food · overeating

Four worries Sam has about intuitive eating

Blue sky, grey water. A man wearing a suit up to his chest in water. He's got a very worried face and he's running his hands through his hair.
Search for “worries” on Unsplash and you get this guy. I’d be worried too if I were wearing a suit and I was up to my chest in water. Photo by Mubariz Mehdizadeh on Unsplash.

I think really that most of us aspire to eat intuitively, to have an uncomplicated relationship with food. You know the basic ideas, if you’ve been reading this blog for awhile: eat when you’re hungry, stop when you’re full, no foods are off limits, listen to your body, and follow “gentle” nutrition. I admit it sounds heavenly. Me too. Me too. And I think it’s terrific for people who have a broken relationship with their body’s signals , people who eat what a diet says, when it says, ignoring all the cues our bodies give us. Getting in touch with hunger–which many of us have the privilege to not experience very often–can be super useful.

But I have so many worries about intuitive eating as a social phenomenon.

We talk about intuitive eating a lot around here since we’re all anti-dieting and against demonizing foods. Tracy is the biggest fan of intuitive eating. See Intuitive Eating: What It Is and Why I Love It! and It only took 27 years, but now I’m a bona fide intuitive eater.

But I’m the worrier. I’ve worried about it for awhile. See The weak link in intuitive eating, our hunger signals aren’t terribly reliable and I’ve written about my own experiences with misfiring hunger cues here, Forgetting to eat? Who are these people? and here and here.

And like me, Catherine is skeptical. See Hidden values in intuitive eating, or can I eat a Big Mac intuitively and Is intuitive eating enough? Inner capacities vs. outer food cues .

So I am going to try to sort out my concerns in a numbered list, like philosophers are in the habit of doing.

First, I worry that it’s often a disguised diet where “working” as in “does intuitive eating work for you?” is measured, in part, in terms of your weight. If there were more fat people, at stable weights, not obsessed with diets or food, held up as intuitive eating success stories, I’d be happier.

Second, I worry that it’s connected to another way of judging fat people. You’re supposed to only eat because you’re hungry. Intuitive eating, done right, is supposed to land you at the right weight for your size (see above). Therefore, larger people must be eating for reasons besides hunger. You’re supposed to be vigilant about emotional eating. So often there’s judgments about mental and emotional health of fat people, as if we can read your emotional well-being off the number on the scale. It assumes that if you take care of your mental and emotional health your weight will fix itself. And that you can tell that people–and here pretty much we mean women–are emotionally unstable, because they’re fat. Just no.

I’ve written in defense of food as comfort and emotional eating here.

Photo of yummy looking cinnamon buns with frosting.

There are many amazing photos of food on Unsplash. This is a tray of cinnamon buns. Photo by Otto Norin on Unsplash.

Okay, but these two worries are about intuitive eating as a thing, as a social phenomenon, about the way we think about it and talk about it. We could stop all that. We could hold up some fat people as successful intuitive eaters. We could stop assuming that fat people aren’t eating for hunger. We could do it right.

Third, I have worries about the actual practice of intuitive eating. I worry that hunger is not exactly the most reliable bodily signal in town. My own experiences in this area are pretty wild and they have to do with thyroid levels. I’ve had thyroid cancer and as a result take a synthetic version of thyroid hormones called synthroid. There’s a lot of juggling in getting your thyroid levels right. Lots of things can throw it off and the thing I notice is the most is how this affects hunger. I can go from raging hunger all day, like waking up during the night hungry, to not caring at all about food. It’s really striking.

Lots of women, not just those of us who have had cancer, have issues with thyroid levels. It’s very common. See International Women’s Day and How Thyroid Disease is a Feminist Issue and Why Hypothyroidism is a Feminist Issue .

It’s clear to me now that our hunger signals aren’t perfect at all. They’re pretty darn flexible.

The other group of people who experience this are formerly obese people. As a group they have much higher levels of the hormones that signal hunger.

Here’s one such study, from Science Daily.

The study involved 50 overweight or obese adults, with a BMI of between 27 and 40, and an average weight of 95kg, who enrolled in a 10-week weight loss program using a very low energy diet. Levels of appetite-regulating hormones were measured at baseline, at the end of the program and one year after initial weight loss.

Results showed that following initial weight loss of about 13 kgs, the levels of hormones that influence hunger changed in a way which would be expected to increase appetite. These changes were sustained for at least one year. Participants regained around 5kgs during the one-year period of study.

Professor Joseph Proietto from the University of Melbourne and Austin Health said the study revealed the important roles that hormones play in regulating body weight, making dietary and behavioral change less likely to work in the long-term.

“Our study has provided clues as to why obese people who have lost weight often relapse. The relapse has a strong physiological basis and is not simply the result of the voluntary resumption of old habits,” he said.”

Why does it matter? What’s this got to do with intuitive eating? My worry here is that intuitive eating assumes that our bodies are right about various things, that the signals they send us are correct. But if the formerly obese person eats when hungry, they’ll be eating a lot more often than is consistent with maintaining their weight. Still thinking about this? Want more information? Here’s two articles from Precision Nutrition that do a pretty good job of explaining the hormones that regulate hunger: Leptin, ghrelin, and weight loss and Weight loss & hunger hormones. It’s pretty complicated.

If your hunger cues are reliable, great. If you’re not a formerly obese person or someone who struggles getting their thyroid levels right, enjoy! But recognize that as a privilege and don’t assume that it will work for others.

Fourth, I worry about intuitive eating in an environment where some foods are designed to make us want them. Sugar + fat? Yum! Read here for how junk food is designed to both create cravings and convince your body that you’re not full and can keep eating more. From the article just cited, “Foods that rapidly vanish or “melt in your mouth” signal to your brain that you’re not eating as much as you actually are. In other words, these foods literally tell your brain that you’re not full, even though you’re eating a lot of calories. The result: you tend to overeat.”

We’re not all alike and if intuitive eating works for you, then great. But what do I mean by work? I don’t mean weight, that’s for sure. I mean if you eat this way are you, on reflection, happy with the food choices you’re making? Are you leading a life you enjoy? Are you meeting your own food goals around nutrition? Do you have energy to do the things you love? When I say it doesn’t work for me, I mean that sometimes I am hungry all of the time. I can be hungry 20 minutes after finishing a meal. Hungry again before bed. Hungry during the night. When I am like that I have to ignore hunger because I know I have eaten enough. At other times I am hardly hungry at all and I can skip meals without noticing. Then I have to make sure I still eat to fuel some of the activities I like, like riding my bike. So as long as this hunger fluctuation is part of my life there’s no strictly intuitive eating for me.

How about you? How well do your hunger cues track the need to eat? Do you listen to your body about what to eat? Are you happy with the choices you make?

diets · eating · eating disorders · food · health

If not Weight Watchers for children, then what?

Regular readers know that I’m no fan (to put it mildly) of Weight Watchers. See I hate you Weight Watchers.

I think it’s extra awful that they are offering free summer memberships to children and I’ve written about that too.

(Added: Yes, it’s not just Weight Watchers. Goodlife Fitness does it too for high school students. FWIW, I also hate them.)

Yet, I can see the attraction. We know adults find it impossible to lose weight. That diets don’t work is a regular theme here on the blog.

Still, many people who agree that there is not much we can do about adult obesity other than helping people not gain weight in the first place, view children as the front line in the “war against obesity.” The thought is that if we can stop obesity either before it develops or in its early stages, we can avoid the health problems associated with overweight and obesity.

(Added: For those who don’t know the blog that well, I’m using talk of “obesity” and the “war on obesity” even though I think these are very problematic. See Catherine’s post with which I agree, “Obese” is a bad word—it’s got to go. I’m doing it because I think that even if that’s your framework you shouldn’t endorse dieting for children.)

What’s the problem then? Couldn’t children who are looking for help, who struggle with their weight, find some sensible advice at Weight Watchers? It’s got to be better than the semi-starvation plan that got me through high school. I lived for years on coffee, cigarettes (and, this was the 70s and 80s, we didn’t know better) bran muffins. We know lots of older children and young teens try wacky diets. At least Weight Watchers is all about regular food and includes all the food groups.

The big problem is that while common sense seems obvious, it’s actually not clear what works. “Eat less, move more,” sure, and what could be wrong with that? (James Fell says it’s bullshit and he makes me laugh.) But we don’t have a very good grip on the causes of obesity. Nor do we have a very good handle on what works to reduce childhood obesity. It’s definitely not as simple as “eat less, move more.”

If a medication had the same success rate as dieting—where ‘diet’ is behavior aimed at producing a calorie deficit by eating less and moving more—and a similar track record of bad side effects (including significant weight gain), there is no way we’d prescribe it to anyone, let alone children.

What do we know? We know what doesn’t work. Shame and stigmatization don’t work. See campaign takes creative aim at Georgia’s anti-obesity ads.

You might think who would recommend shaming, anyway? But bioethicist Daniel Callahan outright advocates shaming in his opinion piece, “Obesity: Chasing an Elusive Epidemic,” Hastings Center Report 43, no. 1 (2013): 34-40.

fat activist marilyn wann

What about labelling without shame, simply describing overweight and obesity without judgement?

However, even telling children they are overweight has bad effects

“A recent study by researchers at UCLA found that if girls had been called “too fat” by someone by age 10, they were more likely to be “obese” at age 19, and that the more people who told her she was “too fat” the more her chances of being “obese” increased. The study included controlled for income, race, childhood weight and puberty age.” See here.

Girls who are told by a parent, sibling, friend, classmate or teacher that they are too fat at age 10 are more likely to be obese at age 19, a new study by UCLA psychologists shows. The study looked at 1,213 African-American girls and 1,166 white girls living in Northern California, Cincinnati and Washington, D.C., 58 percent of whom had been told they were too fat at age 10. All the girls had their height and weight measured at the beginning of the study and again after nine years.

Overall, the girls labeled fat were 1.66 times more likely than the other girls to be obese at 19, the researchers found. They also found that as the number people who told a girl she was fat increased, so did the likelihood that she would be obese nine years later. (These findings appear in the June 2014 print issue of the journal JAMA Pediatrics and are published online April 28.)

“Simply being labeled as too fat has a measurable effect almost a decade later. We nearly fell off our chairs when we discovered this,” said A. Janet Tomiyama, an assistant professor of psychology in the UCLA College of Letters and Science and the study’s senior author. “Even after we statistically removed the effects of their actual weight, their income, their race and when they reached puberty, the effect remained.”

See also “Adolescent Dieting May Predict Obesity and Eating Disorders” Journal of the American Dietetic Association 2006.

Doctors suggest weighing children without judgement. It’s just a number. That’s all.

A set of swings with no one in them. Photo by Aaron Burden, Unsplash.

One other suggestion is to decouple inactivity and obesity and focus is on the inactivity side of the equation. There are obesity related reasons to care about inactivity but that’s not the only reason. There are also good reasons to decouple them. Efforts at improving activity (and nutrition) shouldn’t be measured solely in terms of impact on obesity.

There are no studies showing harmful effects of increasing children’s activity levels. Thin people need to move more too and overweight and obese people shouldn’t quit exercising if the scale doesn’t move

I think a similar focus on nutrition and developing a healthy relationship with food would be good regardless of its impact on weight and BMI.

But until we have a good handle on the causes of childhood obesity I think that guilting parents and shaming children has to end.

We know diets don’t work. We know body shaming doesn’t work. It turns out that even naming the problem makes it worse. Children who are told they are fat by friends, family, doctors are more likely to gain weight.

So what to do?

First, don’t take them to Weight Watchers.

Second, help them learn to appreciate the bodies they have and the things that these bodies can do. Make movement fun and joyful.

Third, help children learn to cook at home and make family meals happy occasions.

The American Academy of Pediatrics new guidelines (see here) on dealing with weight and kids suggests getting rid of body shaming, weight talk, and dieting because it predisposes kids to eating disorders and to eventual weight gain as a result of disordered eating. Since the old way of trying to eliminate obesity tends to make people more prone to illness, there are also new guidelines including emphasizing exercise and nutrition, NOT body size.

That’s all I’ve got. How about you?

diets · eating · fitness · food · health

Are fat people lying?

When I was a kid the thing I hated the most about being young was not being believed. See Seen but not heard: children and epistemic injustice for a discussion of this phenomena in the medical context.

Lots of groups aren’t given the credence they deserve. It’s not just children of course. It’s also women, disabled persons, people of colour. And people who bear multiple minority group status can be doubly or triply not trusted.

You can add to this list of victims of epistemic injustice, fat people.

See There are no right answers for your fat friend.

It’s about the interrogation fat people face about what and how much we eat.

“Sometimes, when I tell her how I eat, she will flatly insist, that’s not possible. Because to her, my body is evidence in a trial that’s already underway. Like a childhood nightmare, I am failing a test that was never announced. I am on trial, and she is judge, jury, executioner. Her eyes are fiery, overtaken with a determination I do not understand. She is a bomb I cannot defuse.

This is the interaction, with staggering reliability, and not only with her. The interrogation is visited upon me from old men and young women; city-dwellers and rural folks; people of all ages and many walks of life. Whoever you are, wherever you’re from, this is how we will interact. Every question is a turning point, and every answer a dead end. I am forever searching for an escape that does not exist.”
I get this too. I hate feeling like I am a mystery or a liar. For awhile a group of fat athletes were posting food logs online. In a “believe me now?” exercise they shared without logs and food logs for the world to see.

But the thing is it never works. It’s all about fear. If I’m fat and exercise and eat well, it could happen to you too. That’s horrifying news.

No one wants to believe that. Thin people want to believe they work hard and deserve their thinness. So it must be that I’m lying. Or I haven’t tried the right thing that works. Most recent was a cycling coach (not mine who also struggles with his weight and knows) who said there must be some number of calories you could eat and lose weight. Do that! What if I ate that few calories and couldn’t ride my bike? Lose weight now and ride your bike later. Unbelievable.

It’s frustrating. It makes me angry. It makes me feel unseen and unbelieved.

I wish I had something positive to say about this, some suggestions for a way out, but I don’t. I do know that going down the road of telling people what I do and what I eat isn’t worth it.

I don’t hide in my room and emotionally eat cookies. I don’t. I don’t say I’m exercising when I’m not. Really.

Do you experience this? What’s your strategy?

A photo from Unsplash of colorful cookies, the word “love” and pretty pink flowers
food · nutrition · sports nutrition · weight lifting

Want to keep muscle after 40?: Eat all the protein and lift all the things

A cricket protein bar
A cricket protein bar

Researchers at nearby MacMaster University set out to do a meta analysis in search of an answer to the question of whether protein consumption made a difference to ordinary adults over 40 who set out to gain muscle.

What’s nice, from this blog’s perspective, about the studies is that many of them included women.

Gretchen Reynolds wrote about their research in the New York Times.

Lift Weights, Eat More Protein, Especially if You’re Over 40

“They wound up with 49 high-quality past experiments that had studied a total of 1,863 people, including men and women, young and old, and experienced weight trainers as well as novices. The sources of the protein in the different studies had varied, as had the amounts and the times of day when people had downed them.

To answer the simplest question of whether taking in more protein during weight training led to larger increases in muscle size and strength, the researchers added all of the results together.And the answer was a resounding yes. Men and women who ate more protein while weight training did develop larger, stronger muscles than those who did not.”

How much protein? 1.6 grams per day per kilo of bodyweight. That’s well over the recommended daily amount of protein.

When? It didn’t matter when in the day people are the extra protein. So you don’t need to fuss about before or after workout or other special timing.

What kind of protein? That didn’t matter either. You can eat it in the form of animal protein or vegan protein. You can drink protein shakes. It’s all good.

See the scientific article here.

I haven’t tried the cricket protein bar just yet.

body image · diets · eating · eating disorders · fat · food

Weight Watchers is going after children and Sam thinks that’s extra awful

As you may know, if you’re a blog regular, I hate Weight Watchers.

They’re now marketing to children, offering free classes with parent’s permission. See here.

Rebecca Scritchfield writes,

“Weight Watchers this week announced its plans to offer free six-week memberships to kids as young as 13, beginning this summer. The company’s move is part of a bigger plan to grow revenue and a loyal customer base for life. (Start ’em young, right?) As a health professional and mother, I am appalled. With celebrity names such as Oprah Winfrey, who is on the board of directors, and DJ Khaled, the latest spokesperson for Weight Watchers, the company is on track to exert powerful influence on people far and wide. Kids will undoubtedly pay a heavy price for this “free” membership, in the form of body shame. It will not only affect those who participate, but also every other teen who is exposed to the message that some bodies are “problems,” and if you’re at a higher weight, your body needs to be fixed. Thus, kids of all sizes will have something to fear.”

There are many problems with this plan but even if you just care about weight, it’s a disaster.

Study after study shows that early dieting is a huge predictor of weight gain.

The reasons aren’t clear. See Why does dieting predict weight gain in adolescents? Findings from project EAT-II: a 5-year longitudinal study.

I’m one of those kids who joined Weight Watchers and attended with my parents’ permission. I’m not sure if and how that contributed to future weight gain but I do know that I wasn’t really that chubby when I started.

I also know it made me think of myself as someone whose weight, whose body, was a problem to be solved. Best tackle it while you’re young, people would say.

It did start the habit of dieting that persisted through my teens and twenties.

What do you think of Weight Watchers, diets, and weekly weigh ins for children?

Bowls of fruit
Three bowls of breakfast berries, photo by Unsplash
diets · eating · food

Food demonizing and the perils of “all or nothing” thinking

There’s an article making the rounds and it’s recycling an old idea: “Nice ‘Health’ Foods You’d Be Better off Avoiding.” The recycled idea: some foods are evil. We’ve blogged a couple of times about this already. See my “Why Food is Beyond Good and Evil” and “Let’s Think Differently about Healthy Eating,” and Catherine’s “Beyond Good and Evil (Food)” and her follow-up the next week.

My big theme is about food moralizing and how just makes things worse. You’re not “good” because you ordered the salad instead of the fries. You’re not “bad” because you ordered the fries instead of the salad. Fruit juice isn’t “evil.” Celery sticks aren’t “virtuous.” It’s all food.

So what’s on the latest list? Some familiar items that people like to label as “bad”: fruit juices and smoothies (because sugar); granola (because sugar); fat-free or low-fat things (because sugar); dried fruit (because sugar); agave nectar (because sugar). Then there were a few surprises: almond milk (because not as much protein as cow’s milk); gluten free unless you’ve got celiac disease (because sugar and fat); coconut oil (because saturated fat); and vegetable chips (because fat and salt).

What’s really being demonized here, if you read the explanations? Mostly sugar. Next culprit: fat. And finally, salt.

Now here’s the thing. I don’t have any quarrel with the idea that if all of the foods I ever chose to eat were sugary dessert-type foods, my diet would be lacking in nutritional value. It goes without saying that the body requires a diversity of nutrients and that means branching out into veggies, whole grains, and foods that are rich in protein.

I also like Catherine’s point about being a food pragmatist. She says that she and her fellow food-pragmatists “eat what works for us. We figure out what works through a complicated process of experimenting, reading and learning, forming some goals for ourselves about what health means to us, taking into account our preferences and constraints (economic, social, geographic, cultural, etc.).”

I’m also something of a food pragmatist these days. It’s the evolution of my successful transition to intuitive eating. There are foods that do not work for me (garlic — I cannot digest it in anything but the smallest of quantities; fried foods at lunch time — they make me want to sleep).

That’s not the fault of these foods. As Catherine and I both say, different foods are neither good nor evil. They just are. Maybe they agree with you. Maybe they don’t. Maybe some have more nutritional value than others, but nutritional value isn’t the only reason we eat. Think of the central place socializing and celebrating around food has in just about any culture you can think of.

When we demonize foods and decide that we will never eat something because it is “bad” (even if we like it), we generate a feeling of deprivation and temptation. It’s human nature often to want what we (think) we can’t have. I see this all the time around food.

Last night I was out for Indian food and at the end, when I was already satisfied and done, they brought the bill along with a mini-chocolate for each person. Instead of pocketing mine, I opened it. I took one bite and realized that not only was it not a good chocolate, I simply didn’t want it. So I left half of it on the table in the wrapper. One of my companions noticed and said “aren’t you virtuous, eating only half a chocolate?”

And a few weeks ago a box of Cinnabon cinnamon rolls ended up in our office. A whole box. As a food pragmatist, I know one thing if I know anything: those things give me a headache.  So terrible is the headache I get from them that I do not feel the least bit tempted to eat even half (nevermind that they are decidedly un-vegan). But the whole day everyone in the office was treating the Cinnabons as if they were the embodiment of the devil. I really shouldn’t was either explicitly said or implicitly conveyed in the guilty look people had as they slunk back to their offices to enjoy their decadent treat in private.

I don’t know, but when I’m going to enjoy something that I think is a delicious treat, I’m going to enjoy it wholeheartedly. I’m not going to proclaim how many times a week a person “should” eat a cinnamon roll or what else they might want to include in their daily diet, but I can promise you that no one in the office lives on these things. They were special treats to be enjoyed. If regarded instead as something that you “shouldn’t” have but are having anyway, then the full potential of savouring it in all of its delicious glory falls to the wayside.

All or nothing is not a great strategy and can work against us.

There are exceptions. Sometimes, as Catherine said about her and pasta, there are things that for whatever reason we have a lot of trouble being moderate about. But again, that doesn’t make them demons for everyone. I am fully abstinent when it comes to alcohol. That’s not because alcohol is inherently evil. It’s  because it’s not something that works for me (pragmatist).

Do you demonize foods? Is it working for you?

body image · diets · fitness · food

Why the “Thigh Gap” Makes Me Sad #tbt

Sam and I have been reviewing our older content lately to get a sense of our most read posts and topics. I’ve also revisited “the thigh gap” topic this week proof reading a paper I wrote that’s coming out in the Oxford Handbook of Food Ethics (Ann Barnhill, Mark Budolfson, and Tyler Doggett, editors) very soon. My paper is called “Food Insecurity: Dieting as Ideology, as Oppression, and as Privilege.” It’s almost five years since I posted these thoughts here on the thigh gap. And it and any other arbitrary thin ideal that makes people, especially women, feel poorly about themselves if they don’t achieve it, still makes me sad.



thigh gap push pushIt’s not the newest news, but the whole “thigh gap” thing, especially among young women, has been a simmering pot that came into media focus a couple of weeks ago when I was off the grid on a sailboat vacation.  It was on the news and in the paper and on the web. It’s a popular hashtag on Twitter.

Sam alluded to it in her post about bathing suit anxiety.  The “thigh gap” aspiration is the newest thing driving young women to obsessive dieting and disordered eating.

I am a woman in her late forties with no teenagers, so I’m a bit out of the loop sometimes. When I discovered the world of tumblrs (such as “fuckyeahthighgap” and “thigh gap” ) devoted to the thigh gap, I confess to being not just shocked, but profoundly saddened.

I don’t even want to link to the sites because they are so…

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