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)