Fat Tax

And, what do you think about this?

Hello, Skinny!

There's a big sign in the contemporary jeans section at Bloomingdale's that, in an ode to the skinny jeans trend, reads: "My Skinny Is Skinnier Than Your Skinny."

Um, ok. . .

I googled the phrase to find out more about this particular advertising campaign and serendipitously stumbled on this.

Thoughts?

Book Review

I just finished Such a Pretty Fat: One Narcissist's Quest To Discover if Her Life Makes Her Ass Look Big, Or Why Pie is Not The Answer and wanted to discuss it here. Author Jen Lancaster also penned Bitter Is the New Black and Bright Lights, Big Ass (have you read them?), but it was this title that grabbed my attention at the local book store.

Quick disclaimer--for those with clinical eating disorders, this book could be triggering, as Ms. Lancaster's book deal is based upon her losing weight. For the "Every Woman" variety, I don't believe this piece will be triggering, but rather that you'll find yourself identifying with much of what Ms. Lancaster has to say. To be clear, it's kind of a diet book, but it's an anti-diet, diet book. You'll see what I mean. . . .

What surprises me most about her book is Ms. Lancaster's general acceptance of her weight (at any size), her ability to take weight gain in stride, and her sense of humor about it all. All this despite some challenging formulative experiences:

My mom was so damn mad at me after my freshman year, especially once she saw me in a bathing suit for the first time. I went from 135 pounds to 150 and you'd have thought I'd flunked out given her reaction. She always used to tell me her greatest fear was that I'd walk across the stage at my high school graduation overweight. Really? I remember thinking. With forty girls in my school who'd either gotten pregnant or had babies, this is her issue?

In reaction to her parents beginning officiating weekly weigh-ins, Lancaster writes:

I desperately hated the whole process, especially because I had no choice in the matter. I knew being heavier didn't change who I was, and I was furious at being forced to alter something about which I felt perfectly fine.

How many college students do you know with this kind of persepctive? More to the point, how many full-grown adults can say this for themselves?

When Ms. Lancaster begin her weight-loss journey (the point of this particular book deal), she weighs herself a couple of times in disbelief:

I trot down the hall--which I can do because I'm not completely obese--and try to calm myself down. I'm totally overreacting here. I am fine. I know I'm fine. Whatever I weigh is just a number. I'm fun and smart and I can perfectly blend three shades of eyeliner. I enjoy my own company and I make myself laugh. I dress well, even on a budget while wearing Crocs, and no one makes a banana daiquiri like I can.

I suppose it's not that surprising that she was alarmed by her weight--she chooses to focus on so much more. I find her attitude incredibly refreshing, particularly in a current cultural context that demands we focus on looks at the expense of all else.

Lancaster writes about our obsession with thin celebrities:

[Nicole Ritchie] really didn't get famous until she got pin thin. Ditto Kate Bosworth and Lindsay Lohan. And no one would have even remembered Mary Kate Olsen if she'd just eaten a sandwich once in a while. This makes me wonder how much the media plays into the self-image of [dieters]. Did they call Jenny because fashion and gossip magazines force photos of hungry women down our throats and try to make us believe their boyish bodies are the ideal? If so, we're all destined to fail.

Personally, I never want to be as thin as most of the women in this magazine; they look gross to me. The only ribs I want to see are covered in barbecue sauce.

Ms. Lancaster has had her share of weight-loss experiences, illustrating why diets don't work:

Consuming a thousand calories a day with very little protein, I felt lightheaded and weak every second for three whole months. I wasn't just hungry. I was famished. Starving. Ravenous. Not only did I want to consume my parents' cooking in vast quantities; I was in such a state that I'd look at the love of my life, a 140-pound Great Pyrenees mountain dog named George, and I'd fantasize about his tender, meaty flanks, charbroiled over a hickory-wood fire and served with a side of home fries.

Perhaps most illuminating is Ms. Lancaster's realization that food restriction can work against us. She chats with a friend:

"Funny, but when I'm not dieting I can go hours and hours without thinking about food. Some days when I'm busy it might be four in the afternoon before I remember to eat something. But now that I'm doing Atkins*, all I can think about are bagels and donuts and Lucky Charms cereal, and I'm making myself crazy."

(Spoiler alert)

In the end, Ms. Lancaster does lose some weight, and it's no surprise how. But, if you read closely, you can't help but realize that her weight-loss is just another life task for her (like writing a book, or learning a skill), accomplished with curiosity, humor, and positivity, the inspriational outcome atypically disengaged from her self-esteem.

*I had a typo on "Atkins" and guess what? Spellcheck on Blogger corrected it for me.

More on Thanksgiving

An email advertising this post-Thanksgiving day workout arrived in my inbox last week. Sure, exercise is an important part of a healthy lifestyle, but can you can you identify any problems with an advertisement like this?

On Thanksgiving

Recently, I overheard the following exchange:

"What are you doing for Thanksgiving?"

"We're going to the so-and-so's. They're having 20 dishes. It's disgusting. I'm going to bring a salad for myself."

I read somewhere that Americans consume an average of 4,500 calories at their annual Thanksgiving meals. As we all know, what began as a feast of gratitude has morphed into a national binge. Many people report feeling uncomfortably full after their meal. Sure, we all eat past fullness on occasion, but the culturally sanctioned degree here is cause for concern, as nausea trumps satiety with the rationale that we're all in this together.

In response, especially for people who struggle with disordered eating and body image, there's Thanksgiving day anxiety. . . or disgust. 20 dishes? That sounds like a smorgasbord of wonderful opportunity--a chance to sample a little bit of this, a little bit of that. But, because we don't trust ourselves to do this, because we see such occasions (similar to cruises) as respite from the shackles of dieting, we go overboard.

So, where does moderation lie? Somewhere between 4,500 calories and carting along a salad as armor against the spread. . .

Have You Gained Weight?

Several weeks back, I attended a therapy conference, one that meets several times a year. Because of I've been to a few of these, I've come to know some of the members of this particular group. On the first night of the conference, I ran into another psychologist. I smiled at him as we passed each other in the hall and he said, in greeting, "Have you gained weight?"

Sigh.

No one at this conference knows about my EWHAED idea, so I decided to broach the topic the next day. When we met in a smaller group, with said colleague included, I mentioned how he had greeted me the night before and why this struck a nerve. Outside of a moment of snarkiness (which I feel obligated to report), I explained to him why the focus on weight is troubling to me, why it is troubling to all of us.

"Did you stop to think I was noticing your body?" he explained.

Yes, I did. Not helping.

"I just remember that when I met you last year, you were training for the marathon."

Still not helping.

I explained to the group that this reinforces the idea that women are noticed/judged for their bodies at the expense of other attributes. And, then, I said what seemed to shock the group the most, something I've written here before: "By the way, I also don't want you to ask if I've lost weight."

"Then, what are we supposed to say?" another male colleague asked, clearly frustrated by the parameters I set.

"Nothing! You don't need to say anything about my body or about the way I look. I can connect with you in so many ways, outside of my appearance. Can't we focus on that?"

I think I eventually got my point across, but I'm still marvelling at how difficult it was to make, ironically, in a room full of mental health professionals. Should I have taken on this battle? What would you have said?

Pretty Girls

Recently, I saw a play, containing a line of dialogue that sparked a lot of thought. The female lead character announced (paraphrased, I believe): "All little girls should be told they're pretty, even if they aren't."

Questions: 1) Should we routinely tell our little girls they're pretty? 2) Should we do this even if they're not? I'm curious about your take. . . .

Stories: Part V

A reader named Stina recently sent me a letter, entitled: "Edie, Me, and the Whole Dang World":

Dr. Stacey,

I'm a newlywed, married to a man who still gives me butterflies, who adores every bit of me, and who I know would do anything to make me happy. I have a job that many people envy, and most wouldn't consider work at all. I live in a house that is lovely and perfectly-sized. I have two cats that I treat like children. I have a great family. My close friends are incredible. I have all this. . .but I'm still unhappy.

How is this possible? What is it that makes me unhappy? What do I still crave, and what is holding me back?

It's not a what, but a who. And her name is Edie. And what do I crave? To be rid of her.

Your blog has helped me re-connect with fighting her and learning to live a life free of her incessant, caustic remarks. I came across your blog as I was searching for validation for my frustration at our general society as a whole. The magazines that woman are suppose to be drawn to (because they talk about issues we. apparently, deem "important") bombard us with contradicting messages, so that even if we were trying to be happy and healthy (as so many magazine shove us the secrets and tools on just how to do this) they fill it with pages critiquing the weight of someone and the weight loss of someone else. Even magazines whose sole purpose is to show us how to treat our bodies better - like, Self, for instance - stuff their pages with diet pills and ads, giving us the option of either listening to their latest exercise regime, or finding the quick fix in a supplement pill.

I'm tired of it all, and most of all, I'm tired of the pressure I've placed on myself to meet those standards. I invited Edie into my life so I could get to that ideal - that perfect size so I could have the perfect life. She has been with me for 11 years, and instead she has given me misery.

I'm not sure when Edie and I first met. I remember an aunt of mine, who I always noticed was incredibly self-critical of her own weight and looks, once looked at my nine-year old legs and declared dejectedly, "You have the family thighs too." I knew she did not mean this as a compliment and began looking at my legs in a new way. I hadn't truly noticed the flaw in them before, but I always felt felt something was different about me - and not in a good way. And perhaps now I had an answer - it was my huge thighs!

Maybe it was then that Edie came into my life. She was almost transparent at first, I hardly acknowledged her, but I acquiesced her judgments and resigned them as "help". She would tell me secrets on how to be more popular, for more people to like me, and let me in on the reasons why people did not like me: I was not pretty enough. And the only thing holding me back was my weight.

Edie continued to hover by my side through the rest of my life - popping in on nights of big occasions - like prom - examining my stomach and showing me how to position my hands in pictures to cover the rounded area. She was there when bad things happened - like when I broke up with my first real boyfriend. She knew the perfect way to get back at him was to show him he meant nothing, to look better than I ever did, and the only way to do that was to throw up any morsel I ate, so no fat would linger on my body.

She was there, constantly with her critiques, her thoughts, her non-stop chatter about my body and my weight and my looks - pushing me to be better, encouraging me to punish myself if I ate too much, and chastising me for thinking a boy thought I was cute. Impossible, she would whisper. You're too fat to be cute.

And then I met my husband, who Edie hates. I met him and he told me Edie was crazy - that I was, in fact, gorgeous, that I was smart and intelligent and funny, and that was all me - Edie didn't create that.

The more I listened to him, the more Edie screamed at me to listen to her. She fought with me bitterly to keep me all to herself, but she didn't win. I married that man, and learned to tune her out or at least quiet her dismay. I spent my whole wedding and honeymoon without her, and it was amazing. But, it's as though now I'm back in the "real world", where true happiness can not last because I am not a size 2, I do not have a flat stomach, and my thighs are not sticks. Looking back at wedding pictures, her voice is still there, complimenting me on how I held my bouquet to disguise my stomach, and shaking her head disdainfully at the pictures of me eating cake.

Edie never really left, and Edie never will. I will live my whole life with an E.D. (eating disorder) and I've got to find a way to really learn to live without listening to her - without giving strength to her thoughts. I want to thank you for your blog for helping me to continue on my journey, to know that I am not alone with wanting to not only change myself, but change the world -especially for all the young girls that are about to find out from society that they just aren't good enough until they disappear.

After writing this, Stina decided to start her own blog. You can stop and say hello here.

News Feed

Thanks to the EWHAED news sleuths who forwarded me these:

1) The concept of fining overweight athletes--what do you think?

2) Think your flu-induced weight-loss must be temporary? Think again. Reactions?

Ending Fat Talk

Check out this new video from the sorority, Delta Delta Delta.

Love it.

NYC Menu Labeling

A colleague and I are working on an article about New York City menu labeling laws--if you live in NYC, you probably already noticed calorie counts posted on in-store menu boards. Menu labeling is now a law--restaurants with 15 or more locations nationwide are required to post calorie counts.

For now, I'd like to look at a number of assumptions inherent to menu labeling laws.

1)Consumers don’t already have an idea about the caloric content of their favorite foods: Those most likely to respond to calorie postings likely already have a sense about the nutritional information of the foods they’re eating. They’ve read the pamphlets or scoured the internet in order to reduce their caloric intake. In-store menu labeling may encourage consumers to base more and more of their food decisions on caloric amounts, leading to greater food restriction, a pathway to clinical eating disorders. For those who already struggle with eating disorders, menu labeling can be emotionally triggering, as patients in recovery work quite diligently to remove their shift from calorie counting.

2)Consumers are concerned about caloric content and will choose lower calorie foods: Another subset of consumers represents those that typically eat higher calorie diets, enjoy their dining out, and aren’t particularly interested in calorie counting. Customers at fast food restaurants, for instance, are often driven by taste and cost, and likely won’t be swayed by caloric labeling.

3)Reducing calories is the only way to promote healthier eating: Another pitfall with caloric labeling is that only the calorie count is posted. Therefore, there is a potential for consumers to choose lower calorie foods, while disregarding other variables such as protein, carbohydrate, fat, and fiber content, along with the host of vitamins and minerals that certain foods contain. An eight-ounce glass of skim milk is more caloric than a similarly sized serving of Diet Soda, but the milk is more nutritious.

4)Consumers will be able to sustain a lower calorie diet, requiring them to sacrifice what they prefer to eat: It’s estimated that over 95% of all diets fail, as humans do not respond well to the experience of deprivation—whatever weight is lost through dieting is often regained (and then some) as we compensate for a period of deprivation. If we make food choices based on caloric information, rather than on what we crave, we’ll begin to feel deprived, just as dieters do. Food choices based on food cravings (“I feel like a cheese sandwich for lunch” vs. “I should have a salad”), as part of a balanced overall diet, are more likely to be associated with healthier attitudes toward food and reduced incidence of overeating.

Does Your Facebook Make You Fat?

An article in The Washington Post reports that Facebook users who come across dieting ads may actually be setting themselves up. Advertisers are privy to the type of person you are based on your profile and the content of messages you send. A lot of diet talk? Muffin top, you are.

What type of ads appear on your Facebook (or other favorite web page) home? Does this relate to what you reveal?

The Leptin Connection

New research on the science of weight focuses on leptin, a hormone associated with regulating food intake. If your leptin levels are sufficient, when you eat, they signal satiety to the brain. "You've had enough" or "You're full," the leptin communicates. So, what effect does dieting have on leptin levels and what happens when leptin levels are insufficient?

A new study by Columbia University Medical Center, published in July's Journal of Clinical Investigation, suggests that obese participants who dieted down to lower weights experienced significant reductions in leptin. . . related to increased food intake. Implications for weight loss? When you diet, your body works overtime to help you re-gain the weight, explaining why over 95% of all diets fall.

The Columbia Medical Center Record quotes Dr. Rudolph Leibel, an investigator on the project:

Weight gain is unfortunately very common following otherwise successful weight reduction. . . . Brain images confirm that the body is subject to powerful biological forces that regulate food intake--forces that are beyond an individual's conscious control. Obese people who may have struggled to shed 20 pounds will have lower blood levels of leptin that will cause persistent hunger. Combined with reduced energy expenditure--also caused by lower leptin--that's the perfect storm for re-gaining the weight.

Just Not Fat

Eva Longoria insists she's not pregnant. In order to quell the pregnancy rumors, inspired by photos like the one above, she announced: "I'm just fat!" Costar Felicity Huffman reiterated Longoria's announcement, telling People: "She's just fat, that’s all there is to it!"

Longoria might be pregnant, or she may have gained a few pounds. Whatever it is, she's just not fat. Calling her so dilutes our struggle for fat acceptance, akin to the tongue-in-cheek acceptance of a blackface person of color.

Happy is the New Thin

There's this book I'd like to read, Thin is the New Happy. Have you read it? Then, there's this post (yes, this one) I'd like to write, and when I think of a launching point, somehow, that book title comes to mind. Except in this case, I unconsciously flip flop the terms.

Happy is the new thin.

Out with the thin, in with the happy (or in with both, if that's just the way you are). But, out with trying so hard to be thin. Out with depriving ourselves of what we want, of abusing our bodies, both with actions and with words. In with happy. . . in with good coffee. . . and in with the remnants of summer sun, peaking in my office window, warming my shoulders as if to say farewell.

As fall arrives, I'm acutely aware that we're supposed to be doing something about our weight. Yes, I realize that bikini season is closing its doors, but still, there is something, right? Are we supposed to be "shaping up for fall?" With "back to school," do we go back to our diets? Enough lollygagging about, what with flirty drinks and sand-crusted beach chairs and lengthy summer reads. . . . or, maybe it was a particularly active summer, in which case, it's going to take a lot to keep that up. . . not enough time in the day. . . better start cutting back, watching what we eat.

There's always something.

How about nothing?

Happy is the new thin.

Have a Minute?

Want equal coverage for e.d.'s and other psychiatric matters? If you have a free moment today, please contact your local Representative, using the instructions below, provided by the American Psychological Association. We're getting awfully close to mental health parity, but insurance companies are still taking advantage of certain loopholes (e.g., providing session limits that bypass out-of-pocket maximum allowances), creating a significant mental/physical health discrepancy. For mental health parity, act now!

APA Practice Organization Action Alert

Date: September 9, 2008

Re: National Call-in Day for Parity

Congress has just returned from the August recess and has three short weeks to pass the historic bipartisan agreement on parity before adjourning for the year. Your Senators and Representative need to hear from you on Wednesday, September 10 that Congress must finish its work and send parity to the President’s desk this month.

Targets: All U.S. Senators and Representatives

Action:

Call your Senators and Representative on Wednesday, September 10 using the toll-free Parity Hotline: 1-866-PARITY-4 (1-866-727-4894).

The Parity Hotline reaches the Capitol Hill Switchboard, which can connect callers to their legislators when specifically requested by name or their ZIP code is provided.

Message:

I am a constituent calling to ask Senator/Representative __________ to urge the congressional leadership to pass the historic bipartisan agreement on mental health parity this month before Congress adjourns.

Summer Holiday

(An ad for a women's-only gym, snapped in New Jersey)

EWHAED is taking a blogging break for the month of August. I'll still be responding to emails, but won't be publishing any new material. Happy summer, and I look forward to seeing you in the fall!

Just Lose the Weight

(Banner spotted in Miami, FL)

A recent New York Times Article, titled “Too Fat and Pregnant” warns against the dangers of gaining weight during pregnancy, particularly among the already fat population. The article notes that the already-fat demographic is more likely to experience complications with pregnancy, including hypertension and diabetes. Moreover, the fetuses of fat women are often too large to navigate the birth canal, resulting in a higher incidence of cesarean sections. To combat this, new crops of bariatric obstetric centers are advising fat patients not just not to gain weight during pregnancy, but to lose it.

That's a wonderful recommendation that comes with just one minor flaw. I might be being a little presumptuous here, but if weight loss were possible, wouldn’t the mother have done this already? How is it going to be any easier when she’s with child? Don’t we already know how difficult it is to lose weight, not to mention lose it and keep it off?

More on Language

There are two phrases in our diet vernacular that I find particularly irksome. The first is, "She let herself go." She did? Where'd she go? How's the weather out there? The second has a more positive connotation and is typically reserved for post-diet or -pregnancy changes: "She got her body back." Wait, where was her body? Was there a ransom involved for its return? Any other common statements you can think of that are similarly provocative?

As I sat in a nail salon this morning pondering these phrases and why they seem to hit a nerve, a woman, obviously a regular, entered the salon. "Manicure or eyebrow wax?" an employee questioned. "Bikini," the woman responded. Already primed to think about our language and what it signifies, I began thinking about the concept of a bikini wax and why we call it that. If we're there to wax our legs, we don't call it the shorts/miniskirt wax. When we're there for our eyebrows, we don't ask for a sunglasses wax. Why must we misrepresent our genitalia, only referring to them as the parts of clothing we use as cover? What's so wrong with calling a spade a crotch? Anyone willing to ask for a pubic/labial wax?

I exited said nail salon, picked up my Iced Mocha and walked into my office building. An elevator companion noted, "Your drink smells good." "It's a mocha, I replied," to which he commented, "I hate to mention the amount of calories in that."

Another Carcass, Courtesy of Calvin Klein

(Window display, Madison Avenue)

The Smallest Loser

Liz Vaccarielo, Editor-in-Chief of Prevention magazine, recently posted about watching The Biggest Loser with your kids--about a reader, who mentioned watching the weight-loss show with her five-year-old daughter, Vaccarielo writes:

My first thought: Tragic! Five years old is too young to worry about her body. But then this controversial light bulb went on in my head: The Biggest Loser should be mandatory viewing in grade schools, and ever mom should watch with her kids. It's never too soon to start teaching kids what it takes to be healthy, especially when the rate of overweight children ages 6 to 11 had more than doubled in the past 20 years. And The Biggest Loser message is crystal clear: It's a whole lot easier to just not gain weight in the first place.

I'm pretty sure you know my thoughts on this (not to mention the fact that if you're interested in teaching healthy living, why not enlist your daughter's help in the kitchen or take her on a walk outside or to pass around a soccer ball--rather than watch TBL?), but I'm interested in yours. . . .

Free Rice

In a forum in which most of us have a surplus of food, it's sometimes difficult to remember that much of the world does not. I stumbled upon Free Rice, a website designed to making a dent in the world hunger crisis. Today, rice supplies are frighteningly thin--linger on Free Rice in order to do your part, while, at the same time, nourishing your lexicon. How many grains of rice have you donated? What's your best level? Enjoy!

Greetings

"Hi! How are you?"

"Good--how are you?"

You've just greeted a girlfriend you haven't seen in a while. You know what comes next, don't you?

Think about it. . .

"You look great!"

"So, do you!"

And, henceforth, the greeting is complete. We've exchanged appearance-focused compliments, we've established a competitive cease-fire and now, only now, can we begin to communicate.

I decided a while back that I didn't so much like this game. I make a pointed effort not to focus on others' appearances and don't like how banal these greetings have become, uttered often, it seems, without thought, as simply a formality. I wonder, how can I look great all the time? Don't I just look average then? Shouldn't we reserve these niceties for when we really do look great? Philosophical arguments aside, I don't hate the players, just the game, and so I started curtailing my own compliments and quickly changing the subject when a friend would voice her obligatory praise. "Thanks, how have you been doing?", I'd redirect.

Why the focus on appearance? I sent out a website link, recently, highlighting a professional accomplishment of mine (which contained a bio and photo), and received from several recipients, "You look really pretty." Now, it's not that I don't like to hear that. I do. But, how about the fact that I've accomplished something, that I'm more than the sum of my features, that I'm making strides as a woman, but that society keeps throwing me back in my allotted space? How about that? Is "pretty" the greatest compliment of all?

I realized, recently, that it might seem rude, when greeting others, not to respond tit for tat, and that I haven't informed those I know that I've altered the rules of play. So, let it be declared that a) You're all beautiful, but b) That's not the point. I choose not to comment (or focus) on your appearance, because I'd rather connect to the warmth in your smile, the strength in your voice, and the wisdom of what you have to say. That's why I call you a friend.

Rating Our Community

A question that's been weighing on my mind centers around whether or not this blogger community is a helpful resource for those struggling with eating and body issues. As someone who swears by the power of group therapy, I think of this community like a group--a place where bloggers get and give support, offer each other helpful (and sometimes directive feedback), and find comfort in the knowledge that they are not alone. So, why even ask the question?

To start, let's face it, those struggling with e.d.'s are a competitive bunch. Bloggers posting about their diets, their symptoms, their collective ups and downs might trigger others to think and act in unhealthy ways. A woman who partially identifies with others to start may, through exposure to constant dialogue about food and weight, develop even more of a focus on these things herself. We all enjoy identifying with a group, so I there may be a pull toward dysfunction as a way to connect with others. True, participation in the community is voluntary, and the emergence of symptoms in this fashion is likely indicative of an underlying tendency, but I can't help but wonder if blogging (reading and writing) can actually make things worse.

Overall, have you found the food/body blogging community to be helpful or hurtful? Take the 2nd EWHAED poll to weigh in. . .

The Fat Experience Project

From the trenches. . .

Hi there -

I wanted to let you know, in hopes that you might let your audience know, that I've recently launched a new project that I'm very excited about!

The new project is called "The Fat Experience Project." and you can view it here:

The goal of the Fat Experience Project is to map the global experience of fat in a way that is human, has a face, a heart, a mind, a body and a voice. The Fat Experience Project is an oral, visual and written history project which seeks to be a humanizing force in body image activism. By collecting and sharing the many and varied stories of individuals of size, the Fat Experience Project seeks to engage with, educate, empower and enrich the lives of people of size, our allies and the world at large.

As the project grows, it will be filled with first-person, non-fiction narratives (in text, video or mp3 format) that speak to the many and varied aspects of the life lived large. Some of the content will come from interviews already gathered on an extensive 2-month road trip (with the lovely Val Garrison) in both audio and video format. Some content will come from trips on the horizon. Most content will be submitted via thewebsite by readers such as yourself.

It is my hope that the project will be a community tool to combat prejudice/stereotype/discrimination as well as to help externalize shame so it can discussed and dissipated. The things we keep silent about are the things that do us the most harm. Shared burden is lighter. I am hoping, as well, that the project may eventually be used as a humanizing resource for fat studies and social anthropology courses.

I am writing to ask for your help in both the promotion of and the participation in this project. It is my fondest hope that, ultimately, with time and resources, this project will grow beyond a specific and exclusive fat focus and move toward addressing the many intersections of shame.

In the meantime, I would love your help in the form of passing this along to your readers/mailing lists/friends/family/anyone you feel may benefit from hearing about this project.

I also welcome comments, constructive criticism and volunteers.

Thanks for your time and energy!
Big BIG love

Diet Plates

Self magazine clued me in to these plates, replete with inspirational messages designed to motivate that stalled dieter in you. Self writes:

Customize your plate with a diet motto: write you own or select one of the sometimes shocking prefab versions ("No seconds, fat ass"--hey, whatever works for you, but we think this one is a little mean. . .)

A little?

Would you use a plate like this, or know anyone who would? What would you want your customized plate to say? I'd like mine to convey something simple, like "Enjoy Your Meal!" or something like the image I found below. Anyone up for a visit to your local pottery painting store? I'll publish your photographed plates. . . .

Metabo-ism

Thanks to the EWHAED communications team for forwarding me this. Thoughts?

This Is Who I Am

I just finished This Is Who I Am: Our Beauty in All Shapes and Sizes by photographer Rosanne Olson. In the book (which I've added to the EWHAED book club list--scroll down to the right), Olson captures the bodies of women of all shapes and sizes. . . women of various ages, ethnicities, professional backgrounds. . . modestly posing nude or nearly nude and then discussing their thoughts and feelings about their forms.

Olson's project was born of early influences. In her introduction, she reveals: "In a sense, this book arose from my own experiences. As a teeenager, I encountered anorexia, which helped give me insight." She had me right there--what an interesting way to phrase it, not "struggled with," or "suffered from," but "encountered."

And so, Olson focuses on encounters, on the experiences of the women she captured on film--experiences of being in the world with their particular bodies, experiences we've all had working toward certain expectations of and standards for our bodies, experiences we've had judging others' bodies and ourselves.

Olson writes:

I wondered what would happen if I invited women of all shapes and sizes to discuss their feelings about their bodies and then let me photograph them in the nude. My goal was one of completel revelation--not hiding behind clothing but exposing both body and mind. What would we learn about ourselves? What would we learn from each other? Would we--could we--become more compassionate? Not only toward ourselves but toward one another.

I emailed Olson to tell her how much I enjoyed reading her book, and she noted that other therapists have contacted her with analogous types of praise. It seems we similarly appreciate the therapeutic and socio-political implication of Olson's work--observing other women's bodies and what they have to say about them can be a tranformative experience. The women are beautiful, their stories compelling, and I recommend you take a look.

Media Bites

We continue to be bombarded by media messages about weight and shape, as if we're constantly dodging attacks. Last week alone, AOL News told us "How Not to Look Fat in Tank Tops," new mom Angela Kinsey, of The Office fame, shared with People that she's not yet "red-carpet ready" (what kind of ridiculous bar have we set?), and in US Weekly, actress Marisa Tomei revealed her means to weight-control success: "I pray a lot, like, Keep me skinny, please."

All this in just a few days. . . Did you see it? How do you react to these kinds of media messages? Is there a way to insulate ourselves?

Tri On

A couple of weeks ago, I found myself at a local bike shop, trying on triathlon gear. The largest size tops and bottoms they had was a 10 (their Large), roughly equivalent (via my scientifically sound method of trying on the clothing myself) to a typical Size 6. . . begging the question that if you're looking to get into the sport, and wear larger than a Size 6, how do you outfit yourself? (Additionally, if you'd like to complete a triathlon in a destination that requires you to fly, you may have to cough up some extra bucks, according to a loyal reader and friend who forwarded me this.

Are you familiar with larger-sized triathlon clothing? Should the cycling shop be carrying larger than a Large?

If you're a larger woman, how do you try a tri?

Jenny, Jenny, Who Can I Turn To?

Have you called Jenny, yet?

Y'all know I'm anti-diet, so why am I asking? Last night, I considered calling Jenny myself. I wanted to know about this diet (which bills itself not as a diet, but as a "weight-loss program"), just as I have about others, in order to write with journalistic integrity, unbiased by my predetermined ideas (remember my Medifast blast?) But, I can't do it--as you might recall, my Zone Chefs experience was atrocious, and I'm not willing to give a diet (even by another name, even for the sake of research, even for only a week) another shot. But, more and more, I'm hearing people turn to Jenny--whether it's a good program or the company has great marketing, I'm unclear--now, even the big and beautiful Queen Latifah's on board!

So, my questions for those of you who have tried Jenny Craig are:

1) Did you like it?
2) How was the food?
3) Did you feel hungry on the program?
4) Did you lose weight?
5) If you stopped, why did you stop?
6) If you stopped, what happened to your weight?

Topless New York

I recently received the following email and told the writer I'd post for feedback. I hesitate to do so (the feminist in me shivers at the idea of a casting call for topless women), though I recognize the body acceptance possibilities involved in such a project. Is the photographer's speculation (about size) right on? Would you be willing to drop your top for art?

Dr. Stacey -

I was recently pointed to your blog by a friend after I asked him basically this same question, and I was wondering if you had any insight. I'm a photographer working on an art & politics project called "Topless New York" - celebrating the fact that New York is one of only a few states where women have the legal right to go topless in public anywhere that men have the legal right to do so. In addition to using a popular modeling & photography networking website to find women to pose for the project, I also use Craigslist, and I'm very clear in the headline and in the text of the ad that I'm looking for women of all ages (over 18, anyway) AND ALL SIZES.

Yet 98% of my responses are from younger women, and 99% of them are fairly thin (though there have been a few exceptions). I tend to think this may be because women are self-selecting when they even look for modeling gigs in the first place, but I had hoped that tapping the amateur/citizen-model market through Craigslist would allow me to reach more women of average or above-average weight who were willing to pose for the project as well. Do you think it might be a matter of body image and embarrassment over the thought of baring their tops in public, as well? Or am I overthinking it, and I just need to be happy with the responses I get?

Thanks for any insight you can offer, and keep on blogging!

Jeff
Topless New York

Polly

The National Eating Disorders Association magazine, Outlook, recently published an article on Polly, a valued member of our blog community. The writer was one of Polly's sorority sisters at Virginia Tech, offering another perspective on her. Since many of you knew, or knew of, Polly, I'm posting the article below (click to enlarge).

Hunger

Several months ago, I started a meal process group, where (out)patients (and I) have lunch together, process feelings about the meal, and then usually engage in some exercise about eating/body image. I figured I'd post some of the thought questions here, so that you might think about these topics and hopefully dialogue with one another.

Recently, I asked the group some questions about hunger:

1) How hungry are you right now? (I personally use Dr. Paul McKenna's Hunger Scale).



2) How do you know when you're hungry?

3) How would you describe the feeling of hunger to an alien, who had never experienced this before? (this one's from Karen Koenig)

4) What type of emotions do you usually feel when you experience the physiological sensation of hunger?

5) What, besides food, do you hunger for?

More Leg Room?

On a recent Jet Blue flight, I elected for their "More Leg Room" option, which the airline details here:

We all need Lots of Legroom™. And sometimes, we need Even More. If it's extra space you seek, you've come to the right place! We've made another slight reconfiguration to our Airbus A320 fleet to create Even More Legroom–super-spacious seats at the front of the aircraft* and at the emergency exit rows that provide even more of that much-lusted-after in-flight space. Treat yourself to an Even More Legroom seat and get 38" of comfortable seat pitch in which to stretch out, relax, watch TV, sample our complimentary snacks and enjoy the award-winning Jet Blue experience!

Jet Blue advertises the upgrade for as little as $10, though I believe I paid a bit more.

The extra leg room was enjoyable, akin to (leg-centric) first-class flying. But, the the seat width is exactly the same. It made me hungry for more butt room, more shoulder room, more room on the arm divider so that my neighbor and I wouldn't be forced into a game of passive-aggressive elbow war the entire flight. Oh, and I should note, that I had the window seat, he the middle, and about 30 minutes into the flight, he reached over me, closed the window shade, and returned to his business, without so much as a glance in my direction. Sorry, just had to air that one.

Have you tried the extra leg room option? Would you prefer extra seat width instead? How would you like your space?

Stories: Part IV

Printed with permission. . .

It does seem true that in our culture it's rare for there to be an uncomplicated relationship with food. We are sooooo fortunate to have plenty, why do we confound it? Perhaps it's a transmutation of guilt--for having and wasting obscene amounts when so much of the world is desperately hungry.

I've been on a project to transcribe all of my old diaries into my computer. Currently I'm on #33, which makes it at least the 25th diary (with a long, long way to go) where I'm dealing with the issue of food, eating, body image, and the western cultural imperative to be thin.

I've studied this and suffered over it for years and I don't feel any closer to understanding the imperative. I know that growing up it was implicit--'diet' was an ubiquitous verb. As a child if I went home from school with a friend my mother would ask when I got home if my friend's mother was 'heavy'. That was the euphemism.

drstaceyny writes under her profile on her blog: My contention is that every woman has an eating disorder-- not necessarily anorexia or bulimia per se, but a fixation on food/ weight/shape that is unhealthy, unwanted, and undying.

And, if I might add, wearying.

Like I said, for years I took on the subject, mainly from the point of view of why I felt so susceptible to it and the ways it jabbed me internally. Why could I not dismiss the perfection hysteria for what it is? Especially since I knew it wasn't rational, I knew it was cruel.

My current working theory is that there is a sort of anxiety-fueled need-to-win dynamic that drives it. I got a clear example of this dynamic when watching a comedy television program about a family. The father volunteered to take on coaching his son's dispirited soccer team. Obviously determined that he was going to be a nurturing coach he admonished the coach of the opposing team who was harshly screaming at his kids: "Hey! Come on, lay off, they're just kids! This is supposed to be fun!" To which the opposing coach responded by sneering to his team: "Hear that? That's LOSER talk!" Similarly, to consider swimming upstream from the main by shrugging off a cultural ideal of beauty was undermined by the idea that I was indulging in sour grapes: loser talk.

This issue has been present for most of my life, in varying degrees of intensity and urgency.

I put it in a bottom drawer for the past 3 years. Shortly after returning to Portland I was very low, very depressed. I met a physician who was confident in her ability to help me manage this medicinally.

The first antidepressant I tried was Remeron. I was shocked 3 months later at my GYN checkup when I weighed more than I had ever weighed not-pregnant. The dr. said confidently: "Everyone gains weight on Remeron. I'll often prescribe it to new mothers, stressed, underweight, and not sleeping." Well, this wasn't a time I was prepared to face down the whole weight issue and I asked my primary dr. if I could switch to something like Wellbutrin, which I'd heard had a side effect of weight loss.

The way the weight-loss side effect worked for me is that the experience of hunger was detached from my emotions. I might still feel hunger, but I didn't experience it as suffering. The eating motivator was thus less potent and I lost weight. So for the past 3 or so years I've weighed approximately my high school weight.

The thing is, the drug didn't have that much effect on my mood. Not really noticeably, anyway. Perhaps there was a subtle change to my background mood base and the alteration was so gradual that I didn't notice it. Last year when I started seeing Sharon, my counselor, I told her that I was taking antidepressants. She suggested that at some point I might want to wean off of them and "see who I was without the drugs." But I really felt I wasn't any different with or without the drugs; I felt like I knew 'who I was'. Time, situational change, and a year with both boys full time in school eased the depression symptoms; the medication didn't seem to have much effect beyond the hunger effect and a mild (not unpleasant) buzz.

It was really only the weight effect that motivated me to keep taking them.

I pushed to the back of my mind the awareness that a day of reckoning was coming where I'd face some questions:

1) What does it mean to be thin?
2) Is it important to be thin?
3) Why?
4) Is it still important to be thin when I'm 49/50/51?
5) Why?
6) What does it mean that it's important to be thin?
7) Is it legitimate to use anti-depressants as a diet pill?
8) Is it dishonest to be slender by these means?
9) To whom do I owe 'honesty' about this? If me alone, why should I feel uneasy about (dis)honesty? If someone else--no that just seems absurd. Should I carry a sign that says, "I'm slender because I take Wellbutrin"? Still, I'm dogged by the feeling of misrepresenting myself. (Then comes the 'puritan question'-- if I don't have a metabolism that makes me 'naturally', 'authentically' thin is the only way I can legitimately be thin is if I suffer to do it--either through eating less than I want or exercising mightily? Why should those means be more legitimate than an antidepressant with a convenient side effect? Who says?)

Of course this opens up a whole other can of worms, too. I can see when I read my journals that there was a lot of fevered energy that I now recognize as biological--the drive for a mate. I didn't know it then but it's plain now. A successfully sexually appealing identity once seemed very necessary.

What is the basis of sexual appeal when one is beyond childbearing age? Again, the question, is it important, is it worth an effort, is it even possible? A certain number of pounds hung on my frame now looks very different than it did when I was 20, 30.

And it's not as if I'm interested in entering the world of trying to attract a sexual partner. I have friends my age who are single, friends who are divorced, Out Looking. After 16 years of marriage there is no appeal in that for me. When I get dispatches from that field I have trouble relating personally--it seems like something that belongs to another age and another time. My friends seem very engaged: I just can't relate.

I suppose having two young children makes a mate search additionally irrelevant. It's rare that children from one man, particularly boys, have a successful relationship with a man-not-their-father who is close to their mother.

I started tapering down the antidepressants in January. It's been several weeks now since taking my last. My mood continues to be stable, but I didn't expect to experience any differences on that front. What I'm nervous about is whether or not I'll be having to confront the old demons about appearance and weight. And whether I'll finally be able to make some peace with them.

But She Got Much Back

A loyal reader forwarded me this website, a clothing company called "Little in the Middle," specializing in clothing for normal women. Specifically, the company caters to those of us "pears," who have smaller waists and larger hips and thighs.

I certainly appreciate the brand's philosophy--no more jeans gaping at the back! But, I'm staring to wonder is "Little in the Middle" as detrimental a phrase as "Big in the Bottom" when it comes to body and size acceptance?

Sex and Weight

Yesterday, I was interviewed by an online magazine on the topic of overweight* women and dating. Specifically, the interviewer asked questions about why thinness is glorified in women, how overweight women struggle in general and particularly with regard to dating. She wondered if overweight women might miss out on sexual opportunities and how these women might become more comfortable with sex. And then a bomb dropped: "What do you think about the idea that overweight women are easy?" (as in
sexually promiscuous. . . as in, in order to compensate for their weight)

Is this true? And, even if it's a stereotype, since most stereotypes are based on a glimmer of truth, why do you think this is?

*her word, not mine

The Stomach Bug

I got it. Yep, the stomach bug. You know the kind when you eventually resign to taking up residence on the bathroom floor? That's the one. And, in the week-plus of recovery since (accompanied with little appetite and the requisite weight loss), I've been thinking about what the stomach bug means with regard to e.d.'s.

Would you secretly welcome the stomach bug in order to lose weight? Take the EWHAED's first poll (on the right) to let us know. . . .

I've Got Mail

I love getting letters from my readers, especially when they look a little something like this (posted with persmission):

Hi Dr. Stacey,

You may think this is a little compulsive, and, sure, it represents the extreme end of things, but I have neither of the following things:
- a mirror in my bedroom
- a scale in my house

Consequently, I'm extremely happy, and whether or not I feel comfortable in my body has to do with just that - whether or not I feel comfortable in my own body.

Do we even need a scale to measure weight? There are an enormous number of things around us that do the weight-measuring for us, without the numbers. Everything from our own clothing sizes to other people's comments on any ups or downs in our weight serve to remind us of just where we fall on the spectrum. A scale seems, well, superfluous.

So then, why don't I have a mirror in my room? It's also superfluous. If I want to pluck my eyebrows or put on makeup, I'll go into the bathroom. That decision involves taking an active part in my self image - that is, seeing myself when I want to see myself, using the mirror for an activity with its own purpose rather as a tool to open myself up to the opportunity to self-criticize endlessly. What role could a mirror in the bedroom serve that a mirror in the bathroom could not? Looking to see if I have something in my teeth, washing my face, even trying on new earrings . . these are all things that could happen in the bathroom, with purposeful intent.

The radical part in me thinks we should abolish scales - except in doctor's offices and laboratories. I think it's extremely weird that they developed as a part of our hygiene habits. Shouldn't what we do in the bathroom be about taking care of our bodies instead of encouraging terrible self image? Bathing, toilet, brushing our teeth, combing our hair - this all makes sense. But the scale? Everyone should do themselves a favor and lose it.

Can't wait for your book to come out!

Morning Show Request

Wanna be on TV?

From Michelle Niger of FOX:

Hello, I’m a producer with “The Morning Show with Mike and Juliet.” We’re a nationally syndicated live morning television show based out of NYC. On Thursday, April 24th, we’re doing a segment about a study from the International Journal of Eating Disorders that says that eating disorders are contagious. The study says, “A study of U.S. high school students provides additional evidence that eating disorders may be contagious….researchers found that binging, fasting, diet pill use and other eating disorder symptoms clustered within counties, particularly among female students…”

I’m looking for a personal story from someone who has or has had an eating disorder, specifically someone that was shared with or learned their eating disorder from other women in high school or college. We will cover all travel accommodations to NYC. Please call me asap as this is time sensitive 212.301.5371

Line 'Em Up!

In an US Magazine April piece, entitled, "Hollywood Hunger-O-Meter," "stars weight in on how much, and often they indulge their appetites." The celebrities are arranged on a "hunger meter," with markings from "Feed Me!" to "I Watch What I Eat" to "Not Counting Calories." "Feed me" celebs include Molly Sims ("I just fasted for four days. . . . I'm back on food. Today I had kale, squash, quinoa, and lemon water," while the other end of the spectrum sports Sarah Jessica Parker ("I eat everything") and Michelle Trachtenberg ("I'm in New York for a month, so all I'm going to do is eat pizza!")

Other notables? Julianne Moore ("I still battle with my deeply boring diet of. . . yogurt and cereal and granola bars. . . I'm hungry all the time") to Kate Walsh ("I was afraid of becoming huge. . . I remember [just] eating a mixing bowl. . . of whipped cream with Equal in it") to Ali Larter ("I'm such a hedonist with food. . . . I'm not one of those girls who likes moderation").

Did you see this article? What types of thoughts/feelings emerge when hearing about it? Do non-celebrities model their diets after these women? What does it say about our world that this is the dimension on which we're rating our stars?

What the Buck?

I just arrived back from one of my local Starbucks stores (yes, that's plural in NYC) and need to know--does your Starbucks location post the caloric content of its food items? I've never noticed this before!

There, beneath each pastry name on the little pastry card was written the number of calories it contained. I have to admit, I was quite surprised to learn the caloric content of my beloved Rice Krispie Treat (aka Starbucks' generic "Crispy Marshmallow Square"). I know that this information is posted on-line, but I'm not the kind of person to look.

Yet, here it was, staring me in the face. What do you think about the in-store postings? Yay or nay?

Florida Manatees

Have you heard about the Florida Marlins baseball team's new acquisition? The Marlins have put together a plus-sized, male cheerleading squad they call, "The Manatees."


From the Marlins' official site, calling for participants: "The Florida Marlins are looking for big bellies with the biggest jiggle, big feet with the best dance moves and enthusiasm that will rock Marlins fans out of their seats."

A recent Today Show piece dedicated to the Manatees showed one cheerleader, who lifted his shirt to reveal his belly, and said, "Why have a six-pack when you can have a keg?"

It's funny, right? A Miami Herald.com article declared: "Manatees cheerleaders put the giggle in jiggle." According to press releases, the fans seem to appreciate the comic interludes the Manatees provide. And female attention follows suit. . . One fan, captured on Today, cozied up to the squad, and squealed, "They're so cute!"

Does this represent a step toward fat acceptance (in men), or just another way to mock the fat? Would female "sea cows" inspire the same attention and praise?

Stephanie Kuleba

About two weeks ago, South Florida teen, Stephanie Kuleba, died during breast augmentation surgery. The 18-year-old captain of her high school cheerleading squad, an accomplished student who had already been accepted at University of Florida pre-med, died due to complications from the anesthesia used during her procedure.

In case you didn't know, Kuleba wasn't simply aiming for bigger breasts--according to reports, one of her breasts was larger than the other, and one of her nipples was inverted, causing her distress throughout the years.

I'm curious about your thoughts about this story. Obviously, Kuleba's death is tragic and highlights the dangers of surgery in any case. Elective procedures, especially, are called into question, when medical necessity won't provide justification. But, should Kuleba have lived in shame of what she felt was a malformation? Should a psychologist have been involved? What does this say about women's body image (especially teens') and the perfection our culture demands?

I'm being interviewed by a local news station at 11:30 am to address these questions, so if you happen to see this post before, I'd love to read your comments!

Calling All Orthorexia Commenters!

So, remember the orthorexia post I wrote, in which I mentioned I was contacted by several media outlets? One of them was ABC--they're working on a piece on orthorexia for 20/20. My ABC contact read the post (and your helpful comments) and is particularly interested in speaking to:

1) Anna
2) Emily
3) Fauve
4) Rachel

If you happen to be one of these people, please shoot me an email at drstaceyny(at)aol.com if you'd like to get in contact w/ABC. He reassures me that all communications will remain confidential until agreed upon otherwise.

Thanks!

Intuitive Eating with Restrictions

Editor's note: I received this message last week from a reader I'll call Karen. I responded to her directly but would appreciate my readers' input. Please comment if you have any suggestions or recommendations for Karen.

Hi, Dr. Stacey - I was introduced to your blog through a link on Disordered Times. I love the blog for a lot of reasons - but one of them is just knowing that I'm not alone in my struggles with eating and how I feel about it and even how to do it.

I'd be very interested on your opinion, if you ever have cause to give it, on how folks like me, who have a medical condition that requires an "abnormal" relationship with food, can work to be at peace.

I'm currently really ambivalent about calorie restriction, food logging, dieting in any way - the fatosphere has given me the confidence to say, hey, why should this take up so much of my time and energy, but the social reality of having lost some weight, and the impact of years of negative thinking about my body and all of that argue against giving up the diet I'm currently on. (I'm not supposed to call it a diet - but I think anytime you're restricting or changing your food intake based on some external, artificial measurement, it's a diet, and call a spade a spade!)

But, even if I do manage to kick the diet habit - I still have to write down and be conscious of every goldanged thing I put in my mouth, because I have Type 1 diabetes, and I have to play my own pancreas here, and if I don't know how many carbohydrates something has in it, I can't take my insulin appropriately, and my blood sugar will be screwed up. (It gets screwed up enough even when I do know, or think I know!)

I think for me, it might never be possible to have a comfortable relationship with food for that reason. I know a lot of us feel the same. I'm currently looking for ways to make my peace with that and to find a healthy way to be a food logger and carb counter (if not carb-restrictor). But I wonder - is it even possible? And, if it isn't, if disordered eating is always going to be a part of our lives, why isn't it part of a standard treatment plan for diabetics? I meet with a nutritionist - a very weight-nonjudgmental one, I must say - but no one ever talked to me about how this could affect my life and my psyche. I engaged in "diabulimia" off and on for years and years - I still battle it often - to control my weight and never knew I wasn't the only one until just recently. I'd love for there to be some kind of plan for diabetics to work with therapists or social workers on the impact of how their relationship with food and eating will be impacted.

Sorry this is a bit rambling. Just wanted to say thanks for the blog, and mention something that might be of interest on a slow blog day. :)

File Under: He Won't Notice Those Extra Few Pounds

A coworker of mine is pregnant. She recently approached me in a hushed tone, "I have news!" she said.

"I know," I replied with a smile. "I've been waiting for you to tell me!"

She says she started showing early because of bloat. I think she's growing the next Yao Ming. She's three months in (though looks about five), and I've been suspicious half this time. But, did I say anything? Of course not. . . I wouldn't want to be wrong and (the horror) imply she looked fat. Moreover, I'm sensitive to pregnant women not wanting to share their news until they're ready.

A funny thing happened yesterday when this coworker informed our entire team. A 50-something male colleague seemed shocked. "You didn't know?" I asked, in disbelief. When he shook his head, I laughed and said, "But she's out to here!" (gesturing)

"I think it's a male thing. We just don't notice these things."

"At what point do you think you would notice? When she showed up at work one day with a 12-year-old kid?"

'Round Here

The EWHAED newsroom (and by newsroom, I mean me, at my computer) has been pretty active lately. Take a look:

From Rachel, over at the f-word:

I'm conducting an anonymous survey of bloggers who blog about eating disorders or eating disorder recovery in partnership with a clinical psychologist for joint research and publication purposes. I know your site attracts readers who have struggled with eating disorders, some of whom also maintain blogs. I'm hoping our survey generates lots of responses so that our findings are well-rounded, inclusive and convincing. Would you mind mentioning this survey on your blog to your readers?

More information and a survey link can be found here.

Also, Leslie, at The Weighting Game informs me she'll be on The Today Show this Wednesday during the 10am hour to discuss the question: "Would you rather be permanently 40 pounds overweight and smart, or skinny and dumb?" This is Leslie's second (recent) visit to Today--recently, she spoke about Spring Break and ED's.

Please support these valued members of the EWHAED community!

Treading Lightly

While I was at the spa, I took a class called, "Tread Sweat," a group exercise class on the treadmills, consisting of speed and incline intervals. While I don't really do any treadmill walking, I decided to walk the class (rather than run) because it was early in the morning, and I thought I'd use it as a warm-up, a segue into more difficult cardio classes.

Boy, was I off.

See, I'm not the most efficient walker in town. I tend to bounce (to the point when when I'm in physical therapy, other therapists take pause with their patients to watch me walk). I'm a bouncing curiosity. When you spend so much time and energy going up and down, there's less of both to propel forward. It's basic biomechanics. So, I'm slow. I'm a (pretty) fast runner, but a really slow walker.

So, here I was on the treadmill, warming up, trying to take the class at my own pace, when the instructor approached me and said, "Pick up the speed!" I told her I'm not really a walker and was using the class to warm-up. She walked away. Phew.

Take two: she approached me again and said (and, to clarify, this all occurred over the microphone): "C'mon, you can pick up the pace!" Having done so since her last visit, I replied, "I'm doing a couple of other classes today. I'm fine." The coast was clear for now.

But, then she came back again, looked at my heartrate (broadcast on the treadmill) and said AGAIN, "Let's pick up the speed!" And, that's when I decided to pick up the (verbal) pace: "That's the third time you've asked me. I'm taking other classes today. Can you not ask me to speed up again?" Thankfully, she didn't return.

It's frustrating this go-all-out mentality, particularly in a population that might not be so accustomed to exercising. She didn't know who I was or what (if any) medical conditions I have, nor how to motivate me to perform. She didn't know that I am confident in my level of cardiovascular conditioning. She didn't know that I have a fitness background, and that I know it's not good instruction to approach someone three times (she had singled me out for some reason, perhaps because my heartrate was lower than it "should" have been) when she's clearly walking to the beat of her own drum.

I had to assert myself. But, how many people would do the same? How many others would feel that they couldn't keep up, that they weren't doing it right, that they really were out of shape, that they should be ashamed for this? How many others would leave the class feeling dejected, like they had failed the task?

Fat Camp

Last week, I went to Fat Camp. I didn't know I was at Fat Camp (I thought I was at a spa) until I overheard a woman dining next to meet at lunch say to her companions, "I think of this place as Fat Camp." I gotta hand it to her--she was right.

I'd been to said spa* before and enjoyed the array of exercise options, the spa treatments, the healthy living lectures, and the great rooms, replete with old library collections, roaring fires, and comfy sofas on which to nap or curl up with a good book. My problem was with the food (we'll get to that later), though I will say now that I came prepared with stores of my own.

At FC, the staff encourages a lot of exercise--you finish one cardio class and they're already asking you which class you're taking next. Most people end up doing 3-4 classes a day, if not more. It reminded me of The Biggest Loser, where uber-exercise is combined with a restricted diet--not a good prognosis for long-term success. The classes are fun and varied--I tried spinning and cardio aqua, kickboxing, rebounding, and striptease aerobics. Speaking of previous posts, there were a couple of 14-year-old girls who attended striptease. I know this because I approached one of them and asked, "How old are you?" and she said, "14." The class was fun, and everyone's inner Carmen Electra shone. For the record, no men attended, nor did FC offer a male equivalent.

Now, the food. . . Fat Camp food is actually pretty good, with lots of selections and healthy eating options. They find a way to create unprocessed, balanced meals, heavy in protein, fiber, and complex carbs, and low in fat, sodium, and anything else unnecessary in larger quantities. Still, the food, for the most part, tastes good.

My gripe? The portion sizes. The food is really, really. . . small. If I were there long-term, I'd think that they were slowly starving me to death. Now, the difference between this and real Fat Camp is that you're allowed to ask for seconds, or even thirds (and, you're allowed to bring food into your room, without having it confiscated as contraband). I learned the first time around that often I'd need to order two entrees, along with appetizers and sides. Because when you're exercising as they encourage, you need some extra fuel. . . unless, of course, you're trying to lose weight. . . which wouldn't be hard to do. . . though, you and I both know what would happen when you went back home.

Fat Camp also offers desserts--low calorie, low fat treats that provide that post-meal, sweet-tooth zing. Day one, I ordered a brownie:



Can you see the size of this? I said to my server, "Can I get three more?" I figured that four of these equalled. . . an actual brownie.

On my last day, I sat down to lunch before heading out on the road. The restaurant menu, displayed on a stand outside, beckoned, "Italian-Style Grilled Cheese." Yum!

Here was my grilled cheese (accompanied by a salad):



If you can't tell by the photo, the "Italian-Style Grilled Cheese" would be more aptly described as two tiny slices of Italian bread, served bruschetta style. Each one was easily consumed in two bites. They were small, and I had just played too hard for food that was small.

So, I left wondering, for people who attend these spas, looking for long-term weight-loss success, is this a set-up for disaster? The first time I attended, I hit Carvel in the airport before even getting to my gate. Even if guests return home with their Fat Camp cookbooks in tow, is exercising three hours a day really sustainable? Are they sacrificing long-term success for short-term results?

*I'll try to write about the couple of lectures I attended in forthcoming posts.

More Leg Room?

An advertisement for Continental Airlines' new jets, spotted at a bus stop in New York:

"Do our new planes make us look fat?"

Smart marketing, or another bone to pick?

Inside Beauty

Magali Amadei and Claire Mysko are the founders of Inside Beauty, an educational and outreach program designed to promote health in the fashion and beauty industries. According to their website:

Magali Amadei has appeared on the covers and pages of virtually every fashion magazine in the world. But at the height of her career she was depressed, lonely, and bulimic. She took a break to take care of herself and became the first top model to tell her story on behalf of an eating disorders organization.

Claire Mysko is a writer and an expert on girls' and women's issues. Throughout her teens she starved herself and binged and purged while devouring the picture-perfect fantasies in the pages of magazines. She got help and went on to be the director of the American Anorexia Bulimia Association.

Working together, Amadei and Mysko have developed efforts to target the unhealthy standards and expectations in the modeling world. They have asked those in fashion and beauty to support 5 resolutions designed to transform the current state of affairs.

Just two more women, doing their part. Check out their campaign. . . .

Orthorexia

A couple of media outlets have contacted me recently to talk about orthorexia, and I'd like you all to weigh in. The term "orthorexia" was coined by Steven Bratman, a physician specializing in alternative medicine, in 1997. Orthorexia is understood to be an unhealthy fixation with eating healthy foods (often accompanied by a righteous, holier-than-thou attitude), to the point where either important nutrients are often omitted (like fat) and/or the person becomes emaciated because quality foods are not available enough. This isn't just healthy eating.

Bratman asks the following questions in order to diagnose orthorexia:

Do you wish that occasionally you could just eat, and not think about whether it’s good for you? Has your diet made you socially isolated? Is it impossible to imagine going through a whole day without paying attention to your diet, and just living and loving? Does it sound beyond your ability to eat a meal prepared with love by your mother – one single meal – and not try to control what she serves you? Do you have trouble remembering that love, and joy, and play and creativity are more important than food? Have you gotten your weight so low that people think you may have anorexia?

If you recognize yourself in these questions, you might have orthorexia.

As opposed to anorexia, the goal of orthorexia is not weight management/loss, but health, and therefore, the emphasis is not on the quantity of food consumed, but the quality. As with any psychiatric diagnosis, orthorexia is understood to impair daily functioning, to impact work/school, family, and friends because of the time and effort devoted to meal planning and consumption.

But, orthorexia is not a psychiatric diagnosis. There is a dearth of research on orthorexia, particularly quality, peer-reviewed research. Many folks in the e.d. community don't see orthorexia as significantly different from anorexia (or from an anxiety disorder, such as obsessive-compulsive disorder). I'm able to describe the condition as the lay community has described it, and I realize that some people may meet the criteria proposed above, but I, too, am not sure that it differs enough from anorexia or OCD (w/food behavior being the obsession and compulsion used to manage anxiety) in order to warrant a freestanding diagnosis. I think some folks struggling with bona fide e.d.'s may play the "health card" in order to avoid suspicion. In this way, they may present with orthorexia when the main motivation is weight control, therefore indicating anorexia.

Do you struggle with orthorexia or know anyone who does? Can you say that it is significantly different from these other disorders? Please help!

Book Report

You may have noticed a new edition to the EWHAED book club (quick, look over on the right!) It's Abby Ellin's Teenage Waistland, a part-memoir, part-reference look at how parents can best help their overweight (and, here, I mean this in the most literal sense--over the "ideal" weight our society has agreed upon, as some of the adolescents Ellin describes, including, herself, are not really fat) teens. In Teenage Waistland, Ellin tackles difficult questions, such as: 1) What should you say/not say about your child's body? 2) How can you respond to your overweight teen who is bullied at school? 3) Should you send your teen to "fat camp?" 4) How about diets? 5) Is losing weight simply a matter of willpower? 6) Why don't heavy teens want to be thinner? 7) What should you do with your overweight teen who eats well and exercises but can't seem to lose any weight?

As for the answers to these questions, you'll have to read the book. And trust me, it'll be a treat--not just because it's chock full of helpful information and case studies, but because Ellin reflects on her personal experiences in a sensitive, yet light-hearted way and because she uses careful and poignant language to make her point and to convey the deep-seated relationship between emotions and our weight. There are plenty of books out there on how to help your children lose weight and/or gain acceptance of their bodies. Ellin, having personally climbed through the fat-camp and diet-fad ranks, can effectively tell us how.

The "Big" One

Several weeks back, I attended a Broadway show with a friend. In between numbers, I whispered to my friend something about one of the cast.

"Which one?", she asked.

"The big one," I replied.

My friend looked at me curiously. "I'm surprised you said that," she said, all-too-familiar with my work.

The show went on, as did our hushed dialogue.

"Why?" I asked, "I didn't mean it negatively. I was just trying to identify her." And, I was, in a sea of tiny, ballerina-bodied cast mates, simply targeting the feature most quick to differentiate. I also could have said, "The one with the long, black hair" or referred to her as the part she was playing, but this was honestly the first thing that came to mind, and when you're talking during a Broadway show, sometimes brevity is key.

For the record, the "big" one was probably as Size 12. She just stood out. And, to me, there's nothing wrong with referring to someone as "big," or "fat," or "large." (I actually much prefer these to "obese" or "overweight.") They're simply descriptors. . . just like long, black hair.

So, was I wrong? Should I have found another feature by which to identify her, or was I (un)consciously working to destigmatize big?

Living & Eating

Master chef Julia Child once said: "Life itself is the proper binge."

I came across the quote recently on a birthday greeting card, and immediately, the wheels started turning--first, IS life really a binge? (Certainly, this is an individual question). And, if it isn't, is this reflected in our eating? If we feel that we're not getting enough out of life, do we compensate by bingeing on food?

Geneen Roth is famous for saying, "We eat the way we live." I wonder, though, do we sometimes eat the way we DON'T?

Baby Weight

A while back, a pregnant friend informed me that her ob-gyn had issued some pretty strict guidelines about her pregnancy weight. I was surprised to hear some of her doctor's recommendations and asked this friend if I might interview her for my book/blog; we agreed to talk once she had delivered. Said friend is now the proud mother of a healthy, adorable baby girl, has returned to work (as a psychologist), but still found time to answer the questions below:

1) What foods were you advised to eat, to avoid? Did she propose a daily caloric intake?

She said to avoid fruit (eat it only once or twice a week), avoid the "bread basket" and refined flour. . . . It sounded to me like she was recommending a low carb diet. I was told not to eat any more than I was eating before I got pregnant since I looked "normal" and "thin" (pre-pregnancy). She said that the fetus does not need much in terms of calories.

I told her that I was eating fruit, bread, etc. She said "okay" but encouraged me not to eat more than I was already eating or change my eating habits (except to avoid high mercury fish, more than one serving of caffeine per day, avoid alcohol, etc.).

Another patient that I met in the waiting room (our doctor told her that she was gaining too much weight) said that our doctor told her to eat the following: eggs for breakfast and maybe some yogurt and then salad with protein for lunch and dinner (fruit as a dessert/treat 1-2 times per week). She was told to avoid bagels since they are high in carbohydrates/calories.

2) What did your doctor suggest would be a healthy weight-gain during your pregnancy? What were her concerns about you gaining more?

She said that she recommended to her patients not to gain more than 20-25pounds despite the standard medical recommendation being 25-35 pounds because you don't need more than 20-25 pounds. . . . She explained that any more is "just weight you have to lose."

3) Do you think the above information was correct? How do you think the advice would have differed in a non-NYC population?

Most doctors (even in NYC) suggest gaining 25 to 35, but there is definitely more emphasis on weight gain here. I don't think her advice was very helpful. The way she encouraged her patients to eat (avoid fruit when it is so rich in vitamins, etc.) did not seem helpful. A plan-based diet rich in whole grains (e.g., whole wheat bread) and fruits, etc. is a part of a healthy diet during pregnancy (and always). She is encouraging eating behaviors that are not consistent with nutrition research or standard advice given to pregnant women (especially for someone that may have struggled with an eating disorder). Then again, doctors don't get much nutrition training in medical school.

The average weight gain during pregnancy is supposedly 25-35 pounds (that is what most doctors recommend to their patients). Most people I know gained at least that, often 40 or 50 pounds. To be honest, I don't think you have total control over it. My girlfriends have varied so much! And it did not totally have to do with how much or what they were eating. With respect to weight gain during pregnancy...I think some of it genetic, depends on body type, weight before pregnancy, etc. You can stay active (exercising in moderation) and avoid binge eating, eat healthy, etc. to prevent excessive weight gain but at a certain point you only have so much control.

I felt that her advice was extremely troubling! There seemed to be more emphasis on weight gain than eating healthily. I understand gestational diabetes is a problem and some people see pregnancy as a break from watching their weight (e.g., eating a lot of sweets or high fat foods, etc.) and end up gaining a large amounts of weight...HOWEVER, women already have enough to worry about during pregnancy (the baby, health, body changes, etc.).

I think the advice should should be on health NOT weight gain. It should be to eat as healthily as possible and to eat sweets, etc. in moderation...and to stay active (doing exercises adapted for pregnancy) to promote a healthy baby (first priority) and healthy pregnancy and postpartum recovery. Weight monitoring should be emphasized to make sure the baby and mother are healthy...not as pressure to keep your weight gain low so that you look good afterwards. Patients should be informed that there is a great deal of individual variation, so they should just try their best to eat a healthy diet and exercise in moderation (to feel well and prepare for late pregnancy when it harder to get around & labor & recovery).

4) Did you follow your doctor's guidelines? Did you, at any point, think about switching doctors?

I was quite ambivalent about staying with her. I felt self-conscious and the major goal of each check-up was to check my weight gain (even during visits when she did not bring it up, I found myself bring it up and seeking her approval). I think that if I had gained more than her recommended amount, I would have changed. I seriously thought about it during my second trimester (when I gained the most weight, at the point I had gained 15 pounds) and she suggested that if I wanted to "follow" her recommendation of 20-25 pounds instead of the average 25-35 (30ish), I should slow the weight gain down. She asked me if I was exercising as "vigorously" as before, what types of foods I was eating, etc. She said not to "stress" too much since I was "thin" to begin with if I ended up gaining around 30. She said that if I had been overwieght to begin with, she would have been "upset" that I had already gained 15 pounds.

I did not gain much during the third trimester and she complimented me on it several times, telling me that she was "really happy" with my weight gain. The reality is that everyone's weight gain occurs at a different rate (some people gain more in the middle, others at the end). I don't think it was due to me doing anything to slow my weight gain down.

I ended up gaining 22 pounds. However, I did not really follow her diet advice. I think it was just genetic (similar to my mother during her pregnancies). I ate a decent amount of fruit and bread products, chocolate, etc! I was just mindful of eating everything in moderation (not restricting), trying to eat as healthily as I could) and staying active.

5) What did your doctor have to say about you losing the baby weight post-delivery?

Not much, thank god. But if I had gained more weight, I am sure she would have! If there's anything else, please let me know! Thanks so much, Stacey

Thanks, G, for sharing your story. . .