The Dangers of Nutrition Labels

It would have been difficult to predict the cultural impact of nutrition labeling on foods. At first, transparency of ingredients and additives seemed like a win for the consumer. As processed foods became a universal part of one’s diet, people needed to know what they were eating. Over time research has shown that many manmade ingredients were not particularly good for one’s health.

However, government regulators could not have foreseen how labels might pervade the daily intake and food decisions of a large majority of the population. Without adequate knowledge of general points of nutrition and of nutritionism (the faulty philosophy of nutrition based on building blocks, i.e, fat or protein, rather than real food), it’s incredibly hard to make sense of the information on the labels.

Even more confusing is that children are often taught about biological macromolecules through food labels, equating this information with scientific facts. Food labels have transformed from corporate transparency into false nutrition and dietary law for much of the population.

Too many people assume calorie facts on food packaging is absolutely true. They don’t realize that the information only needs to be within 25% of the actual value. Also, companies can determine serving sizes based on how best to sell product. There is no regulation to create serving sizes that people would actually eat. And the percentages that labels apply to the daily overall diet only approximate a general idea of human needs. Using this data as a hard and fast rule often only encourages dieting.

The immediate benefits of assessing packaged foods has instead turned into a supposed guidebook for food choices and dietary consumption. People who have grown up with food labels are much more likely to count calories, consider dietary choices based on macromolecules rather than food and assess healthy food choices through food industry-devised data.

The next post will give some guidelines about how to use the nutrition labels effectively.

The Halo Top Curse

In light of the upcoming Thanksgiving holiday, I felt the urge to rant about the most recent egregious exploitation by the food industry: Halo Top ice cream.

From a marketing standpoint, the new, low calorie ice cream is an absolute success. The brand is easy to find everywhere and is the most talked about new ice cream in a long time.

The unfortunate news is that the brand has taken an incredibly cynical approach to our food culture. It markets itself as the easy way to eat an entire pint of ice cream guilt free. It encourages people, especially women, to feel free to eat an excessively large amount of ice cream either as dessert or, better yet, as a meal replacement. It feeds the guilt of a generation of women constantly torn between endless dieting and liberation from our culture of thinness.

Rather than enable a feminist escape from the exploitative pressures of modern culture, this brand attempts to box women into the shame of eating ice cream indulgently while preserving the desire for thinness.

As a last insult, the brand doesn’t divulge the possible side effects of overeating the artificial sweeteners in Halo Top: gastrointestinal distress and diarrhea.

In the eating disorder treatment world, the brand encourages binging, discourages eating meals and real food and condones eating behaviors that reinforce these illnesses.

That we live in a culture which allows marketing of explicitly damaging brands is abhorrent. It is one thing to market cheap food alternatives and another to exploit the psychological and emotional vulnerabilities of our society for a profit.

Does an Eating Disorder Make You Special?

One reason for the rise in eating disorders in recent decades is the fundamental need to be special in modern life. As longterm health improves, lifespan lengthens and basic life essentials are taken for granted, first world populations have much more time and energy to expend elsewhere.

Striving to be exceptional appears to be one of the most common ways people have found a life purpose. Not infrequently, this common desire to be special is diverted to particularly unimportant goals. One such goal is thinness.

For many people with eating disorders, the goal of thinness feels paramount in life. Achieving it often leads to overwhelming praise, increased opportunity and the promise of a greater life. Whether or not this goal promotes obsessive thinking about food, eating disorder symptoms or extended misery is besides the point.

The idea of giving up on thinness as a primary goal feels like failing on many levels. Not only does surrender mean disavowing the collective fallacy that thinness has true meaning in life, but it also allows for the difficult concept that we are all average.

Ultimately, being human implies being one member of the large dominant species on earth. We can find special parts of any person, especially anyone we are close to, but with eight billion people on the planet, not one of us is truly unique. Using weight and thinness as markers of being special looks absurd in light of the larger scope of humanity.

Past the immediate horror of admitting mediocrity is the relief of just being a person. The incredible pressure to be something more than yourself makes each day so much harder. The unnecessary goal of manipulating food in order to weigh a certain amount only limits how fully a person can live.

If living means developing relationships and trying to develop meaningful activities or work, then expending energy on food and weight has no true purpose. None of us are remembered for how we eat or what we weigh.

The drive for thinness is linked to the drive to be special. Rearranging our priorities, even in a world where so much is given to us easily, is a critical step in limiting truly unimportant goals from dominating our experiences.

The Reality of Medications and Eating Disorder Recovery

A conversation I recently had with the editor of an eating disorder content website highlighted a fallacy about medications and treatment. The editor spoke about how hard it is to find an in-depth, definitive article regarding all different types of psychiatric medications and eating disorder treatment. His concern reflected a deep misunderstanding of the role psychopharmacology in recovery.

The research into medications and eating disorders is extremely limited. The only illness researched with any depth is anorexia but with very disappointing results. No medications have shown to be effective for this disorder.

As I wrote in the last post, a few medications have shown some benefit for binge eating disorder, but even those articles have very few subjects and are of limited utility.

Medications are primarily of value when treating other psychiatric illnesses that are primary, in other words independent of the eating disorder, usually depression or anxiety. 

There are individuals who benefit from medications for various eating symptoms, but the overall psychiatric literature does not point to medications as a central part of treatment.

The problem with a supposed definitive article about this aspect of treatment is that it would be inherently misleading. The underlying message would be that medications can have a significant impact on recovery when reality and research prove otherwise.

Medications and Eating Disorder Treatment

The central components of eating disorder treatment are meal planning and therapy, both individual and group. Medications play a peripheral role but can be important in certain circumstances.

Medications are most effective for comorbid psychiatric problems, especially when they are separate from the eating disorder. Treating depression and anxiety alleviates symptoms that typically exacerbates the eating symptoms and allows for more direct focus on recovery.

Seeing a psychiatrist knowledgeable enough to tease apart depression and anxiety secondary to the eating disorder, which typically respond less well to pharmacological intervention, and psychiatric symptoms separate from the eating disorder will help streamline overall progress in recovery.

Medications directed at the eating disorder symptoms have more mixed results.. The research into psychopharmacology for eating disorders is limited but gives a few important results dependent on diagnosis.

Despite the most rigorous research, no medication has proven to be effective for anorexia at this point. Many medications used in psychiatry, and some outside the purview of the field, have been studied to no avail. Even antidepressants tend to have no impact on people with anorexia who are depressed. The overall effect on the brain from starvation appears to trump all other interventions. The essential part of recovery is nutrition.

The most successful effect of medications is for bulimia and binge eating disorder. High dose SSRIs such as Prozac or Zoloft can be very effective for the sickest of these patients who binge at least twice daily almost every day of the week. Medications tend to reduce symptoms by about half after six weeks of treatment. Topamax, an anticonvulsant, also has benefit for people binging frequently but with less robust research results.

For the large number of patients with symptoms not easily categorized in one of the limited eating disorder diagnostic options, there is minimal evidence of benefit of medications. Treating underlying psychiatric problems can be beneficial, and attempting to use medications can have a moderate impact on progress, especially for adjunctive symptoms.

One last benefit of antidepressants is actually via a side effect. Most SSRIs can diminish the intensity of emotional reactions, a side effect called emotional flattening which often leads people to stop taking the drugs. For patients early in recovery who feel often unbearable emotional intensity, this side effect can be beneficial. The decreased intensity temporarily helps people stay on course with the food plan and tolerate the intensity of nourishing their mind. It is an often ignored but very useful pharmacological choice.

Psychiatric medications play a peripheral but often important role in recovery. Seeing a doctor versed in less common aspects of psychiatric care for eating disorders can be helpful to see alternative benefits of medications or to separate primary from secondary psychiatric symptoms related to the eating disorder. When the psychiatrist is integrated as part of a treatment team, the patient will always get the best results.