5/25/17

The Magical World of the Perfect Diet

With all this knowledge about biology and weight, it would seem obvious that these facts would change our behavior. However, this knowledge fades into the background amid unsubstantiated, clearly untrue dieting advice. 

It's hard to conceive of why the public would choose a clearly impossible goal of weight loss over a proven path of following the body's own internal signals. Clearly the scientific facts could provide some sense of peace. Yet the drive for thinness remains paramount for the modern adult. 

The meaning of thinness surpasses all success in our culture. Without achieving it, any other achievements are discounted. Even without other meaning in life, thinness itself counts as true success. 

The cultural zeitgeist has elevated thinness to a true measure of a person's value. In these circumstances, scientific knowledge can't be fully accepted. The fantasy that permanent weight loss brought by the perfect combination of diet and exercise must exist, according to this precept.

To conceive of a world without that panacea is analogous to a child believing in a world without Santa Claus. 

In fact, the deeply held belief system around weight leads our population into dangerous territory all the time, heedless of the risk. Children taken to weight loss camps at age eight. Doctors chastising patients about weight without any facts to substantiate their medical recommendations. Communities of adolescents teaching each other how to purge in the school bathroom. Hoards of adults willingly allowing doctors to surgically destroy their gastrointestinal systems. 


As the repercussions grow for various weight loss regimens, the risk to our community also grows. The long term questions about our state of mind and our collective life purpose become clearer. How can we all wake up from this nightmare and define a successful and useful life outside of food and weight? Facts may be necessary but clearly aren't sufficient. The next few posts will address this concern.

5/18/17

The Hard Facts about Weight Loss and Biology

Nothing about homeostasis and weight, as discussed in the last post, is new information. There is more research in recent years to provide evidence for this biological function, but it's not news that the body monitors and manages weight for overall health. 

However, the constant messages from the diet, exercise and food industries completely ignore this reality. These business interests dominate the information available about food and weight and have convinced people, medical practitioners and even government organizations that weight is within our control and a necessary part of overall health. 

Since the cultural norm in recent generations is thinness, it's not hard to convince the public that being thin is preferable. Using weight as a measure for health, longevity and well-being is an easy sell for a population already inclined to believe that thinness is equated with personal value and self-worth. 

In addition, these industries all give clear instructions for attaining said goals. Each new diet regimen purports to be the magic fix for weight loss. Every exercise plan is guaranteed to lead to permanent changes in one's body. Bariatric surgery programs or weight loss centers provide hope for those who fear being destined to their current weight forever. And the food industry rolls out one new food product after another meant to insure health and weight loss. 

What information does the knowledge about homeostasis provide? Can it compare with the prescriptive advice that comes from industry and the media?

Biology only promises that if you eat regularly through the day with typical size portions for meals and snacks and if you follow your hunger and fullness cues, then your body will fall within a reasonable weight range of about 10-15% of your current weight. And if you try to go out of that range, your body will resist weight loss but may gradually allow weight gain. 

Given the choice between the messages of industry and biology, it's clear why the various industries, with their extensive public relations, are much more successful. 

Yet homeostasis is the fundamental basis for how the body manages weight. And all the other messaging about food and weight are patently incorrect. 

So the goal really has to be to learn how to work within the rules that make our bodies function. Philosophies such as intuitive eating or Health at Every Size explain at length what it means to learn how to pay attention to our own internal cues. These approaches aren't easy in today's world, but they are realistic.


Our common goal has to be learning to listen to how our bodies work. Fighting those instincts only leads to misery and endless hours spent on fruitlessly managing an unmanageable task.

5/11/17

Homeostasis: Health and Balance in our Bodies

Homeostasis is a cornerstone of human health. It represents the concept of balance from a biological standpoint. All organs function well when the body can maintain balance and stability of all of its variables. This includes blood levels of electrolytes such as sodium and potassium, ample amount of vitamins and minerals and hydration levels both in the blood and in our cells. The body doesn't require an exact level of these variables but just to be within a normal range. As long as the values remain within that range, our bodies thrive. When the levels go out of range, our bodies will immediately adapt to try to right the system. 

Homeostasis also includes weight. 

Our bodies have intricate signals to monitor weight, nutrition and fat levels. They are a variety of hormones, many of which we still have not even identified, which travel in our bloodstream and alert our organs and brain about our current weight, nutritional status and fat stores. These signals can affect many organ systems and body functions including appetite regulation, metabolism, fat storage versus fat usage and more or less efficient digestion.

Over the course of human existence, the human body has honed these signals for survival. The ultimate goal is to thrive as a species. That means that the paramount objective is to maintain the biological state commensurate with health and longevity. 

It does not mean lose weight or maintain a lower weight, despite our own personal desires. In the end, homeostasis determines our weight. 

Chronic dieting and obsession with thinness challenge our basic biological system. Although many social forces have led to our competing wishes between thinness through dieting or exercise and the desire for ample supplies of processed foods provided by a powerful food industry, our biology trumps all of these pressures. 

The end result is twofold. First we now have a population that has gradually increased in weight for many reasons written about extensively. Second the diet industry has influenced widespread food restriction which triggers a biophysical response to regain weight and stabilize physical health. Ultimately, biological imperative will be victorious over even our best laid plans. Maintaining a weight necessary for survival matters; our desire for thinness doesn't. 


If we accept the biological reality of homeostasis, what direction do we have for eating disorders and disordered eating treatment? I will address this in the next post. 

5/4/17

The Three Biggest Myths about Weight

Several myths about weight drive an enormous amount of mental anguish in our society. They support the diet, food and exercise industries. They increase the risk of developing an eating disorder. And they cause an enormous amount of suffering and misery. 

Here is a list of the top three with some explanation of the reality. 

1 Diets work but just demand enough willpower. 

Research study after research study has proven, without a doubt, that diets don't work. In fact, extensive research proves that diets inevitably lead to long term weight gain. Sustained periods of malnutrition push the body to release hormones that increase hunger over time and that lead to increased fat storage, all to avoid the risks from extended periods of famine. 

1 Weight loss leads to improved health. 

There is no correlation between weight and health. Despite clear evidence proving this point, doctors will often exhort patients to lose weight without recognizing they are only proponents of a powerful social bias. Health is attainable at any size. 

1 Exercise leads to weight loss. 

Exercise improves long term health significantly but leads to no sustained weight loss. The body compensates for exercise by needing more energy either through increased intake or extracting more calories from food, but long term research has shown no effective change in weight. 


These myths all stem from our collective need to feel like we can lose weight. Since weight has become the paramount sign of success in our culture, people are willing to accept any means of losing weight even if ample evidence proves otherwise. However, the myths don't jibe with basic knowledge of how the body works. The next post will address what actually affects our weight: balance or, in medical terms, homeostasis.

4/27/17

The Truth about Bariatric Surgery

A caveat to the recent posts about weight is the professional dilemma about Bariatric surgery. These weight loss centers, as they are called, have become a profit bonanza for hospitals. People bereft after years of unsuccessful dieting finally capitulate to the pressure for surgery from friends and doctors. It feels like a last resort, the final decision, and one couched in the misguided concept of improved health. The surgical centers are PR meccas able to reel in even the most ambivalent of patients. Once hooked, these people become true believers. 

They say they are done dieting and know they "haven't been able to use the tools of dieting successfully." The language of personal blame, well honed by diet gurus, allows doctors to recommend surgery and also not take personal responsibility when the surgery fails. 

We will all look back one day in shock and horror that the medical world sanctioned slicing off half or more of a person's stomach for weight loss. These surgeries may very well be the lobotomy of our time. When all data shows dieting to be not only ineffective but also harmful with clear proof it leads to long term weight gain, how can we stand by as the diet industry leads these people to a place of hopelessness and the medical establishment leads them into the operating room? The hypocrisy and craven desire for profit are astounding. 

The central issue is to wrest back the conversation from the extremely powerful diet, food and exercise industries which have completely monopolized the conversation. Sadly, the medical establishment has been led to the same conclusion and now acts as unwitting promoters for diets and surgery. 


The answers to this problem lie with medical education. Unless medical professionals understand the basic facts about food and weight, there will be no counterpoint to the marketplace powers which have capitalized on the fear of fat for enormous gain.

4/20/17

Weight, Part III

A friend recently diagnosed with a serious illness told me a story. She is working hard to maintain weight due to the potential for weight loss from her illness, and she heard someone bemoan her need to lose weight. This friend only wished her biggest problem was losing weight. 

It's a truism that poor health puts all mundane worries into perspective, but this story illustrates something more powerful in light of the recent posts on this blog. Worrying about weight is more than just a mundane concern. It represents something more profound about the empty struggles of modern day life. 

Ruminating about body and weight is now an acceptable way to vocalize and internalize daily problems. We all seem to have accepted that striving for thinness is necessary for overall success, and not achieving it can undermine any other, more meaningful accomplishments or realities. 

The problem with this concern is twofold. First, obsessing about weight and food triggers a deep part of our brains. Food obsession is linked with survival and basic needs of being a biological organism. Watching how food motivates pets is an easy way to prove how ingrained food behavior is in all animals. Once this brain circuit is triggered, it can become all encompassing and have a significant negative impact on daily life. 

The second issue is sanctioned starvation, something I have written about extensively in this blog. The diet industry juggernaut capitalizes on our collective desire for weight loss and paints dieting as a prudent way to live. However, the danger of dieting, always followed by compensatory overeating, is to actually precipitate disordered eating and eating disorders. 

If there is anything my ill friend pointed out, it's that our obsession with weight loss mirrors our loss of values. We must work hard to figure out what to prioritize in a world constantly vying for our attention. The important things in life need to reflect our own selves, not the demands of industry, vanity or culture. Weight obsession is a manufactured reality intended to capture our minds. Our deeper values can't be drowned out by this endless noise.

4/13/17

Weight, Part II

Weight is but one data point to assess medical progress during recovery from an eating disorder. When any person eats regularly for over a year, weight can still fluctuate quite a bit due to several factors such as fluid shifts, hormonal shifts, changing seasons and changes in daily routine. The body attempts to keep weight within a range, but that range is much wider than what many people can accept psychologically. 

Weight reflects part of the natural state of balance the body seeks in order to maintain stability called homeostasis. The human body works to stay in a range of weight to promote health but a specific weight is not important. 

People with eating disorders and many people focused on food and weight believe otherwise. They think they can control weight within a pound or even less, with the advent of scales that measure to the tenth of a pound. The psychological and emotional effort expended to maintain a specific number dominates many people's lives and completely takes over the mind of most people with an eating disorder. 

During eating disorder recovery, one's body often needs to switch into a healing mode which can have a significant effect on weight, albeit temporarily. For instance, many people become constipated as their gastrointestinal system heals which leads to bloating, fluid retention and increased weight. Metabolism can slow down to adjust to periods of starvation in all eating disorders which can result in a temporarily higher weight. Normalizing of fluid maintenance, how the body stores water, often leads to fluid retention and weight gain as well. 

These changes are short-term but cloud the use of weight as a marker of health. 

In addition to weight, there are many other ways to assess improvement in health. Regular food intake is the first and foremost sign of recovery. No matter the other factors, improvement in daily eating is a sign of health. People often experience increased energy, higher stamina, normalization in gastrointestinal function, ability to withstand temperature changes and improved circulation, to name a few. These markers of health take more time to follow and assess but give a much more thorough picture of health and recovery. 


The next post will take these thoughts about weight a step further. What are some reasons for our obsession with weight for people with eating disorders and for our society?