Body Wraps, Toxin Removal and More: What I Learned at the Gym Today

I'd much rather be hiking...

It's hard enough starting at a new gym. Generally, I dislike going to gyms, preferring instead to enjoy a long bike ride, a hike or a cross-country ski or snow shoe when weather permits. But living in New England, there are times, like now, when conditions are simply not favorable for either of those activities.

So off to the gym I went, attending my first spin class of the season, at a new gym with a new instructor. And I could barely get through it. No, I am not that out of spin shape—although those cycling muscles certainly needed a workout. Rather, I was feeling my blood pressure rise as I sat through the marketing pitch and endless misinformation by this supposed promoter of health—the spin instructor.

I'm still headachy from it, so in truth, I am blogging to air my annoyance and frustration.

You know me be now—I am not shy to share my opinions, particularly those I feel strongly about. But this was a challenging setting. Jane, I'll call her—no, Barbie better suits her—stood before the class of about 35 cyclists confidently spewing her crap. Misinformation spilled from her mouth with no objection from the group, until I, a newcomer there, just had to speak up. But it was hardly the forum to debate in, and my rebuttals could be endless if I countered every outrageously false claim about weight loss.

No, neither body wraps nor green
powders will remove body fat.
Sorry!

She endorsed a powder she was selling with her personal testimonial about how she believed it really helped her, as it releases the toxins from the body, those horrible things which fester and cause disease. (Toxins, by the way, are released from our bodies every day, with no need for a product to make it happen.) And it gave her natural energy and promotes weight loss. (For the record, calories are the form of energy we get from foods; a product with no calories has no energy, although you may get a short-term boost from stimulants such as caffeine.) Then I heard her endorsement of the body wraps for sale, which essentially shrink your body a size or so overnight! All without dehydrating you! And finally I learned that you should be drinking half your body weight in ounces of water each day. 300 lbs? That's 150 ounces each day of water, about 5 liters or quarts per day.

So why am I all upset, you ask? Where shall I begin?!

• because while for me it was simply an irritation (and a big one at that), I know how others will be lured by this misinformation, sold products with false claims, sucked into unhealthy thinking and potentially dangerous supplements; more misinformation makes sensible thoughts a challenge;
• because she was speaking to a group of completely normal weight individuals, none of whom could afford to lose weight;
• because no one should be sucking down water or non-caloric beverages instead of eating when they need fuel, simply to mask their hunger;
• because she's setting people up for failure and unrealistic goals, luring them for her personal financial gain, to buy a product, in the case of the wrap, that at best may contribute to a decrease in hydration for a temporary appearance or short-lived sensation of lightness;
• because if we each spoke up every time we heard something we know to be false or inaccurate, then maybe we could make a difference!

Yet another gym promotion. Uggh!

There, I feel so much better now. I think I'll go have dinner, now that I can more calmly and peacefully enjoy it.

Thanks for letting me rant!

Obsessive Workouts and Protein Powders: How Concerned Should We Be?

Reactions to the NY Times article and the Pediatrics study on teens and muscle-enhancing behaviors.

I'm bothered by something I read. "Compared with a sedentary lifestyle of video games and TV, an obsession with working out may not quite qualify as a health hazard", as stated in last week's NY Times article. While the article brought to light the silent struggle many boys deal with—or rather, don't deal with—their obsession with weight training, dietary modification and steroid use to achieve the 'perfect' body—it failed big time in educating readers about when to be concerned, and what we can do to prevent this unhealthy trend. But this is not just about boys—the Pediatrics article identified that girls, too, are taking steroids and more frequently protein shakes to increase muscle mass while pushing activity.

Yes, teens, both boys and girls, have become more focused on increasing their muscle mass. "Strong is the new skinny" is a current sentiment; neither being healthy nor slim is good enough. The bar has been raised necessitating increased muscle mass to change one's appearance. And the price they pay is far greater than suggested in the Times' quote above.

Lean and muscular, yes, but nor much of a sex drive!

But how big a deal is it if a teen—or an adult—takes a supplement or pushes their training to change their appearance? The actual study, in my humble opinion, did little to differentiate unhealthy disordered behaviors from more innocuous ones. What's the issue with weight training to increase muscle mass, any way? What's the harm in your taking a protein shake to bulk up your muscle a bit? (Steroid use is another story, and that is well addressed in the Times article.)

If you're like twenty-three year old Nathan, it's quite a big deal. He relied on the gym-endorsed protein powders, "to promote muscle growth". All things high in protein were considered safe—if they were also very low fat. Despite my urging to reduce his exceedingly high protein intake, and to liberalize his intake of fats and carbohydrate, his kidneys began to fail, struggling to filter the extraordinarily large load of protein waste products. His thoughts were all consumed with when he'd be able to get to the gym and when and what he'd be eating next.

But this is not solely a male thing, as the Pediatrics study shows. Girls, though, are more likely to modify their diet, while boys will increase their gym training to 'meet their needs'.

And what if it were high in carbs?

Like Karen, you may be spending more and more time at the gym while restricting your intake, ultimately finding it too stressful to live life with school and work demands, along with your rigid workout regimen.

Certainly, drinking protein supplements is not itself a cause for alarm. But relying on shakes in lieu of real food is. It impacts our ability to socialize, to be flexible in eating situations and to get all that we need nutritionally. A diet devoid of fats and carbohydrate will be deficient in much-needed nutrients, and typically in calories. A sense of deprivation often results, accompanied by obsessive thinking about food and eating and weight.

As for the workouts, where do we draw the line about what is healthy and safe, and what is excessive? If you're in a community of triathaloners, marathon runners or iron men/women, a few hours at the gym will seem inconsequential. 

But is it driven by a preoccupation and distortion that anything short of a few hours will leave you fat or unfit? Many of my patients believe falsely that working out is always a good thing. Nothing can be further from the truth. When intake is inadequate, working out not only won't build muscle mass, it will help break down muscle to convert it to fuel! And when net intake is substantially less than need (either because of very high activity or low intake) metabolic rate slows down, so you burn fewer calories 24/7. Certainly not what you intended!

Surprisingly, there was no mention of the low testosterone levels that result in males, similar to the drop in hormones seen in females with anorexia. Tell this to those boys and it might motivate for change. Sex drive drops, facial hair diminishes and risks to bone density increase as well. For boys in their growing years—which might last until 18 or 19 years—the consequence may be stunted growth. And the opportunity for catch up is lost once the bone growth plates have closed. Most boys and girls do care about their height, but do they realize this may result?

And what messages are we conveying to our kids with their school BMI screenings? Are we faulting them for their high BMI (which will remain high as muscle mass increases and height fails to increase)? Or are we fairly looking at an increasing BMI percentile for that individual as a possible marker for unhealthy behaviors—be it steroid use resulting in rapidly increasing muscle mass or binge eating? Are we presenting being obese as so horrific that even if their behaviors are healthy, we tell them they need to lose weight? Is a drop in BMI in an overweight child healthy if they starved themselves or compulsively exercised to get there? 

Shouldn't we be screening with questions about thoughts and behaviors, not just BMI?

Are we reinforcing their interest in fitness because we perceive it as healthy—no matter what? Do we share the same distorted views about all things protein-rich being "good" while villainizing carbohydrate-rich grains and fat-rich foods, too? Are we contributing to the misinformation they hold fast to? Why don't we recognize that there is sometimes pathological thinking and behaviors that drive extended workouts and dietary changes?

I don't have the answers.  But I do know that we are influenced by cultural standards of beauty, and that these images have become more and more unattainable. Yes, without steroids, you can't possibly bulk up like many of your weight-lifting role models, nor can you be both healthy and low weight as the air-brushed magazine pics would lead you to believe.

Something has to change. And it can start with you. Add your comment. Share this piece. Counter misinformation and acknowledge unhealthy behaviors—even when society fails to.

Consider these older posts for more information on topics covered in this post:

http://dropitandeat.blogspot.com/2010/07/daily-exercise-is-must-or-so-you-think.html

http://dropitandeat.blogspot.com/2012/03/protein-new-black.html

Lessons from the Ride: Tales of Intuitive Eating, Anxiety and Mindlessness.

Tell me this isn't great?

Let me preface this post by saying that I’m no exercise fanatic. I like to work out—it makes me feel good—but if I don’t get the chance to, I’m not bent out of shape.  I’ve never been much of an athlete. No need for tears, but in elementary school I recall being one of the last ones chosen for teams. I’m over it now, though, really. It was not until my diagnosis of MS, Multiple Sclerosis that I began to regularly bike ride although I’d done my share of hiking. This past weekend marks my 10-year anniversary riding this 2-day fundraising ride, a total of 156 miles from Boston, Massachusetts to the tip of Cape Cod—Provincetown.

During the ride thoughts of blogging never entered my mind. But afterwards, I was struck by several observations that I just had to share.

Intuitive eating? Not quite

As you’re well aware, I’m a big advocate of intuitive eating. But the truth is, intuitive doesn’t always work. Case in point: I’d ridden 15 miles to the first rest stop, soaking wet from the rain, with an elevated heart rate. Was I hungry? Not at all. Did I need to eat? Perhaps. By the next rest stop, now more than a couple of hours from the start of the ride, I still wasn’t hungry. Perhaps it’s because of the volume of fluid I was drinking in an effort to stay well hydrated. Perhaps it was the adrenaline driving me, revving me forward, preventing me from being aware of my body’s need for fuel.

Just arrived at the lunch stop

Nonetheless, intellectually I knew I needed to eat. I knew that my body was using up energy and needed replenishing. And so I made myself eat. I had little interest in the sports bars nor in the cookies at the rest stops, but I ate them. And they successfully fueled me until the lunch stop just an hour later. Then I fed myself a sandwich and multiple bags of chips, along with assorted other snacks. Oh, and more Gatorade.

This is how it went for each of the two days. There were times I did get hungry—generally after I had cooled off and my heart rate had dropped. But for the most part, I had to just do it, to simply eat because I knew I needed to, to keep me safe while doing an activity that needed fueling. And even without exercise, we need to eat to fuel ourselves throughout the day.

Intuitive eating returns

By late Sunday night, I returned home, and at 9:30 PM, after consuming more complete meals and smaller snacks than I can even recall, I was starving! So what’s a girl to do? I ordered Chinese food—the sodium-rich cuisine was just what I felt like— and I enjoyed every bit. This was intuitive! Yet had I, like so many of you, been stuck with the misinformation that eating after a certain hour was bad, or that I had already eaten my umpteenth meal and shouldn’t be hungry, I would have failed to meet my body’s needs.

My husband, who also rode, was also quite intrigued by the regulation of his food intake. He asked me how much I thought we had each consumed and I did a very rough estimate of our intake—trying very hard to remember all we had eaten. Then he asked how much I thought we had burned. So I did some equally estimated calculations for our expenditure.

And what did I find? Each of us had consumed within 10-15 calories of our estimated need! It was astounding! This combination of eating at regular intervals—just because I knew I should—together with eating whenever I got hungry worked like a dream. Our high activity is really beside the point. The key thing is that you burn calories 24/7—and certainly more if you are moving or exercising. And it’s critical to both respect your hunger when it is present, and use your sensibility (or the wisdom of a professional who’s working to keep you on target)—because anxiety, exercise, distraction, fluids, fiber and volume of food can stand in your way from eating enough.

Other lessons from the ride

Anticipatory anxiety

Yes, it's raining!

I hate the thought of biking in the rain. It scares me. They threatened precipitation for Saturday, but that did little to reduce my fear of having to ride in bad weather. About 45 minutes before we started pedaling, the rain started. Steady rain. The ride was not called off. The teams were called, one by one, to head out to the road. And so I did. 


Yes, my eyes were stinging from my hair gel dripping into them, and I was getting covered with grit and spray from the bike in front of me, but you know what? The reality was much better than my fears. Would I choose to ride in pouring rain? No! But having had to do it, truth is, it’s really not too bad. I survived, as did everyone of the 2000 or so riders that rode. And after a couple of hours, the sun came out, and I dried off. And by the end of the 156 miles, I was so thrilled I didn’t allow my anxiety to stop me from achieving my goal. See where I’m going with this?

Sometimes the solution is right in front of you!

Ok, this brilliance I’ll share—just don’t think any less of me, please!

At the finish, not yet hungry, but quite tired!

I had a headache all Saturday morning, a painful, aching headache. I didn’t get it—I was drinking plenty and eating regularly, so go figure. Then lunchtime came, and I pulled off my bike gloves, and my helmet and ate. And the headache disappeared. Yet when I returned to the road, the pain returned.  Thoughts of stroke and aneurysm crossed my mind—really! But by the next rest stop I figured it out.

The indentation on my forehead told me that I had mindlessly secured the darn helmet way too tight!  Yes, sometime the solutions are really right in front of you. And sometimes, your symptoms have nothing to do with how much you had eaten! (Just being honest!)

Yes, that’s what I learned from my ride last weekend. Thoughts? Comments? I’d love to hear what you’re thinking (unless, of course, you respond to my inability to appropriately fasten a bike helmet!)

This Time It’s Simply About The Calories

Piedmont: Great Wine, Great Challenges

I’m a snob. I admit it. When it comes to food, it’s got to taste good. Because I intend to really taste it. To enjoy it. To savor it. Every bite of it.

But Thursday, after many long, hot hours biking the grueling hills of the Piedmont region of Italy, we were hungry. Really hungry. The hills took us much longer than expected; we had no idea what it really means to be in shape for riding hills!  And the snacks we carried? We downed those within the first couple of hours.

So we rolled into a tiny town, known for its hazelnut production. Now give me a dessert with hazelnuts and chocolate and I would’ve been just fine. But that didn’t happen—no bakeries in sight. But it didn’t take us long to identify the only eating establishment around. Think retro, stale, cigarette-smoke-filled air luncheonette before it turned quaint and chic.

In our broken Italian we ordered the only Panini that sounded acceptable. Oh, and a salad.  What comes to your mind when you think salad? Fresh, crisp vegetables? A brilliant assortment of colors, flavors, and shapes? Think again. They offered what is known as Russian salad—a heaping mass of mayonnaise, containing diced potatoes, peas and a speck of carrot.  We had it along with the white bread sandwich packed generously with cheese. And I neglected to mention (how could I forget?)—that there were two rolled up sardines with olives. At least they added some color.

Well, I ate at least 90% of this lovely meal. And I hated every bite. (Although given my sweating from the unseasonable heat, the sodium rich sardines and olives were much appreciated.) This was so far from the fabulous cuisine I had heard so much about and had begun to enjoy my first day in the Piedmont (more posts about those meals to follow). The Piedmont, after all, is know for the Slow Food movement http://www.slowfood.com/international/6/faqs, amazing wines (Barolo, Barbaresco and Barbera) and white truffles (these are intense mushroom like fungus, not chocolates, my friends), with their distinctive flavor which embellishes foods with a mere drop of a truffle infused oil.

At this point, exhausted and overheated, depleted of energy, it was strictly about the calories, the fuel. I wasn’t going anywhere without eating this awful meal. I had no other options. I couldn’t find my voice in this language I barely spoke, and I suspect there were no other options, given the appearance of this place. Yes, mayonnaise-laden salad with a bland cheese sandwich was the only answer. Simply non-negotiable. There was nothing else to do but eat it.

Provence, not Piedmont!

What’s the meaning of this post? It’s not about my disappointment, of things not going as planned—that could be a whole other post. It’s not about adjusting expectations, because who could have expected this? Never mind that the biking was a total drag, nothing like our fantasy rides through Provence with climbs we could manage and stunning varied vistas to distract along the way.

No, the meaning is much more literal. Sometimes it comes down to Nike’s message—Just Do It.

For those of you who undereat—I know there are times when you are not hungry, and eating seems totally unnecessary. And when a fat-containing food may overwhelm. Or you question why you have to eat more than everyone else around you. Or the uncertainty of a meal’s content leads you to want to choose the safest route—food aversion. Or the allure of not eating, or restricting, promises a pleasant disconnect which might be so welcomed at this moment.

As for the overeaters and binge eaters (and anorexics, too)—skipping meals or snacks certainly sounds promising. Why take in those extra calories when a coffee will suffice? Because sometimes, you need to just do it. And when you’re feeling hungry even if no one else is, you need to just eat—because you need to begin to listen, to trust your body and its signals. Because you so deserve to be well nourished. Because your size has nothing to do with your need for nourishment in the moment. Yes, you too, need to trust it’s okay, it’s necessary to eat. And that you deserve to eat, regardless of what others’ glances may suggest, in spite of the messages from family members you hear or replay in your head, regarding your need to lose weight. Be in the moment, and trust that you should eat.

A cool drink after a long day of unmanageable hills and bad food!

I won’t be heading back for another Russian salad-filled lunch in the Piedmont. But I’m pleased I was able to fuel up for the challenging ride back. In the end, we enjoyed a lovely meal at dinner, and a refreshing drink just after unclipping from our pedals.

Wisdom From A Girl Like You

Moving On After Triggering Comments

I’ll never forget the SoHo gallery that July day, about 14 years ago. No, it wasn’t the memorable art, but the chatty 20-something employee there. I stood bewildered at first, in my short black sleeveless dress, with its Empire waist, feeling quite good about myself, I might add. That is, until our conversation. Perhaps it was the heat, but I wasn’t so quick to get her references. "How much more time till the big day?" "How are you feeling?" And finally, "Have you picked out names?"  Yes, I was assumed to be pregnant—but I wasn’t!

And how would you feel?

I wish I could say I hardly remember this event, but unfortunately I do. People can say the most triggering things.

To better address this point, please read the following piece, so beautifully and powerfully written by a very wise patient of mine. Welcome my very first guest author, who I’ll call Molly.

I walk in the cemetery to revel in the peacefulness, to breathe in the lush smell of flowers and mulch, to admire the stately row of hemlocks that borders the “Olde Burying Ground,” coniferous soldiers lined up the protect the granite headstones and perfuming the air with the sharp scent of pine. On that hill, I learned to ride a bike without training wheels; at that pond, I would catch frogs with my sister on hot summer afternoons, our murmurs of excitement swallowed by the thousands of headstones that extended for acres in every direction.

The cemetery was my safe place, a sanctuary away from the challenges of becoming an adult and claiming my space in the world.

It was a safe place. Until a Friday when a caretaker turned off his lawn mower as I walked by and said, “A young girl like you should be running, not walking!” He swung his arms like a marathoner as he spoke, as if that would make his comment funny or clever, as if that would ease the harsh sting I felt, the reprimand, the accusation of laziness, and the stirrings of a familiar voice.

My eating disorder used to make me run every day, rain or shine, and I hated every moment of it. I hated changing into running clothes, no matter how cute they were (and my closet looks like a lululemon store, so great is my quest for cuteness). I hated queuing up a playlist on my iPod that would keep me motivated for an hour. I hated the feeling of my ponytail swinging from side to side like a clock pendulum with every step. I hated when cars went skirting by, strange faces appraising me in the side mirrors. I hated the way my fingers swelled and my nose ran and my thoughts galloped in an endless loop: I hate this I hate this I hate this. Most of all, I hated peeling off my running clothes, stepping into the shower, and thinking, I have to do this again tomorrow. Sure enough, the next day I would go through the same miserable routine.

I wasn’t running because I wanted to, because I enjoyed it. I was running because my anorexia had an iron grip on me, murmuring in its at once soothing and terrifying voice, You fat cow, you disgusting pig, you worthless girl, burn calories, be miserable, take control, run from life. It was my anorexia that forced me to run in January’s freezing rain, the hail stinging my face, turning my cheeks an angry red. It was my anorexia that made me run on the treadmill and obsess about those annoying dots that mark off time remaining and calories burned. (I remember when the emergency stop cord disappeared from the treadmill in my dorm common room at college and I practically cried with relief because the treadmill wouldn’t work without it; then I really did cry when I realized that putting a magnet in its place tricked the treadmill into working, and my anorexia gleefully made the workouts resume).

When I finally entered residential treatment, I learned that the compulsive exercising, in conjunction with severe restriction, had lowered my potassium to what the doctor referred to as “heart attack levels.” In spite of the fact that my period had been absent for six months, and that my body had grown a soft coat of hair to compensate for the loss of body fat, I still believed that running my way to thinness, to perfection, to absolute control, was the only way to prove I was worthy of living.

A girl like you should be doing what's right for you!

After six months of hospitalized treatment, and ten more working with a wonderful outpatient team that brings new meaning to the phrase, “It takes a village,” I am now standing on my own two feet, a college graduate, a proud daughter, a loving sister. And though the ghosts sometimes still haunt me, and my eating disorder still berates me, and life still becomes overwhelming, I am not running away. But I want to, I desperately want to, when uninformed and ignorant comments turn calorie counting and starvation and misery into a glorified ideal.

Eating disorder experts often say that positive body image is the last puzzle piece that falls into place during recovery. But with people saying things like, “You should be running!” or the psychiatrist who skeptically asked, while looking me over from head to toe, “You were anorexic?” I honestly don’t believe I’ll ever get to that place of self-acceptance.

I loathe the phrase, “You look healthy,” because my eating disorder warps it into, “You look fat,” so loved ones who know about my struggle have learned to say things like, “I love seeing your smile again,” or “Í’m so happy we can talk about books again now that you’re able to concentrate when you read.” When I came home from residential treatment, my dad said to me, “There’s a person behind your eyes again,” and I’ll never forget that moment.

But the real world isn’t as educated. Commercials for diet plans and pills are everywhere. Photos of celebrities flaunting their bikini bodies decorate magazine covers. People gossip—who lost weight, who gained, who helped themselves to an extra cookie at the PTA meeting. Random strangers ask why you’re walking instead of running. We constantly evaluate—and praise or mock—people based on food choices, weight, and exercise regimen.

Much better than letting someone's comments derail your progress

That afternoon when I got home from my not-so-mindful walk and burst into tears while trying to eat my snack, I was confronted with a choice: restricting or living. And while my eating disorder was shouting at me, tantalizing me with promises of thinness, numbness, and perfection, the rational part of me got on the phone and scheduled an emergency session with my therapist.

Triggering comments and experiences are an unfortunate reality, but they don’t have to derail everything you’ve worked for. Alternatively, you can never fully know a person’s story, and assumptions can be both dangerous and harmful. That man’s comment could have sent me spiraling back down a road I’ve traveled before (and the destination isn’t a luxury resort). Though I had no control over what he said, I did have control over my response.

A young girl like me shouldn’t be running. She should be living, eating, thriving. And walking—at a slow, mindful place—seems to be the best way to get there. 

The War On Obesity: Preventing Collateral Damage

Mrs. D rushed into my office apologetic. “So sorry I’m late”, she said. “I was held up at the principal’s.” The principal’s? Mrs. D is well into her 30s, and her middle school aged son hardly seems to be one that would cause a visit to the principal’s office. And then the details unfolded.

Mrs. D and her son Sean had unknowingly broken with school policy, committing a public school crime. She had allowed Sean to bike to school. And in spite of the presence of bike racks (which one might think suggested that bikes might be allowed on the premises) biking to school is forbidden.

 According to the principal, if he allowed Sean to ride his bicycle to school, than there might be 100 students who’d want to ride their bikes to middle school. Imagine that—dozens of middle-schoolers getting more exercise, incorporating biking into their daily routine. The school might even need to get more bike racks.

In theory, the principal appeared to understand. But permission for policy change is only granted by a school committee vote. That is, if it were deemed important enough to land on their meeting’s agenda. And the school committee only meets periodically during the school year. So for now, Sean will need to skip his biking to school, lest he break the rules again.

Why the recent interest in biking anyway?

Several months ago, Sean’s school began its own war on obesity. First, they screened all the kids, evaluating them based on their BMI. (for more thoughts on BMI and its problems, check out http://dropitandeat.blogspot.com/2011/02/where-bmi-goes-wrong-lessons-from-cupid.html) Their weight report cards were then sent home. They were not, by the way, accompanied by a fitness assessment, which might have included measurements of strength or cardio fitness.

Concerned and caring mom that she is, Mrs. D responded to her son’s high BMI by seeking appropriate guidance. And so they presented to me.

Remember when kids were allowed to have milkshakes?

Sean has done remarkably well these months since we began working together. He’s eating better and learning to better manage his previously excessive portions, by responding to his physical cues. And he has significantly improved his food choices when dining out; no, he hasn’t given up burgers and fries, but now he might share a single portion of the fries or skip the cheese on the burgers. Those endless sodas at restaurants are now a thing of the past. In addition, this shift toward healthier eating has led to more meals prepared at home—an added benefit for the whole family.

Moving more was also on Sean’s to do list. After brainstorming together Sean and I decided that bike riding would be a fun, manageable activity to help improve his fitness. He began with weekend rides and then suggested biking to school, weather permitting. Yes, Sean was only trying to do well—to eat healthier, be more active and fit, and respond to the school-prompted campaign against obesity in a sensible, practical way. How unfortunate the school was so short sighted about its unhealthy policy.

As a side note, let me tell you a bit about Mrs. D. She has long struggled with anorexia and has also been working with me on her own eating issues. The school’s Get Fit night, together with the BMI materials send home, were nothing short of triggering. While well intentioned, the evening’s focus on eating less and exercising more, a seemingly harmless message, was not a healthy message for someone struggling with food restriction issues. 

One-size-fits-all recommendations can often do more harm than good. Simple nutrition overgeneralizations, classifying foods into good and bad categories only leads to trouble. While the school meant well trying to control obesity, sending the message of eat this, not that teaches nothing valuable.

It’s kind of like the My Plate message stating that we (all) should Eat Less (http://dropitandeat.blogspot.com/2011/06/time-to-clear-my-plate-before-you-get.html) If 50 or 60 % of all kids are overweight, that means that the rest are not overweight, right?

Did all the Get Fit night guests need to be told to eat less? Did they need to have fats identified by their calorie density, without labeling their many benefits? Did they have to be categorizing desserts as forbidden, while failing to teach self-regulation and balance?

Not Sean's favorite, but definitely mine--French macarons.
(the reason why it's taken me so long to get a post done this week)

Hard and fast rules and simplistic messages are not the answer for weight management. A healthy diet includes cupcakes, macarons and chocolate as well as fruits, vegetables, nuts and oils, dairy and lean meats. It’s all about balance. 

Counseling an overweight preteen as well as his anorexic mom forces me to think carefully about what war we really should be fighting. Should the focus be on what foods to include and which to omit from the diet? Should I encourage some foods for a mom, while forbidding those items from the son’s diet? Not a chance. Whether underweight or overweight, the message is strikingly similar—honor your body and respect its needs. And if hunger and fullness awareness feels foreign, trust that you can re-learn them.

Photo courtesy of Sean

As for Sean, his BMI has dropped significantly, as a result of a slow reduction in weight while his growth has continued. He still enjoys his favorite foods, including ice cream and French fries, but is starting to determine when he has had just enough. And this summer, now that he is out of school, he’ll be spending a lot more time cycling, with minimal TV time. That is, when he’s not watching the Tour De France.

Weighing your Actions. More Guidance on Feeding Children and Managing Weight.

I write this in response to the wonderful comments I received on my Frosted Flakes For Healthy Kids post (http://bit.ly/j0kwS1). And in honor of all the mothers who blame themselves for their children’s weight and eating issues, whether compulsive overeaters or anorexics, or simply obese without the components to label it a disorder. It is, after all, Mother’s Day this Sunday!

"Grandma the clown" in the Big Apple Circus

On behalf of the mothers reading this, let me confess, we don’t always do or say the right things. We, too, are works in progress. We may not have had the best role models for parenting. Or we may be working on juggling too much—working at a job, parenting, running a household, and lastly attempting to meet our own needs (although that one rarely seems to take much of our time!) Or we may not know what’s the best way to parent, or feed our children, or ourselves. We sometimes know all the right things to say, and inadvertently say the stupidest things. (Yes, I’ll be the first to admit it, boys!)

I’d like to highlight a few points that may have gotten buried in the last post:

I believe in balance.

Yes, there's a place for low nutritional value foods, but in a balanced diet. What is a balanced diet? One that contains a variety of foods and nutrients. It contains generous amounts of fruits and vegetables, as well as dairy sources (or milk alternatives for the vegetarians among you). And yes, it could even be chocolate milk and sweetened yogurts. That, too, is balance.

It includes grains and starches of all types. Sure, higher fiber and whole grain choices have great merit. But white pasta or rice and low-fiber French bread has not caused any health risk as part of the Mediterranean diet. And it includes protein sources from animals or plants as well.

I believe that how we eat matters perhaps more than what we eat, when it comes to weight management.

Eating mindfully, at the table, without distraction truly makes a difference. Yes, I know you and your kids are talented at multitasking, but it just has no place when we are eating. Eating mindfully allows you to acknowledge what you are eating. That may be why my anorexic patients struggle with this task; they often prefer not to know what they eating, not to acknowledge it. Limiting eating to the kitchen or dining room also helps us contain things, to give some order to our eating behaviors. It also elevates our eating, to something special.

Parents are responsible for setting appropriate limits with their kids.

This is as true about eating as all other activities. You can say, “you can buy school lunch, but only once per week”. That is your right. And you can say “instead of Lunchables, I’ll make you Lunchable style meals that you’ll enjoy, while limiting the number of highly processed, high sodium and saturated fat items in this convenience boxed lunch.

We need to educate our children and ourselves that immediate gratification in the name of fullness, comfortable fullness, is a fantasy.

We generally do not observe fullness in the 10-15 minutes it takes us to finish our meal. Rather, there may be stomach fullness, the first stage of fullness around that time, which is more volume dependent and can mislead us. For instance, have a bottle of Diet soda with no calories and you’ll feel full. But that fullness won’t last—and it certainly won’t fuel your body! It can take an hour or so for the our brains to sense fullness. The exceptions to this occur in those with slowed gastric emptying from chronic eating disorder behavior, or with gastroparesis, a delay in stomach emptying from conditions such as diabetes and neurological changes.

Acknowledge that it’s normal to feel hungry immediately after their short meal. But reassure them that they can eat again later (in perhaps an hour) when their body really can tell if it needs more. Then honor it! Allow them to eat again, regardless of the time of night!

Isn't this great? Taken at Chateau Chevernay in the Loire, France

Use your resources!

These days, if you don't know how or what to cook or serve your family, there are plenty of resources to assist you. See an RD for individualized guidance or check out mypyramid.org to learn balance and portions. Explore the wealth of cook books, websites, and cooking classes in stores, schools and towns.

Physical activity is key.

 
 Well actually, balance of intake and activity is what’s essential to consider. If you are restricting your intake, I do not support exercise (unless you can fuel it with enough food!). There have been plenty of studies correlating BMI with the numbers of hours of what is now termed “screen time”.

Preventing “now or never” thinking is critical.

Now or never thoughts about foods can happen because you set restrictions on what foods are acceptable to keep around see Jane’s story in last post). But it can also happen, as Quincy Carole pointed out in her comment on that post, when shopping is limited to one day a week. Knowledge that “when it’s gone, it’s gone” may drive us to overeat around the shopping days. The solution, be sure to reassure that there will always be more. If you can, keep additional packages of favorite snacks, so kids realize that they don’t have to get it all in today!

Thanks you readers for inspiring this post with your honest and most valuable comments!

Happy Mother’s Day!