Tag: weight loss

diets · weight loss

Losing Weight and Keeping It Off…

Tracy I12 Comments

diets2This topic has come up for me again lately because of (1) a barrage of email from Precision Nutrition asking me if I want to do it again (no thanks; see here for why) and (2) another excellent post from Ragan Chastain over at Dances with Fat talking about the ridiculousness of our obsession with weight loss. See her post “Even if Weight Loss Would Solve Every Problem.”

As she points out,

Even if becoming thin would solve every single problem in every single fat person’s life (and I don’t think it would), the truth is it doesn’t matter.  Because we don’t know how to get it done. The belief that we know how to help people lose weight long term, and that weight loss leads to greater health, is a major Galileo issue of our time – widely believed, fervently defended, and unsupported by the evidence.

So we throw around this hope, this dream, that one day the research will tell us something different. But even the science team at Weight Watchers isn’t hopeful that this will happen.  Here’s the dirt:

Weight Watchers own numbers show that the average person maintains a 5 pound weight loss after 2 years (a feat I feel could be accomplished by regular exfoliation and without paying a small fortune to Weight Watchers.)  When asked by the Federal Trade Commission to do longer-term studies, representatives from WW refused because “it would be too depressing for our clients”.

No, we wouldn’t want to depress clients with…the truth.  That would be unconscionable wouldn’t it? And why would the truth be depressing? Because, as Ragan Chastain quite rightly points out, we’ve come up with the kooky idea that losing weight is a cure all for everything that is wrong.  And it’s kind of depressing to discover that the magic cure is almost unattainable.

Better to keep people hopeful and trying.  That’s the WW strategy. That’s the PN strategy. That’s the strategy for just about every weight loss program out there.  They use before-after pictures, but the small print says “results not typical.” And it’s rare to see “after” shots that are way after. Like two or more years after. Why? Because it’s really hard to see anything dramatic in a 5 pound weight-loss, which is what WW for example says that the average person maintains 2 years out. Pics from 5 years after would be an even harder sell.

So there are a couple of things going on here. First off, we need to seriously examine why weight-loss is ascribed all the magical happy-making qualities it is. What’s that all about? It’s not as if everyone who wants to lose a few pounds is facing major health risks if they don’t. It’s not as if everyone who is in the perceived “normal healthy” (ugh!) weight range is actually healthy.  And it’s certainly not as if losing weight will solve our financial problems or marital problems or make our kids give us no grief or make the boss our best friend or stop our neighbor from dying or prevent us from getting in a car accident or make airline travel a pleasant experience, give us more vacation days, better sleep, and tickets to see our favourite band. And yet so many people, large and small alike, are filled with self-loathing and despair because they can’t lose weight and keep it off.

And then, we need to even more seriously consider why we reject the evidence before us about what a futile endeavor this actually is for the vast majority of people who undertake it. Please do not start on the “if people just did what they were supposed to do they would lose it and keep it off.” When we individualize this as if it’s all the fault of the people who can’t stick to the program as presented we miss the larger issue, which is that maybe, just maybe, these programs are a waste of time and money.

Ragan Chastain:

Almost everyone who attempts weight loss fails.  Yet doctors keep prescribing the same things and blaming the vast majority of people for “not trying hard” enough or “not doing it right”. Can you imagine if Viagra only worked 5% of the time and we blamed 95% of the guys for just not trying hard enough?  It’s completely ridiculous.  But when I point this out people roll their eyes and say “everybody knows” that you can lose weight if you really try.

Let me say it again – even if weight loss would solve every problem (and I don’t think it will), it doesn’t matter because we don’t know how to get it done and my opinion, based on the research that exists, is that it is a massive waste of time, money, and resources to keep suggesting, marketing, prescribing, and pursuing weight loss.

And finally,

If people want to keep researching weight loss methods that’s fine, it’s also fine if they want to keep researching ways to help people fly like superman, but I certainly won’t be dieting or jumping off my roof and flapping my arms. Attempting weight loss to get healthier is doing something that nobody has proven is possible for a reason that nobody has proven is valid.

It’s been a long time since I built a blog post around quotes from someone else’s blog post, but this message cannot be delivered enough. We all want to think we’re exceptions. That this time we will do it and it will work because we’ll do it better, we’ll be more vigilant, we’ll be “good,” la, la, la.

But, and I hate to be a negative ninny about it but hear me now: a new diet will probably fail and even if you lose weight and keep some or even all of it off, that is not going to mean you’ll suddenly become happy.

But there are lots of other tangible things we can do to live now in the body we have today. So rather than obsess and wring our hands over the impossible, why not move on from that and live in reality?

What do weight-loss studies REALLY show? Looking behind the scenes
Weekends with Womack

What do weight-loss studies REALLY show? Looking behind the scenes

catherine w13 Comments

Every so often, one of the big medical journals will publish a study by hard working medical researchers who look for answers to the question, “Which weight-loss programs are effective for long-term weight loss?” (SPOILER ALERT: the answer is “none of them”).

A couple of weeks ago, the Annals of Internal Medicine published a meta-analysis examining a bunch of studies that themselves tested various commercial weight-loss programs for effectiveness. By “effectiveness”, they meant whether and to what extent the participants in the studies (not the programs in general) registered weight loss 12 months after starting the program. Some of the programs evaluated were:

  • Weight Watchers
  • Jenny Craig
  • Nutrisystems
  • Atkins
  • Medifast
  • Optifast
  • Slimfast
  • And a few others

So, what did the study show? Well, it depends on where you read about the study, and what you can read from the study. Of course, readers of this blog have been well-served by many posts that show and explain scientific evidence for how unsuccessful diets are. And, if we look behind the scenes at what’s actually in this study, we can see just how limited the evidence really is.

This matters for a lot of reasons, but two big ones come to mind: 1) Almost all of these weight loss programs are expensive—at least $100/month, and some cost upwards of $600/month. Most people can’t afford that, and if their insurance covers it, that’s money not being spent on other (more effective) health promotion treatments. 2) Given the dismal success rates of all of the programs, they set people up to fail and feel bad about failing (while paying money for the privilege). So let’s now take a closer look.

If you read about the commercial weight-loss program study in the popular news media, you heard a variety of messages. Both the LA Times and Reuters reported the most digestible results, which were that Weight Watchers and Jenny Craig were more effective for long-term weight loss, with 3% and 5% average weight losses at the end of a year.

Time provided a more thorough and nuanced report, in which the positive results are listed, but they’re put in perspective by medical experts who say that 3-5% weight loss is not much, and the design of the studies limits their applicability to real life (they’re not kidding—more on this in a minute). However, ever-optimistic about the possibility of long-term substantial weight loss, they quote several experts who maintain that 3—5% is a good start, and that a small amount of weight loss can nonetheless translate into better health measures (like blood pressure, blood sugar and cholesterol).

The Associated Press story is more upbeat about the study’s results, and even throws in a personal story of a former employee of one of the researchers who is now on Weight Watchers and has lost 7 pounds in one month. We’re now all supposed to think: Wow! Maybe that could be me, too! Or: Oh, I tried that program and gained back all the weight I lost and then some; what’s wrong with me?

So what’s the real story here?   What are we supposed to think about commercial weight loss programs based on this study?

Reading through a medical journal article takes some time, patience, and background knowledge. I happen to benefit from the technical assistance and experience of my partner Dan, who’s an internist at a community health center. And I also do research on obesity and behavior change, so I’m used to plowing through this kind of information. Still, deciphering the careful understatement of medical authors takes some doing.

Here’s what I found in a close read of the article.

In order to evaluate a study for effectiveness, you need to take into the account the following factors:

Duration—any study that lasts less than 12 months is useless, as we know that short-term weight loss can happen on just about any diet (grapefruits, anyone?). The hard (which is to say, virtually impossible) part is maintaining it long-term.

Adherence—this refers to how many people actually followed the diet plan of the study. Any study with low adherence rates is not helpful. Why not? Well, maybe they didn’t keep up the plan because the diet was not doable (or too expensive—more on this in a bit).

Attrition—this refers to how many people dropped out of the study for whatever reason (e.g. they moved, they had bad side effects, they lost interest, they didn’t like the diet plan, etc.). This is relevant for reasons similar to adherence.

Bias features—this is a bit complicated, but studies need to select their participants, evaluate their progress, and make conclusions in scientifically scrupulous ways. Any study with a high risk-of-bias is suspect (more on this, too).

Cost—the authors, being sincere and medical and all, actually want to apply their findings in the form of clinical recommendations for primary care providers. This means that cost matters (I mentioned this already but it bears repeating), as many patients can’t afford or aren’t willing to pay large sums for these commercial programs. Also, insurance companies that might consider extending coverage for these plans take cost into account.

Adverse outcomes – this is medical-speak for “when bad stuff happens to people”. For instance, in one of the diet plans (Health Management Resources, a very-low-calorie diet plan that includes meal replacement shakes), 6% of the participants had gall bladder operations during the study (which is many times higher than the incidence of such operations in the general population in North America), and 56% of them reported constipation. Both of these are adverse outcomes (although one of significantly worse than the other).

So here’s the inside skinny on these features of their study:

Duration: Only Weight Watchers, Atkins and Jenny Craig were subjected to 12-month studies. The rest of the programs were used in 3—6 month studies, some of which reported 2—10% weight loss results, but without follow-up, they don’t mean anything (do I have to bring up the grapefruit diet again?). There are lots of ways to lose weight quickly, but so far no systematic ways to maintain weight loss in the long term.

Adherence: Many of the studies didn’t measure adherence—it is hard to measure, as you either have to sequester people in a medical setting (this happens for some short-term studies, but it’s expensive and hard to find participants) or ask people to fill out diet recall forms. These are known to have problems with accuracy. So this means that when a diet plan study has low success, we don’t really know how much of that effect is due to the diet and how much of the effect is due to people not following it.

And in addition, we don’t know WHY people didn’t follow it—this is a question I’m particularly interested in. Does the food not appeal to them? Does it require preparation that they don’t know how to do? Does it conflict with some of their regular eating habits? Do their friends and family not support eating in this way? We don’t eat in isolation—a big study on social networks and obesity )showed that our friends’ body weights have a strong influence on ours. There’s more to say here, but then again, I’ve got a weekly column now (yay!), so I’ll leave it here for now.

Attrition: Attrition is easier to measure– you just count up who is still in the study at the end. Right. But again, like in the adherence case, we want to know WHY people drop out. The same intriguing questions remain, but these studies aren’t designed to ask them. Why not? Beats me.

Bias features: The authors came up with a way to rate the bias of each study, based on the ways participants were selected, ways progress was evaluated, and ways conclusions were drawn. They gave each study one of three ratings: Low-risk-of-bias, Medium-risk-of-bias, or High-risk-of-bias. It turns out that of the 36 studies included, most of them were rated medium to high-risk. And almost all of the Weight Watchers and Jenny Craig studies used to create those positive headlines were medium to high-risk. For instance, one of the studies selected their participants from women who had had breast cancer. Surely this is not a representative sample of the population. Moving on…

Cost: Most of them are expensive, some of the very expensive. As I mentioned above, they simply may not be worth the money—either yours or your insurance company’s.

Adverse outcomes: I already mentioned some adverse outcomes for the HMR very-low calorie diet that was reported in the study. But many of the studies that the researchers looked at didn’t report adverse outcomes. So we don’t know much about them. Let me be clear in saying that I don’t suspect that there are unreported serious medical conditions that are resulting from these diets. But, since very few of the studies examined lasted longer than 3—6 months, and none of them lasted more than 12—18 months, we don’t know about the most relevant adverse effect: regain of weight lost, or the yo-yo diet effect.

yo-yo

Yo-yo dieting has lots of negative effects, both physical and psychological. This is well-known in the medical literature. However, in their recommendations for clinicians, the authors of this study fail to mention the potential downside of yo-yo dieting for their patients. At the very least this suggests that any serious medical studies on weight-loss programs need to follow their participants for longer periods. Of course, studies are very expensive, and body weight variation is complicated. It responds to an array of influences that range from environmental to economic to ethnic to psychosocial. So this is not easy science to do or understand.

One area of research I strongly support is trying to better understand people’s conceptions of health and healthy eating and healthy activity. If public health and medicine can help people better achieve their own health and eating goals, what would that be like? That’s a thought….

Struggles and strategizing: back at the beginning, again
body image · diets · eating · Weekends with Womack

Struggles and strategizing: back at the beginning, again

catherine w22 Comments

I struggle with my weight. It’s been a lifelong drama, with many supporting players: relatives, doctors, well-meaning (and not-so-well-meaning) friends and boyfriends, teammates on the many sports teams I’ve played for, nutritionists, therapists, you name it. Sometimes there’s relative peace—when I’m active, social, well-rested, not too-too busy in my work life, and my relationships are on an even keel—life is calmer and I worry less about it.

Lately, as menopause has announced its presence in my life (I’m sorry, but who thought this was a good idea? evolution, you’ve got some ‘splaining to do) the struggle has resurfaced. My sleep is interrupted, and I have less energy (but more mood swings—yay) and my cravings for sugar and carbs are at an all-time high. Add to this a heavier-than-usual workload this semester and 108 inches of snow in Boston (and by the way, it’s snowing again now—argh) and it’s no surprise that my average baked good consumption is up, and I’ve gained weight.

Samantha, Tracy, Nat and the guest bloggers have written loads about the failures and perils of diets—they don’t work in the long-term and contribute to lowered self-esteem and increased weight. I know this, too—my research areas are obesity, eating, and health behavior change. And yet I keep flirting with the idea of dieting again. For me, diets are like bad ex-boyfriends—I’ve forgotten the pain and suffering they imposed, how the relationships failed or even backfired. I just remember how good-looking or charming they were, full of seductive promises that “this time, it’ll be different”.

So what am I to do about being back in a state of weight-panic THIS time? Here are three things I’ve done this week. I’ll report back later on to let you know what’s happening—what is working, what I’ve jettisoned, what other responses I’ve adopted, and how I’m feeling.

1. I bought a book.

For an academic, nothing is more reassuring than book purchases, especially when one is confused, frightened, stalled, or in need of comfort. Just the thought of reading books, especially in a comfy study or library, is reassuring.

library

The book I bought is Gretchen Rubin’s “Better than Before: Mastering the Habits of our Everyday Lives”. The New York Times Well Book Club is running an online discussion, which caught my eye this week. Partly out of academic curiosity, and partly out of need to do something, I got the book and checked out the online discussion.

There are loads of books with loads of theories about behavior change, and of course this blog has talked about many of them. When I actually get around to reading this book I will fill you in. For now, all I’ve done is taken the quiz to set the stage for where I fit in Rubin’s behavior-change taxonomy. From there she has lots of suggestions for tailored strategies to optimize effectiveness.

Now, I have no particular expectation that this book is better or more effective than others; I will report back on my experiences later on. But for now, just owning this book feels like it’s helping me regain a little more perspective, which is good.

2. I’ve stopped eating sugary foods (at least for now).

While talking with a therapist about my energy levels, cravings, menopausal moods and general dissatisfaction with life on planet Earth these days, she suggested that maybe stopping eating processed sugar for a while might result in improvement of my overall mood and well-being. Just to be clear, I’m not talking about stopping eating these:

apples

but rather, stopping eating these:

bakery

For now.

I’m on day 3 of the no-baked-goods-and-other-sugary-stuff plan, and will report back on what I’ve done and learned.

3. I’ve changed primary care doctors.

This was a very big move—I’d been with the same doctor since 1998, and value familiarity, loyalty, and the deep knowledge base she has. But I never felt comfortable talking about my weight with her, and dreaded what she had to say, which never felt supportive. We squabbled about calcium and vitamin D supplements, and frequency of mammograms (she disagreed with the USPSTF recommendations which I wanted to follow). I would delay physicals in order to avoid being weighed.  Again, even though I know how bad the effects of weight stigma are on women in healthcare settings, it still took me a long time to act.

The first meeting with my new provider was eye-opening: she spent an hour with me (unprecedented in my experience), and we talked about weight, activity, menopause, sex, etc. in ways that felt positive and centered on my goals and needs.  I told her that I was willing to be weighed for my yearly physical and also when there was a medical need for complete accuracy (say, if this was a surgery pre-op visit).  Otherwise, I said I really didn’t want to be weighed, that it was a deterrent to my seeing her  She agreed, and we moved on smoothly.

Here’s how I handled the scale issue with the nurse (who I saw before the provider came in). She introduced herself and said, “I need to get your weight and height”.  I responded right away with “I’m not going to get on the scale, but I’m happy to tell you my weight; I weighed myself this week.”  She said okay.  When we got to the scale, she said, “you’re not going to get on the scale?”  I said no, but then told her my weight.  Then she asked, “are you willing to have your height measured?”  We both laughed, and I said yes indeed.  It turns out I’m the same height as the last time I was measured.

The issue of primary care office visits and weighing of patients is controversial and far from settled.  For what it’s worth, in a US National Institutes of Health document about treating obese patients, one of its recommendations is to weigh them during visits only when it’s medically appropriate.  I’m not here to speak authoritatively about this issue, but I did want to include how I handled my experiences and fears of weight stigma in this environment.

I’m very lucky not to be on any prescription meds, so I don’t see healthcare providers often. But I’m hopeful about my prospects moving forward with this new practice.

I’ll report later on progress, shifts, and lessons learned. For now, thanks for reading.

body image · diets · Uncategorized · weight loss

Weight Loss, Body Hatred, and the Possibility of Other Motives

Tracy I27 Comments

We spend a lot of time on the blog talking about body positivity and self-acceptance.  But sometimes we also talk about weight loss.  Whether it be for performance reasons, as I’ve discussed (with some skepticism that it makes it “okay” to have it as a goal) and as Samantha thinks about re. her cycling or to get the blood pressure in check, as Natalie has done, there are reasons other than normative femininity to lose weight.

But some people think that as a feminist blog, we should never ever talk about weight loss as something to aim for. Weight loss is associated the the pressure to be thin, oppressive norms, and a generally negative opinion of fat, fat bodies, and fat people. I

Not only that, but we have always taken a strong anti-diet position on the blog. Diets don’t work. The staggering statistics in support of their inefficacy speak for themselves. Almost everyone who successfully loses weight with restrictive dieting gains most (often more) of it back over time. Sometimes it takes a few years, sometimes just a few weeks. It depends on the method — fad diets and highly restrictive approaches to weight loss have the worst outcomes.

And if diets don’t work, why are doctors always pushing us to lose weight anyway? They give all sorts of unsolicited advice, making body weight monitoring a regular part of ongoing medical care even for people who aren’t having any health issues at all.

We reject the whole BMI thing.  And both Sam and I promote the idea of finding activities you enjoy and getting out and doing them, no matter what your size and without having weight loss as a focal point.

We care about metabolic health, and are more likely to encourage everyone to eat more, not less! In fact, I’m not sure we have any posts that encourage people to eat less.

We’ve written about all of this and more. And yet sometimes we talk about weight loss.  And a few people have let us know that it disturbs them. That it indicates to them that we’re not “feminist enough.”

I’m not big on defending myself as a feminist, either to anti-feminists or to other feminists.  But what I want to say here is that Sam and I aren’t just feminists. We’re actually feminist philosophers.

Now, not all feminist philosophers believe exactly the same things. But one of the things that makes us fairly compatible is that we’re both fairly moderate and open to other ways of seeing things. This means that on our Facebook page, for example, we’ll sometimes post content that we don’t agree with,. We might do that just because it makes an interesting point worthy of consideration OR because it’s clearly getting something wrong in an interesting way.

But the real question for me when we post about weight loss, at least where feminism is concerned, is: are their any legitimate reasons for wanting to lose weight, reasons that have nothing to do with hating our bodies, trying to fit normative ideals, or even worse, hating and punishing ourselves.

And I think the answer to that is pretty clearly “yes.”

I think we’re right to be skeptical about medical reasons even though in some cases it could make a difference.  The fact is, so does getting active and developing healthy eating habits.  Weight loss could be a by-product of that, but setting it as a primary goal is probably going to be self-defeating anyway.

Then there are the performance reasons that athletes obsess about. I blogged about racing weight not too long ago. And Sam has talked about wanting to weigh less so she can fly up hills more quickly. In my post, I worried that after a couple of years of liberating myself from weight loss as a goal, aiming for “racing weight” or any kind of weight-related performance improvement could take me back to old bad habits associated with dieting: poor body image, weight obsession, worrying about food all the time, berating myself for eating.

I also worried that you can dress it up anyway you like, but aiming for weight loss for whatever reason is going to have the same results. Wanting to perform better doesn’t mean your weight loss is going to be any more lasting than if you did it for other reasons. Athletes don’t even expect to maintain their race weight or the weight they will compete at on game day through the entire year. It’s seasonal.

So I guess I have my worries about that too. Yes, we can have non-body-hating reasons to want to lose weight. And in the end, I think those reasons can be consistent with feminist ideals. But having different reasons doesn’t change the facts about sustainable weight loss.

Sam has blogged about weight loss unicorns before. They’re the people, and we all know some of them, who lose weight and keep it off. They’re unicorns because they are rare.

And even if someone has reasons for wanting to lose weight that are consistent with feminism, I myself avoid entering into any conversation with anyone where my expected role is to praise them for their weight loss efforts. I pretty much never do that because, as I blogged about here, I do not believe “You’ve lost weight, you look great” is a compliment in polite society. Rather, it bespeaks a kind of body policing. It’s really hard to be explicit about noticing someone’s weight loss (or gain) and not be engaged in body policing.

Weight loss and dieting have long been considered as oppressive tools, contrary to the liberatory goals of feminism. Besides blogging about it a lot I’ve also done a bit of philosophical work on the topic. For me, I know weight loss is a dangerous goal. But that doesn’t mean I don’t understand why some people might want to lose a few pounds for reasons that are consistent with the aims of feminism, among which, of course, are the freedom to make our own choices without being condemned for them.

 

Guest Post · weight loss

40 years & 40 lbs (Guest Post)

natalieh (she/her)22 Comments

I’ve seriously debated writing this post, I’m torn really, but in the spirit of open and honest discussions about fitness and feminism I can’t ignore my changing body and writing about it. I’ve shared with readers and friends about my journey from last April’s high blood pressure diagnosis to therapy around overeating and even hitting a tertiary benchmark, losing 20 lbs.

This post though feels, vain, yes, definitely feels like a vanity to share I’m wearing smaller pants. I’ve changed a lot of things in my life that have impacted my weight but my primary goal has been to get my blood pressure down without medication. I’m currently on medications that are keeping my blood pressure in a healthy zone, YAY!

In the healthy range for blood pressure and pulse!
In the healthy range for blood pressure and pulse!

The downside is, as a result of the medication, I now have Raynaud’s Syndrome that restricts circulation to my hands and feet in the cold, making running below 0C very painful no matter how many layers I wear. I asked my doctor in January at what point my declining weight would impact my blood pressure and he said “You have to lose a lot.” Well crap! This was especially annoying because my pulse at the doctor’s office (post coffee, ya ya but honestly I also have a goal of being a non-violent person and coffee assists me with this) being under 60 bpm was pretty awesome considering it was 73 bpm in July and 80 bpm before that in May. My cardiovascular health is definitely improving, which was my secondary goal to support lowering my blood pressure.

My weight has dropped by what I thought was “a lot”. Honestly I didn’t think I could loose 40 lbs without starving myself, measuring food and obsessively counting calories. I do none of these things. I use Canada’s Food Guide and cook from scratch. I eat bread and cheese and on Valentines Day had wine with dinner and chocolate for breakfast.

Therapy around overeating was crucial for me to change my relationship to food, to see it both as nourishment AND joy without it being a way to numb my feelings.

So, while 4 months ago I was freaking out about turning 40, today I’m feeling fantastic and wearing a smaller dress than I have in a long time. So 40 can be a number I’m happy about for a bunch of reasons. I share with you not a before picture, not an after picture, but my picture of feeling great for my date with my life partner. (That’s what all this is about anyway, being around a long time and extracting a lot of joy, right?)

All dolled up for a hot date.
All dolled up for a hot date.

I have no idea where my weight will settle out, it seems to keep going down, so that is cool but I don’t know if I’ll get to the point where I can go off blood pressure medication. I think I just need to be ok with whatever comes next. That feels like a good plan.

diets · eating · food · Uncategorized · weight loss

Vegan for Weight Loss? Not Necessarily but Don’t Let That Discourage You!

Tracy I5 Comments
Everyday Pad Thai. Photo credit: Vanessa Reese. http://www.theppk.com/2013/09/everyday-pad-thai/
Everyday Pad Thai. Photo credit: Vanessa Reese. http://www.theppk.com/2013/09/everyday-pad-thai/

It’s making the rounds again–the idea that a vegan or at least vegetarian diet is the best way to lose weight.  According to this article:

Overweight and obese adults who wanted to lose weight were randomly assigned to one of five low-fat and low-glycemic index diets: vegan (no animal products), vegetarian (dairy products included), pesco-vegetarian (dairy products and seafood included), semi-vegetarian (all food included, but red meat no more than once a week and poultry no more than five times a week), or omnivorous (no restrictions on food type and frequency).

Participants were told they could eat small amounts of nuts and nut butters, avocados, seeds, and olives in their diets but were encouraged to focus on lower-fat food options. The dieters were not given goals for limiting the number of calories they ate. As the researchers put it, “participants were free to eat until they were satisfied.”

After six months, those in the vegan group had lost the most weight, an average of 7.5 pounds. The vegetarian group was not far behind, with an average loss of 6.3 pounds. Those in the other groups lost only half as much weight (an average of 3.2 pounds for the pesco-vegetarian and semi-vegetarian groups and 3.1 pounds for the omnivores). There was no significant difference in reported activity level among the five groups.

I’ve blogged before about why this kind of thing bugs me.  First of all, any diet that restricts whole food groups for the purposes of losing weight is really just a fad diet that’s not likely to stick.

Not only that, and probably related, dieting to lose weight is for the vast majority of those who do it, doomed from the outset. It’s really hard to keep off all the lost weight.  We’ve had lots to say about that on this blog and are basically anti-diet in our approach.  See here and here and here and here for example.

Don’t get me wrong. There are all sorts of good reasons to be vegan or follow a plant-based diet.  Lots of athletes do well on a diet that’s free of animal products.  Like Rich Roll, an ultra-triathlete, and Scott Jurek, an ultra-runner.

I’m vegan, but I can’t say it helped me lose weight or perform better athletically. I continue with my vegan lifestyle (which goes beyond the diet) anyway because my motivation is ethical not based on health or weight loss or performance.

I don’t mind if people are convinced by articles like the one I quoted above to try this approach to eating. But I hate to make its virtues dependent on losing weight or improving athletic performance.

Not everyone is going to respond the same way to every approach to eating. For some people, there may be dramatic weight loss on this kind of diet. But for others, there may be none, or even weight gain.  Especially after they learn how to cook and realize that for every amazing non-vegan food out there that tempts us, there is an equally delicious vegan alternative!

So yes, try eating a plant-based diet.  It’s a perfectly legitimate and morally worthwhile way to satisfy your nutritional needs and keep your palate happy at the same time.  But it’s not a miracle diet.

Here’s a link to a recipe for “Everyday Pad Thai” from one of my favourite vegan blogs, Post Punk Kitchen by Isa Chandra Moskowitz.

body image · swimming · training · weight loss

Why Swim?

Tracy I15 Comments
Swimmer in lake. Image credit: http://www.beaverlakeboaters.net/events/swimmers-trek-40-miles-to-beaver-dam/
Swimmer in lake. Image credit: http://www.beaverlakeboaters.net/events/swimmers-trek-40-miles-to-beaver-dam/

Regular readers of the blog will know that I am totally in love with swimming. So when Sam sent me this post “5 Reasons Why Swimming Is the Perfect Workout for Weight Loss” I kind of bristled. Why? Posts like this rub me the wrong way because they make it sound as if weight loss is the only good reason to do it.

What if swimming turned out to be great for our health but not great for weight loss?  Should we then ditch it?

But back to the five reasons. Here’s what the article says:

1. Burns calories

You can burn much more calories swimming than could while you walk or run. An average built person can easily burn 400-500 calories in a 60 minute session of moderate-intensity swimming.

2. Works out your muscles

The different strokes involved in swimming requires a good amount of muscle power. This gives your muscles a good workout every session. Those looking out for a muscle building workout should try high-intensity swimming as this can adequately stimulate your muscle growth.

3. Tones you out

Swimming no doubt exercises your whole body. When you swim your arms, shoulders, back, core, glutes and legs get a thorough workout thus toning them effectively.

4. Boosts metabolism

Any activity that burns calories and gets your heart rate up also boosts your metabolism. This makes swimming the perfect metabolism boosting activity. An active metabolism in turn aids fast weight loss.

5. Motivates you to try harder

The swimming attire usually requires you to strip down to bare minimal. This motivates you to train harder to look good in your swimwear.

I’m not going to quarrel with the first four things on the list.  It does burn calories, work out a variety of muscles, gives you a good total body workout, and as much as anything that gets your heart pumping it boosts the metabolism.

But that last reason? Really?  Swim suits are skimpy, so if you want to look good while you work out (see Sam’s post on looking cute while working out), you’ll be motivated to train really hard if you swim.  Strange logic.  In fact, emphasizing the minimalism of swim wear is more likely to discourage people who are body conscious from ever stepping onto the pool deck.

A bunch of good reasons to swim are missing from this list, and these aren’t all about weight loss.  Swimming is a non-impact activity, so it’s easier on the body than running.  It provides excellent cardio, so helps build a strong and healthy cardiovascular system. And that promotes endurance.  One of the things I love most about swimming is that feeling that I could go on forever.

I much prefer this post by Master’s swimmer Alex Kotisch: 9 Good Reasons Why You Should Get in the Pool. Among the reasons:

1. Heart Helper
Swimming provides unparalleled cardiovascular conditioning, provided you practice consistently and with good technique. While other forms of exercise may be more effective at elite levels (such as running or cycling), incorporating swimming into a cross-training routine and pushing yourself in practice will result in overall improved fitness.

2. Balance Your Build
Swimming builds longer, leaner muscles that complement the shorter denser muscles that develop from weight training. These “swimmer’s muscles” also help boost metabolism to keep calories burning longer.

3. Cross-training
Swimming not only boosts cardiovascular capacity while increasing muscle strength, but it also gives your body a break from higher-impact activities like basketball, running, and weightlifting. By creating a balanced workout routine, athletes avoid injury by allowing their body time to heal, while not forgoing daily training sessions.

4. Increased Flexibility
A heated pool relaxes muscles, increasing flexibility and enabling important stretching. Also, after intense lactic-acid-building endurance workouts (running, cycling, weights), an easy swim helps flush out toxins preventing muscle tightness and soreness the following day.

5. Strengthen Your Core
Swimming develops core body strength because it utilizes all the body’s muscles simultaneously. Although 70 percent of a swimmer’s effort comes from the upper body, kickboard and fin workouts can provide an excellent leg workout.

6. Endurance
Swimmers are able to swim longer than they can what they could sustain doing other activities. With the right technique, a swimmer will be able to train for longer periods of time than if he/she were running and, as a result, more calories are burned.

7. Adventure
Swimming has branched out from the darkened, indoor community pools of yesteryear. Many new health club chains offer clean lap pools, and local communities are finding renewed interest in outdoor facilities during the summer months. Seek out available natatoriums in your area (swimmersguide.com) and if you are able, locate a natural body of water (lake, ocean, pond, or quarry) and explore the joys of open-water swimming.

8. Social Outlet
Imagine meeting the man/woman of your dreams, and seeing what they look like without their clothes on for your first date! That’s one benefit, at least, of joining a Masters team or triathlon training group. In addition to the possibility of romance fueled by mutual interests, team programs offer peer motivation and professional coaching to provide you with increased performance results.

And finally, the last reason is: weight loss.

9. Weight Loss
“People who consistently swim strenuously enough to be out of breath when they finish and elevate their heart rate do burn calories and lose weight,” says Jane Moore, M.D., a physician and active swimmer from Tacoma, Washington. “The key is to push yourself a bit.”

“Putting on a swimsuit and appearing in public should also motivate one to shed a few pounds,” says Kris Houchens, head coach of the YMCA Indianapolis SwimFit Masters.

Again, there’s that ridiculous comment about having to appear in public in your swim suit.  Ugh. I’m all for promoting the other reasons to swim, but highlighting the horror of looking “unsightly” in a swim suit is, as I said before, much more likely to discourage people from taking a dip than it is to encourage them to work harder in the pool. We need to get people to the pool first.

I swim because it makes me feel energized and strong. I love the rhythm of my breathing when I swim, and the feeling of gliding through the water. I also find it a very meditative activity. I’ve blogged about that before.  Also, though I’m not the fastest swimmer in the pool, I am faster than a lot of people, and that makes me feel good.  It’s also amazing to take it out to the open water in the summer.

So for all the great reasons to swim, dive in! The water is fine!

diets · eating · health · weight loss

Non-Dairy Ice Cream Cleanse. Really?

Tracy I4 Comments

coconutThe article asks: “Would you go on an ice-cream diet to lose weight? New cleanse prescibes FIVE PINTS a day for four days straight.”

Let’s start with my answer to the question: No.

I don’t care if it’s dairy-free. Even if it were completely vegan (it’s got honey in it, so I’m kind of surprised that they’re claiming to be a vegan ice cream shop). I would not go on an ice cream cleanse to lose weight or to “detox.”  And I especially wouldn’t pay $240 for it!

Here’s are the deets:

Kippy’s, a vegan ice-cream store in Venice, is offering a $240 cleanse in which dieters eat five pints of raw coconut-based ice-cream a day for four straight days.

The cleanse, which amounts to 1,000-1,200 calories and 70 grams of fat per day and boasts 20-25 grams of sugar per ice-cream pint, is designed to help people lose weight and achieve a clearer state of mind.

What you get is four days worth of ice cream and you eat it five times a day. They’ve got a “master cleanse” flavor and a “Superfoods” flavor, as well as dark chocolate with Himalayan fire salt, coconut yogurt (for breakfast), and orange creme.

There are lots of reasons I wouldn’t do this.

First, you can’t lose weight in four days and expect to keep any of it off.  The journalist who tried out the cleanse learned this first hand:

A reporter for Gizmodo, who reviewed the ice-cream cleanse with his girlfriend, revealed that despite their typical cleanse grovels (missing the feeling of chewing, salty foods, and solid foods in general), they both lost a similar amount of weight – approximately six pounds each.

But he admitted that ‘in the span of one long weekend, I managed to put all of that cleanse-weight back on (plus another pound or so).’

No surprises there.

Moving on:  all this talk of “cleanses” is just ridiculous. This article on the website “Science-Based Medicine” talks about the whole “detox”/”cleanse” trend as a scam ($240 for four days of ice cream, anyone?)  and gives suggestions about how to avoid it. According to the article, the premise that our bodies ingest and accumulate toxins that we need to cleanse ourselves of is just plain bad science:

Today’s version of autointoxication argues that some combination of food additives, gluten, salt, meat, fluoride, prescription drugs, smog, vaccine ingredients, GMOs, and perhaps last night’s bottle of wine are causing a buildup of “toxins” in the body. But what is the actual “toxin” causing harm? It’s nothing more than a meaningless term that sounds scientific enough to be plausible. A uniform feature of detox treatments is the failure to name the specific toxins that these rituals and kits will remove.

The colon remains ground zero for detox advocates. They argue that some sort of toxic sludge (sometimes called a mucoid plaque) is accumulating in the colon, making it a breeding ground for parasites, Candida (yeast) and other nastiness. Fortunately, science tells us otherwise: mucoid plaques and toxic sludge simply do not exist. It’s a made-up idea to sell detoxification treatments. Ask any gastroenterologist (who look inside colons for a living) if they’ve ever seen one. There isn’t a single case that’s been documented in the medical literature. Not one.

We see this vagueness about cleansing and what is to be cleansed in the claims made by Kippy’s coconut ice cream diet: “It helps us digest, repairs the gut, feeds the brain, boosts the metabolism and is a powerful agent of detoxification,” or so claim its developers and purveyors.

That the offending toxins are either unnamed or, if named, invented or falsely identified, leads to the debunking of the second assumption of cleanses: that the toxins are the root of illness.

And the final suspect claim is that these detox regimens and cleanses remove toxins.  According to the article, “there is no evidence to demonstrate that detox kits do anything at all.”

Yeah so what that says to me is that the very idea of a cleanse of any kind is just a waste of time and money.  My radar for that sort of thing is fairly sharp. I just have to hear the word “detox” or “cleanse” and my hackles go up.

And I think too that there’s a ton of slippage between the cleanse motive and the weight-loss motive.  If you challenge someone about a detox on the grounds that they’re not going to lose weight and keep it off, they will claim that what they’re really doing is detoxing.

Another thing worth pointing out is that there are medical applications of the term “detox.” It refers to a pretty horrible process of withdrawal that people addicted to substances like alcohol or narcotics go through when they are attempting to quit, or people who have ingested poison have to go through to literally clean out their systems. So it’s not a completely bogus idea, it’s just not the sort of thing that is covered in things like an ice cream diet or a cayenne and lemon juice drink or a “rapid cleanse” (which sounds just scary).

Here’s the conclusion of the article I’ve been referring to from the Science-Based Medicine website:

Any product or service with the words “detox” or “cleanse” in the name is only truly effective at cleansing your wallet of cash. Alternative medicine’s ideas of detoxification and cleansing have no basis in reality. There’s no published evidence to suggest that detox treatments, kits or rituals have any effect on our body’s ability to eliminate waste products effectively. They do have the ability to harm however – not only direct effects, like coffee enemas and purgatives, but the broader distraction away from the reality of how the body actually works and what we need to do to keep it healthy. “Detox” focuses attention on irrelevant issues, and gives consumers the impression that they can undo lifestyle decisions with quick fixes. Improved health isn’t found in a box of herbs, a bottle of homeopathy, or a bag of coffee pushed into your rectum. The lifestyle implications of a poor diet, lack of exercise, smoking, lack of sleep, and alcohol or drug use cannot simply be flushed or purged away. Our kidneys and liver don’t need a detox treatment. If anyone suggests a detox or cleanse to you, you’d do well to ignore the suggestion, and question any other health advice they may offer.

So I’m saving my money. I have nothing against coconut ice cream, by the way. I love it. But I’m not about to spend $240 for a four-day supply, eat it as my only meal for days in a row, and try to fool myself that I can use it to improve my health.

 

 

body image · diets · eating · health · motivation · weight loss

“Healthy stuff is still healthy, it just doesn’t make you thin”

Tracy I6 Comments

Yesterday Sam posted about the CBC report with latest “news” about obesity research: “Obesity research confirms, longterm weight-loss almost impossible.”  This is hardly news. We’ve said this many times.  It’s one of the most controversial claims you can make that’s fully supported by research.

I responded last summer with the post “If Diets Don’t Work, Then What?”   There I promoted the benefits, mostly in terms of mental health, of the intuitive eating approach.  I didn’t lose weight when I embraced intuitive eating. But I did lose a debilitating obsession with food and weight.  That more than made up for it.

And yet, after a year of intuitive eating, I still chose to pursue the Precision Nutrition Lean Eating Program for Women. Knowing what I know, it may seem like an odd choice. Why, when all the advertising surrounding the program is about body transformation, would I want to do it? I blogged about it in the post “Why I’m trying PN “Lean Eating” after a year of intuitive eating.”  There, I said my main reason had to do with tweaking my nutritional habits:

One of the principles of Intuitive Eating–the last principle, in fact, because it is so loaded for so many chronic dieters–is “Honor your health with gentle nutrition.”  I don’t want to exaggerate. It’s not as if I’m living on junk food and soda pop or anything like that.  But I do feel as if I’ve not quite mastered nutrition since I became vegan just over three years ago. And while I’ve been focusing on a more intuitive approach to eating, nutrition hasn’t been the main guiding principle in my choices.

And truth be told, I’m ready for a change.  From what Sam has told me about the Lean Eating program and from everything I’ve read, it’s not a diet and it can be compatible with an intuitive eating approach to food. So let’s just say that this year, I’m honoring my health with the re-introduction of gentle nutrition.  Nothing extreme will work for me.

And so far, it’s been doing that really well.  What I didn’t know ahead of time is just how compatible with intuitive eating the PN approach in the Lean Eating program actually is. If you could just embrace the two “anchor habits” of eating slowly and stopping at 80% full, you would be a fairly successful intuitive eater. And a whole lot more comfortable after meals.

So I’m engaging in some healthy behaviors and developing some healthy habits. And since they do ask for weight and measurements on a regular basis, I can report that I have dropped a few pounds along the way. But I am not deluding myself this time. The real test of any program is not to be found by comparing the “before” with the “immediately after.” Not at all. Check back a year after. Or two years after. What about five years after?

As Sam reported yesterday, PN doesn’t track that sort of thing at all. No follow-up means no data to report.  With the stats for any program as they are, it’s not surprising no one wants to track the long term results. And the fact that lots of people do PN multiple times is evidence that despite its focus on healthy habits, the results are not likely to be sustainable for the majority of people.  If they were, they would be more enthusiastic about follow-ups and reporting the longer term outcomes for their clients.

The quote from the CBC article that I liked the most, is the one that I put in the title today. Pyschologist Traci Mann, who ran an eating lab at the University of Minnesota for 20 years, says: “Healthy stuff is still healthy, it just doesn’t make you thin.”

As Sam did yesterday, I’m concerned about people who put thinness as their primary goal for engaging in activity or for making balanced nutritional choices.  That’s not the only reason to make those choices. As the research shows, it’s not even a good reason.

I do wonder whether I will keep these “healthy habits” over time.  Does the weight come back on inevitably, or is it because habits slide? “Researchers are divided about why weight gain seems to be irreversible, probably a combination of biological and social forces. ‘The fundamental reason,’ [obesity researcher Tim] Caulfield says, ‘is that we are very efficient biological machines. We evolved not to lose weight. We evolved to keep on as much weight as we possibly can.'”

Okay, so as Sam asked yesterday: liberating or depressing?  For me, it’s helping me a lot to keep any weight loss that I might be experiencing in PN LE in perspective. Thankfully it’s not my primary goal, and even more thankfully the weighing and measuring has not fostered a new obsession. In fact, I have found myself quite capable of adopting the recommended attitude of “get ’em and forget ’em” towards the weekly updates.

I used to feel more hopeful about a different outcome, namely a change not in weight but in body composition. But now I think that aspirations of that nature are just another breeding ground for false hope.

When I reflect on what has been most amazing so far about the “fittest by 50 challenge” that Sam and I are on, for me it comes down to two things:

1. becoming adept at intuitive eating, to the point where I no longer obsess about food.  I repeat: I NO LONGER OBSESS ABOUT FOOD!

2. how much I am enjoying the activities I’m pursuing these days. I’m all geared up for my first triathlon of the season on the weekend and I couldn’t be more excited.  Weight loss and even body composition just aren’t factoring into that picture.

I also have an expanded conception of health that includes my mental health.  I feel more grounded, more at peace with who I am, much healthier in my relationship and attitude towards food, activity, and my body.  I’ve still got a bit of a way to go with respect to body image, but I am further than I was last summer when I wrote this post.

I too fall into the “liberating” camp.  Knowing the facts should also liberate us from stigmatizing fat bodies and making moralized judgments about body fat (on ourselves and others). In moral philosophy we have this principle that says “ought implies can.” It means that you can’t be under an obligation to do anything that is impossible.  If we say you “ought to” then it means you should be able to.

And the stats on long term maintenance of lost weight don’t support the “can.” Therefore, they call seriously into question the “ought.”

At the same time, that doesn’t mean we need to give up on making choices that make us feel better. But making thinness the primary motive is a set-up for feeling much, much worse.

 

 

diets · eating · weight loss

The Mesh Tongue Patch for Weight Loss. No Thanks.

Tracy I1 Comment

small mesh rectangle held between thumb and index finger wearing rubber gloves.Not too long ago I wrote about men who body shame women. One of the people at the centre of the latest controversy when I wrote that was an influential Venezuelan beauty pageant host named Osmel Sousa.  His name has come up again in an interview with a Venezuelan “beauty queen” who has, at Sousa’s advice, had a boob job and surgery to get rid of a slight “hook” in the shape or her nose.

But breast augmentation and nose jobs don’t really shock me much anymore.  I still wish women weren’t so fixated on their looks that they would go under the knife to look different, and I do think that it would be bad for women if the culture of cosmetic surgery (for purely aesthetic reasons) really took hold so that it was expected.  At the same time, I have known women who did indeed feel better about themselves after surgeries.

And body transformation is so rampant in our world, through means that range from extreme dieting to heavy weight training with all sorts of stops in between. But the interview made me aware of a new method for losing weight that seems like some sort of medieval torture.  It’s a mesh patch that is literally stitched to the tongue.

How does it aid weight loss?  By making it too painful to eat solid food!  If we have to draw the line somewhere on the continuum between taking good care of ourselves and abusing our bodies and ourselves so we can lose a few pounds, I’m going to say we should draw it on THIS side of mesh tongue patches that make it too painful to eat solid food.

One thing is for sure. The mesh tongue patch is a short term solution.  The patch is temporary, and so is the weight loss.  Why? Because it doesn’t work on habits. Just like any weight loss diet, the real test is not whether the weight comes off, but whether it stays off.

If you put a patch on your tongue so you can’t eat solid food for a few weeks, how likely is it that you’re going to start eating regular food as soon as the patch comes off? If it were me, I’d be grabbing for whatever solid food was in my grasp–from fruit to chocolate cake, from hummus to veggie burgers, I wouldn’t care–as soon as my tongue healed enough for me to tolerate eating solids.

A doctor who spent 14 seasons on the Biggest Loser thinks it’s “barbaric.” According to this article:

Studies show most extreme dieters who lose weight rapidly eventually gain it all back — and more, he said.

“There’s not one scintilla of hope or evidence that putting a patch on your tongue and not being able to eat for a month is going to have any effect on you at one year, or two years or three years,” he said.

That sounds about right.

Here’s more about the tongue patch fad in Venezuela:

http://www.youtube.com/watch?v=IRDhVvvH1Gg