and that the level of exercise can only be attained in classes or at a gym, in other words by spending money.

The effect of this misinformation is to create a cohort of young adults addicted to exercise and who feel they are not ok, and even cannot eat, without it.

Similarly for those at risk for an eating disorder, exercise has become a gateway to illness. The exercise industry encourages the urge to obsess about body and shape and as a means to justify the intake of any food. More and more, exercise is a cornerstone for young people to develop eating disorders. Instead of exploring the place for activity and movement in our lives, exercise is a personal responsibility and a source of self-assessment, almost always one that leads to negative thoughts about oneself. 

Prior to the sedentary lifestyle of many career choices today, exercise was not an activity but part of daily life. Just the act of standing, walking and taking care of life events helped keep our bodies fit and capable. The goal today is to fit time into our day for that movement, not to create an opening for industry to exploit our own insecurities and fears.


Eating Disorders in the Presidential Campaign

Fat shaming sadly has become a central part of the presidential campaign this week, a place this form of bias clearly doesn't belong. However, the high profile publicity of ridiculing women forces our society to face a hidden and malicious prejudice. 

Just as eye opening as the comment was the presidential candidate's shocking capacity to defend his statement as if it were completely acceptable. Needless to say, some media outlets exposed the callousness of the remarks, but it also became clear that fat shaming is not only an accepted form of attacking women but one accepted by a significant segment of the public. 

Outing this hidden bias exposed a dynamic women must struggle against every day. Just as important, these expectations of thinness, and the general acceptance of shaming women who don't fit into this image, encourages women, including young women and girls, to look into dieting at increasingly younger ages. 

The last few posts make clear the dangers of dieting: it is the most important risk factor for developing an eating disorder. And so the effects of fat shaming run much deeper than a mere insult. 

The overall effect of condoning this kind of behavior is an increased risk and even likelihood that girls and young women will develop eating disorders. Messages about body shape and weight are destructive in their immediate psychological effect and insidious in sustaining the high incidence of eating disorders in our community. 

As harmful as elements of the presidential campaign have been, fat shaming takes the misogyny on display to a new level. Using the largest political platform in the world to indirectly encourage severe, life threatening illnesses is despicable and represents a form of bias that must be fully exposed.


Disempowering the Diet Industry

The diet industry has become a strong, large and incredibly lucrative business due in large part to the insatiable desire for thinness in our society. A new diet is like a new beginning. It's a virtuous way to find a path towards health and wellness. All our daily ills supposedly wash away from the newest diet. 

Just as importantly diets never work. Any one person can choose to start string of diets that end and start anew. The industry has a revolving door of repeat customers ready for the newest health fad. And the fact that diets never work is something the public refuses to acknowledge despite easily accessible and conclusive proof. 

Instead food choice and the ultimate goal of weight loss remain the holy grail of adult life. The diet industry plays off of this desire and encourages us all to conflate diets with self-care. It's an insidious way to capitalize on the general human ennui and create meaning out of nothing, for food in the end is just sustenance and choosing one meal over another on any given day creates no more virtue or success in anyone's life. 

The first step in avoiding diets is to recognize this reality. We are not defined by what we eat, and changing a diet temporarily signifies nothing. That's a difficult step for many people so two other steps are often more realistic to be able to shift away from overvaluing dieting. 

First, the goal of eating needs to change from dieting to eating a variety of real food. Our current world offers a mixture of processed and real foods, and realistically we will all eat what we find tasty and easy to prepare or buy. The ability to be flexible when eating while allowing pleasure, convenience and reason to dictate daily decisions is the key to normal eating. 

The second step is to resist the urge to look for meaning in food. It's very tempting based on the power of the diet industry and the large number of people who ascribe to this philosophy, but meaning in life is largely centered on other facets of the human existence: relationships, career, family or kindness to others. Food and diet contribute nothing to our well being other than the nourishment and pleasure that comes from daily meals. 

It takes energy to resist the pull of the diet culture. Attention to the details of what we eat won't change our lives. It's within our grasp to disempower the choice of food and instead look for real value in other parts of our lives.


The Painful Truth about Dieting

The term diet originally meant the different types of food a person ate each day. The concept described a factual list of foods rather than a prescribed or limited one. 

A diet has clearly become something different in our current world. Today dieting implies intentional food restriction in order to lose weight. The act of going on a diet means one needs to lose weight and will make a concerted effort to do so. It means judgment about one's body and weight. It means someone is taking a supposed virtuous and health-minded step towards wellness. It means something is wrong and a diet will somehow fix the problem. 

Although dieting originates with concerns about weight, by and large the result of dieting is to attempt to fix the ills in one's life. 

The result of any temporarily successful diet is widespread praise. Others comment on changes in weight and compliment on a regular basis. Dieting is a public act that warrants public attention. This is often the main reason people diet. 

Paradoxically, hard data about dieting shows that 98% of them fail. In fact, the large majority of people end up gaining weight after a diet. Despite a plethora of evidence against the benefit, people regularly attempt to diet. There is nothing else to replace the collective desire for the praise that attends short-term weight loss. 

With this background, it's clear to see why adolescents, who are constantly searching for an identity and praise, easily latch onto dieting and weight loss as a marker of personal success. No wonder dieting has become a rite of passage in high school. But exposing most teenagers to dieting looks more like a horrible experiment in the effects of widespread starvation than an introduction to adulthood. 

Chronic food deprivation triggers the biological survival mechanism of starvation. Humans are genetically programmed to respond to food restriction in very specific ways to survive. Symptoms include obsession with food, all consuming hunger, the desire to overeat and focus on all things related to food, to name a few. Specifically, these symptoms look suspiciously like eating disorder symptoms.

In other words, most eating disorder symptoms are the biological response to starvation gone awry. Our diet culture has in large part caused the sharp spike in the incidence of eating disorders. 

As long as dieting is a central part of our general ethos, eating disorders are here to stay. I'll write about some thoughts on how to combat dieting in the next post.


Dieting is the Most Important Risk Factor for Developing an Eating Disorder

Clinical literature, academic research and personal memoirs about eating disorders all ignore one crucial and salient fact about these illnesses: they all start with a diet. 

This seems like an obvious point. The inception of an eating disorder is right in front of us. Dieting is an integral part of our culture, a rite of passage for all adolescents. Weight loss and the compliments that ensue are a sign of the ultimate gold star of success. 

What is lost on the communities that condone dieting is the inherent risk of this ritualized practice. For most people, dieting is one of a few things: a short-term lark, a series of new beginnings which always fail or a misstep in how to eat healthily. But for a small percentage of people, it is the start of a chronic, severe illness. 

Dieting is essentially self-inflicted starvation. The goal is to eat a limited amount of food, significantly less than one's body needs, in order to lose weight. Dieting is somehow considered safe and healthy, largely due to the influences of the cultural norm of thinness and a powerful diet industry. The consequences are almost completely ignored. 

To state the dangers of dieting as clearly as possible, the number one risk factor for developing an eating disorder is dieting and restricting calories over a significant period of time. If people didn't diet, there would be no public health problem of eating disorders in this country. Prior to the late 1960's, eating disorders were a very rare phenomenon. The increase in dieting has in large part spurred the skyrocketing incidence of eating disorders. 

This fact remains unheralded and ignored despite the explosion of public information about eating disorders. Parents will follow a doctor's or nutritionist's advice to put a child on a diet. Most parents won't bat an eye when a teenager diets and loses weight. The willful collective ignorance about dieting continues to leave children unprotected from this growing problem. 

The next post will address more clearly why dieting causes eating disorders.


Why is Coaching a Viable Part of Eating Disorder Treatment

The last post explored the role of coaching in eating disorder treatment but left one question unanswered: how can untrained paraprofessionals safely participate in treating a severe mental illness?

There are parallels in other fields where less extensively trained people treat illness: optometrists vs. ophthalmologists or chiropractors vs. orthopedists, to name a few. These options generally reflect a cheaper form of care when the patient seeks help for more basic problems. But the increase in coaching as a viable alternative or addition to traditional eating disorder treatment reflects something different.

Eating disorder treatment is often successful, but the underlying reason for improvement is elusive. Although different types of therapy can give a patient the choice to find the right fit for them, even seeking the supposed best care doesn't guarantee full recovery. Finding the motivation or reason why one person can take steps in recovery is typically very individualized. Progress depends less on education or training and more on the nature of the therapeutic relationship and the ability to tap into a desire for wellness otherwise unknown to a patient. If successful treatment depends largely on the relationship, then it's possible that the best person for someone may not be a professional. 

Coaching offers a new way for people who have experienced their own struggle with food and body, or even their own eating disorder, to help others without seeking formal training. The risks of seeing someone less trained are clear: a lack of complete understanding of the power of the therapeutic relationship and the nature of recovery can be damaging. However, exposure to the right person can be exactly what someone needs to find their own path to recovery. 

Due to the risks of seeing someone less trained, I would suggest a patient see an experienced therapist as the foundation of treatment, but seeking guidance from a coach whose writing and messages are meaningful can augment recovery in significant ways. In the end, the goal is recovery in any way one can find it.


The Role of Coaching in Eating Disorder Treatment

A relatively new but growing component of the eating disorder treatment community is coaching. Although this industry is generally becoming more popular, helping people with eating disorders is its most significant foray into mental health. 

In general, coaching provides many more options and much more flexibility than traditional clinical treatment. Not bound by the same professional and ethical constraints, coaches can provide not only one-on-one meetings but group online chats or discussions, weeks or months long courses, an assortment of blogs and podcasts and more flexible meetings and hours. 

As I have written many times in this blog, successfully treating someone with an eating disorder demands flexibility. The eating disorder thoughts are present 24 hours per day. An appointment a few times per week may be helpful in the moment but is often insufficient to stave off the power of the eating disorder meal after meal after meal. 

The inherent flexibility in the coaches schema allows for much more accessibility to counter the relentless eating disorder thoughts. 

The rise in coaching people with eating disorders also reflects two facts about these illnesses in our society. 

First, there is still a conflict between the concept of disordered eating/food obsession and an actual eating disorder. The internal struggle with food and weight that is pervasive in our current ethos masks the severity of full-blown eating disorders. Coaching spans all these issues, and many people with eating disorders many not be aware how severe their problem is. That leaves room to research and seek help from non-clinical care. 

Second, the limitations of clinical and often overly medicalized treatment for eating disorders leaves a lot to be desired. Many people are frustrated after seeking out help and are turning to coaching for another avenue for recovery. Coaches are more free to individualize treatment and forge new theories of practice. They also aren't as well regulated and certainly aren't trained to diagnose an eating disorder or identify concurrent problems. But the desperation of struggling with an eating disorder certainly makes another option worth pursuing when clinical treatment has been a bust. 

It would behoove the eating disorder treatment community to embrace the coaching movement. The flexibility of support, positive, creative messages and alternative approaches to countering the eating disorder thoughts can all help someone in the throws of recovery. Since there is no clear path to wellness, any support that is useful to someone struggling to get well can have real benefit.