Thursday, January 31, 2013

The New England Journal's Obesity Mythbusting


Yesterday an article authored by a veritable who's who list of obesity researchers was published in the New England Journal of Medicine. Titled, "Myths, Presumptions, and Facts About Obesity", it details what the authors describe as seven popular obesity related "myths", six common "presumptions", and nine understated evidence supported "facts".

While I agree almost wholeheartedly with the "Facts" section, and agree too that the "Presumptions" (presumptive in that we don't have enough data yet to decide one way or the other if they're true) are indeed still presumptions, I'd argue some of the "Myths" have yet to be busted.

For what they're worth, here are the myths, presumptions and facts and my thoughts occasionally interspersed therein.

The Myths

These are subjects that the authors feel have sufficient data to conclusively dismiss them as false. While I agree in some cases, I don't in all. That doesn't necessarily mean the authors are wrong and that I'm right, just that our opinions differ:

1. "Small sustained changes in energy intake or expenditure will produce large, long-term weight changes".

(Agree this is a myth. Putting this another way, I'll often tell my patients weight loss is insert-adjective here. Meaning small changes only lead to small losses and if you want to lose a huge amount of weight, you'll need to undertake (and sustain) a huge amount of change.)

2. "Setting realistic goals for weight loss is important, because otherwise patients will become frustrated and quit".

(Disagree. Not that the statement's true or false, just that the authors call it a myth consequent to the fact that there isn't robust evidence proving it to be true or false. Until there's robust evidence one way or the other, tough to call this one a myth and I'd have put it into their "presumptions" section. Moreover, tough to apply to everyone as no doubt some people likely respond wonderfully to aggressive goals, while others quit consequent to not reaching a dream destination.)

3. "Large, rapid weight loss is associated with poorer long-term weight-loss outcomes as compared with slow, gradual loss".

(Disagree. Here again is an area where I don't think we have sufficient data. The authors refer to year-long studies as long term data and frankly I don't think that's long term. For instance if a person rapidly loses 80lbs during an 8 month meal-replaced, very-low-calorie-diet looking at 1 year as "long term" only gives that person 4 months to regain. So I'd argue anything less than 2 year data is a short-term outcome and that we need data from at least 2 or more years out to draw long term conclusions and that's truly rare to come by.)

4. "It is important to assess the stage of change or diet readiness in order to help patients who request weight-loss treatment"

(Disagree. Here the authors report that studies that have looked at stage of change in people voluntarily entering weight loss programs didn't predict outcomes. Yet as the authors themselves point out, by definition folks voluntarily choosing to enter weight loss programs are at least minimally ready to face change. But for the clinician working their primary practice and not a practice like mine for instance, no doubt stage of change assessment crucial - if not for success than certainly for a respectful doctor patient relationship.)

5. "Physical-education classes in their current form, play an important role in reducing or preventing childhood obesity"

(Here all I can say is AMEN. No doubt evidence very clearly suggests kids aren't going to burn off or prevent obesity by means of school based PE classes.)

6. "Breast-feeding is protective against obesity"

(The authors report that a WHO meta-analysis on the subject was flawed, and that well controlled trials failed to demonstrate any clear benefit to breastfeeding on reducing obesity risk.)

7. "A bout of sexual activity burns 100 to 300 kcal for each participant"

(By their calculations the authors predict the average act of intercourse burns in the neighbourhood of 14 calories (sorry folks).)

The Presumptions 

These are subjects that as yet remain unproven one way or the other.

1. "Regularly eating breakfast is protective against obesity"

(Agree that it's not true for everyone. But perhaps important to note that the National Weight Loss Registry reports 78% of successful maintainers regularly eat breakfast. The flip side of that is that 22% don't. As I've blogged about (yesterday in fact), different strokes for different folks, though I'd argue (as would the Registry) that for most, breakfast may be important.)

2. "Early childhood is the period in which we learn exercise and eating habits that influence our weight throughout life"

3. "Eating more fruits and vegetables will result in weight loss, or less weight gain, regardless of whether any other changes to one's behavior or environment are made"

4. "Weight cycling is associated with increased mortality.."

5. "Snacking contributes to weight gain and obesity."

(Depends wholly on the snacks!)

6. "The built environment, in terms of sidewalk and park availability, influences obesity."

The Facts

These are the nine points the authors feel there's sufficient evidence to be true.

1. "Although genetic factors play a large role, heritability is not destiny"

2. "Diets (reduced energy intake) very effectively reduce weight, but trying to go on a diet or recommending that someone go on a diet generally does not work well in the long term."

3. "Regardless of body weight or weight loss, an increased level of exercise increases health."

4. "Physical activity or exercise in a sufficient dose aids in long term weight maintenance."

5. "Continuation of conditions that promote weight loss promotes maintenance of lower weight."

(Meaning whatever you do to lose it, if you want it to stay off, you need to keep doing it)

6. "For overweight children, programs that involve the parents and the home setting promote greater weight loss or maintenance."

7. "Provision of meals and use of meal-replacement products promote greater weight loss."

(The inclusion of this "fact" confused me consequent to point number 5! If you lose weight utilizing meal replacements and you stop using meal replacements, the weight lost as a consequence of their use may well return. What percentage of folks in meal replacement based programs are counselled or are prepared to live with meal replacements for life?)

8. "Some pharmaceutical agents can help patients achieve clinically meaningful weight loss and maintain the reduction as long as the agents continue to be used."

9. "In appropriate patients bariatric surgery results in long-term weight loss and reductions in the rate of incident diabetes and mortality."

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Wednesday, January 30, 2013

Does New Study Settle the 3 Square vs. 6 Small vs. the 8 Hour Diet Debate?

So this month yet another study in a never-ending line of studies looking to compare the impact of meal frequency on fullness and biochemistry came out. This one suggested that small frequent helped decrease energy intake in normal weight men.

Honestly I pretty much disregard all of these studies.

Not because I'm doubting or questioning their results, just that I don't think their results really matter.

What I mean is that all of these studies fail to address the practical aspects of living with their recommendations, and as a clinician, that's really all that matters to me.

I've seen people controlling calories, loving life and preserving health with 6 small meals daily. I've seen people do the same on 2, 3, 4, and in some cases even 1 meal a day.

Regardless of the research that comes out, what matters more than what a physiology paper says is how you personally feel.

In my office we do tend to start people on small and frequent meals and snacks. But if that doesn't suit or help the individual we'll shift to 3 square meals. We've also recommended the intermittent fasting style that's suddenly finding some traction on the diet book shelves.

You need to find a life that you enjoy, and just because a new study or diet book suggests there's a "better", or "right", way, if you don't happen to enjoy it, it just isn't going to work.

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Tuesday, January 29, 2013

Child Literacy - The Food Industry's Next Co-Opted Cause Célèbre?

Sure looks that way and it's a brilliant move for the food industry.

After all there are growing calls to ban the provision of toys with junk food, but what if instead of toys, junk food came with books and the purveyors of junk claimed that it was all in the name of improving literacy?

Doing so would give parents a truly feel good incentive to take kids out to dinner and would likely provide a far greater challenge to any call for legislative efforts to curb the practice of selling junk food with toys as now those toys will have a social issue attached to them.

While I've written before about Burger King's reading club and was recently informed of Pizza Hut's longstanding initiative, earlier this month McDonald's in the UK took it a few steps further announcing that at least for the next two years, Happy Meals will come with books (and in so doing they immediately became UK's largest book distributor). And then last week Casey Hinds forwarded me the details of Lexington Kentucy's "Feed the Mind" event designed to, " promote and celebrate reading and childhood literacy". It's being promoted to "thousands of fourth graders", and even feature's Kentucky's first-lady.

What else will Feed the Mind promote and celebrate?

Arby's, who according to Reza Timaji, Lexington businessman and President of the Arby's Lexington Co-op, "jumped at the chance to be involved". And for good reason,
"The cost of the event is being offset by the distribution of special Arby's coupon booklets created specifically for the celebration. For a donation of $5, Arby's customers will receive a variety of coupons and special offers worth over $20"


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Monday, January 28, 2013

McDonald's Uses Ronald McDonald House to Sell Happy Meals

Just in case you thought Ronald McDonald house was all about altruism and charity.

Fact of the matter is that true altruism and corporations simply can't mix. What I mean is that money spent by corporations on charity needs to provide a return on investment. Whether by means of improving a brand's image (and thereby increasing brand loyalty and sales), or by stifling criticism (and thereby decreasing negative coverage or legislation and consequently sustaining sales), or by leveraging the association to sell products (and of course sales), corporate dollars can't be squandered.

For McDonald's I'd bet Ronald McDonald houses achieve all three with the photos here illustrating their use of Ronald McDonald houses to market directly to children.



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Saturday, January 26, 2013

Saturday Stories: Congitive Biases, Gates vs. Polio, and "Health"

Great primer on i09 of cognitive biases and how they trip us all up.

Awesome read on Bill Gates and how he wants his legacy to include polio's permanent eradication.

My friend Dr. Alex Jadad (for evidence based medicine nerds - that Jadad) with a fabulous and thought provoking talk where he asks, "What is Health" (embedded below too).

[And if you don't follow me on Twitter or Facebook, here's this week's US News and World Report column summarizing the science to date behind The Biggest Loser]



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Friday, January 25, 2013

Does Your Dog Have A Skype Account? Maybe They Should.

Today's Funny Friday is a video that truly captures the wonder of our modern age.....or something like that.

Have a great weekend!

(Email subscribers, head to the blog to watch)



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Thursday, January 24, 2013

What The Heck is "Water Extract of Dried Raisins"?

That's the question I had when I noticed author, editor, columnist, blogger and radio host Ann Douglas (is there anything you don't do Ann?), tweeting about the ingredients of a loaf of Dempster's Whole Grain Whole Wheat bread.

My first thought was that it was perhaps the slimiest sugar synonym I'd ever heard, but then looking at the bread, sugar and molasses are both listed and there's only 2gm of sugar per slice.

Next I called Dempster's and I was told that it's part of their move to include more "natural" ingredients, and that it replaced sodium stearoyl-2-lactylate, but when I looked that up I found it was an emulsifier and that didn't sound right.

Digging around on the net I came up with the possibility that the raisin juice (as oxymoronic as that sounds) was there to provide tartaric acid and serve as a preservative of sorts.

All that to say, just because you can pronounce something doesn't mean you know what it is, what it does, or whether or not it's good for you. While I don't think there's any risk to "water extract of dried raisins", there are plenty of fantastically easy to pronounce ingredients that I'd prefer my food not to have so don't fall into the natural fallacy laden trap of thinking that by definition if you can pronounce it, it must be good.

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Wednesday, January 23, 2013

Author Michele Simon's Devastating Report on the Academy of Nutrition and Dietetics' Corporate Ties

Seldom have I read such a damning report as the one published today by Eat, Drink, Politics' Public Health Lawyer Michele Simon where she painstakingly details the unspeakably cozy relationship between the Academy of Nutrition and Dietetics(AND), America's largest association of nutrition professionals, and the food industry.

I honestly can't even begin to do this report justice in a brief blog post.

What I found the most striking was the fact that it seems pretty clear that from their own accounting AND doesn't need the food industry's dollars.

What I mean is that according to Simon's research, corporate sponsorship only generated $1.8 million in revenue last year - a rather paltry sum all things considered, but that paltry sum afforded the food industry unparalleled access to America's dietitians. It provided sponsors with among other things the ability to produce co-branded "educational" materials, access to mailing lists and even the opportunity to provide accredited continuing education (including one course where Coca-Cola taught RDs that there's no evidence of harm to sugar consumption in children).

Putting that $1.8 million in some perspective, AND is 74,000 members strong. If AND decided to protect its credibility and divorce itself from corporate sponsorship it could do so by raising the cost of membership by just $24 a year. In fact if AND raised membership by $42 a year it would also offset the food industry's annual contributions to the AND Foundation - a Foundation already flush with cash having a reported value of $17 million, or 6 times AND's reported annual expenses.

In a private conversation Simon mentioned to me that there are some who doubt the transparency of AND's accounting and that corporate dollars are much greater than those reported. Of course if that were true, the question to be asked is what, why and how much are they hiding? Alternatively, if the numbers are true, and if AND doesn't truly need the money, the question to be asked is why do they allow their reputation and credibility to be sullied by the food industry? Your guess is as good as mine, and I'd bet at the end of the day the answers to all of those questions are direct or indirect personal pots of gold, power, or influence.

I asked Simon what she thought the answer was and she didn't mince any words,
"These corporate relationships go deeper than just money, which is what makes them so insidious. What’s really going on is a battle over the role of the food industry in shaping the very discourse of nutrition education and policy. It appears that the old guard” at AND is desperately holding on to the outdated notion that the food industry should have a seat at the table. But that leadership will soon have to make way for the younger generation of RDs who realize that partnering with junk food companies only harms their profession."
Truly, if you have any interest at all in the risks of partnerships with the food industry and just how ugly and twisted they can get, take some time and take in this report. It's a must read.

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Tuesday, January 22, 2013

Epcot's Habit Heroes Reopens. Did They Remove the Shaming?

Original Source
Longer term reader may remember that roughly one year ago I wrote a scathing piece about a new exhibit at Epcot called Habit Heroes. I felt then that the exhibit did more to vilify obesity, promote fat shaming and empower bullies than teach healthy habits.

That post of mine made a few waves and the story was picked up by the international news media and within 48 hours of posting, the exhibit was moth balled.

Well last week I received an email from Walt Disney World's Director of Public Affairs Kim Prunty letting me know that the exhibit had been reopened and inviting me to chat.  She also pointed me towards an article from the Orlando Sentinel highlighting the launch.

Suffice it to say gone are the obese villains, gone is the lazy stereotype reinforcing gluttonous kid on the sofa, and in their place are cartoons that tackle the enemies dehydration, inactivity and poor nutrition. Gone too are the ridiculously named and further bias inducing heroes Will Power and Calli Stenics.

Disney deserves real kudos for recognizing that the exhibit's first iteration was cringe worthy, as well as for deciding this time around to consult with some experts in the exhibit's imagineering including: The Director of Cornell's Food and Brand Lab Dr. Brian Wansink, the Director of Stanford's Pediatric Center for Healthy Weight Dr. Thomas Robinson and University of North Florida Nutrition Professor Dr. Judith Rodriguez.

A video of parts of the new exhibit is found on the Orlando Sentinel link up above.

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Monday, January 21, 2013

Go Figure - New Study Reports Watching The Biggest Loser Discourages Interest in Exercise

(Original Source:  The Soup TV)
By my count during the first week of this season's The Biggest Loser, three contestants lost consciousness, two threw up, one suffered a stress fracture in their knee and a thirteen year old boy fractured his foot.

Watching that - who wouldn't want to hit the gym?

And that's a question that Tanya Berry and colleagues wanted to answer. Their thinking was straightforward. Since they felt that the Biggest Loser portrays exercise as "work and not fun", and that it's often incredibly extreme in its depiction, it may follow that viewers watching The Biggest Loser rather than be motivated to exercise, will in fact be motivated not to. Their study was published this month in the American Journal of Health Behavior.

So what'd they do?

They took a common viewer demographic (undergrads believe it or not - of who nearly 30% reported watching the show at least once a month) and from it recruited 138 students from an undergraduate psychology class to watch one of two video clips - a Biggest Loser clip or an American Idol clip.

The Biggest Loser clip was 7.5 minutes long and involved a typical Biggest Loser training session replete with crying, screaming, complaining and the clear message that it was very difficult.

The American Idol clip was 5 minutes long and according to the authors it was chosen because it too depicted a reality show competition. The American Idol clip had no mention of exercise and showed highlights of the top 12 contestants along with some judge's comments.

Researchers then used a Go/No go Association Task to measure "implicit" attitudes towards exercise (unconscious attitudes) which basically involved using a computer to rapidly cycle through exercise and non exercise related words with the participant as quickly as possible choosing from a good or bad word association. They also evaluated "explicit" attitudes (conscious attitudes) by rating this statement about exercise,
"For me to exercise for at least 30 minutes each day in the forthcoming month is..."
They then looked at the following 3 items along a 7 point scale: 1. Pleasant to unpleasant. 2. Enjoyable to unenjoyable and 3. Pleasurable to painful.

Controls were put in place for the pretest activity level and mood of the participants and with those variables controlled the team found that watching the Biggest Loser led to a statistically significant decrease in explicit attitudes towards exercise - meaning watching the show led viewers to report that the notion of their exercising regularly for the next month as less enjoyable. Implicit attitudes were not shown to change.

And guess what? When looking at correlations between implicit and explicit attitudes towards exercise and actual exercise it's the explicit attitudes that matter which is why the authors of this study suggest the possibility that watching The Biggest Loser,
"may result in lower motivation to participate because of the anticipation of an unpleasant experience"
The study wasn't perfect. As the authors themselves noted, in their methodology they should have identified the show's regular viewers as their responses and attitudes may differ from non habitual viewers. It was also a small study and only involved a short segment of show, but ultimately I don't think it's a stretch to think that the depiction of successful weight management as being dependent on an exercise regime that is much more readily described and depicted as a painful punishment than a pleasure would make the thought of exercising that much less enticing.



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Saturday, January 19, 2013

Saturday Stories: The Flu, Poverty and Quinoa

Julia Belluz in Maclean's on what we do and don't know about Tamiflu and how that contrasts with our government's recent actions.

Naheed Dosani and Jeremy Petch use KevinMD's platform to explain why physicians should be screening for poverty in their patients.

The Globe and Mail's Amy Verner covers the ethics of quinoa consumption.

UPDATE: And a counterpoint to the quinoa question from the Ottawa Citizen's Elizabeth Payne

[And if you don't follow me on Twitter or Facebook, here's my piece from the Huffington Post calling on the American Academy of Pediatrics to speak out about The Biggest Loser]

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Friday, January 18, 2013

Pretty Sure Obesity And/Or Inactivity Consequent to This Show Being Cancelled

All I can say about this week's Funny Friday video is OMG I'm sad this is no longer on.

I miss the 80s!

Have a great weekend!

(email subscribers, you need to head to the blog to watch)



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Thursday, January 17, 2013

The Aspire Assist: Brilliant or Brutal? Surgically Assisted Weight Loss or Mechanized Bulimia?

So how do you think the boardroom table discussion went when this idea was first being kicked around?
"Um......so maybe we could make a hole in people's stomachs and then hook that hole up to a machine that hoovers up food before it can get digested?"

"Are you effin' kidding me?"

"No, I mean think about it, there are tons of people who aren't bulimic who think about being bulimic, this way we could make it all medical and stuff
".
That's certainly the tenor of the discussion out there as generally the reports on this are either pretty angry or simply express revulsion.

Superficially it really does sound horrifying, and undeniably, at first blush it's not what I would consider to be the intervention I'd always hoped for. But when researching the story of course I needed to know - what type of studies have been done on it to date?

Believe it or not, their very preliminary data's interesting. Now this isn't peer reviewed published data, just a poster presentation, but in it they describe the 11 patients who were given an Aspire Assist (that's what they're calling it) for a year. 10 of the 11 completed the year and from the poster it would appear they lost 44lbs on average.

So yes, back to the shock, horror and repulsion - I readily agree that on its surface both the premise and procedure is less than appetizing (honestly when considering this post before delving into it I had expected the post to be extremely negative), but if larger, longer, studies suggest it's well tolerated, doesn't lead to or exacerbate disordered eating, involves minimal risk, has minimal adverse metabolic or nutritional consequences, and leads to sustained losses which in turn had demonstrable medical or quality of life benefits, why wouldn't I consider it?

As I've written before it'd be wonderful if everyone lived incredibly healthful lifestyles and in turn that living incredibly healthful lifestyles guaranteed desired weights (they don't BTW), but I think my job as a physician is to ensure people are equipped to make informed decisions, not to make decisions for them, or to judge the ones that they make. If the Aspire Assist proves to be both safe and efficacious in the long run, I'll happily discuss its pros and cons with each and every suitable patient. I'll also happily discuss more traditional bariatric surgery, pharmacotherapy, purely behavioural therapy and also the option of doing absolutely nothing with them. And I'll do it all in a nonjudgmental manner too - because my job is to ensure my patients are aware of the risks and benefits of all of their treatment options, including watchful waiting, and then to support them in whatever informed decision they make. To do otherwise in my mind is contrary to the spirit of medicine and suggests one of two exceedingly common and unfair weight biases. First the one that often angrily asserts that unless a person is willing to make formative lifestyle changes, they're not worthy of being helped, or the second - that if only patients wanted it badly enough, they'd just fix themselves. Honestly, if desire were sufficient is there anyone out there who'd struggle with anything?

So is the Aspire Assist brilliant or brutal? Given it's just been born, it's going to be at least a decade before we'll even have the chance of having the robust long term data to make an informed decision. Until then all I can really say is that I'm looking forward to reading it.

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Wednesday, January 16, 2013

This is Really Happening - Calgary Pizza Chain Takes Over 9 School Cafeterias!?

Honestly this isn't a story from the Onion.

Coco Brooks Pizza has been granted permission from the Calgary Board of Education to take over cafeteria operations at 9 Calgary high schools in a move so staggeringly and mind numbingly stupid that according to this article from the CBC, even the students expressed shock,
"They’ve been promoting healthy food since junior high and then they open a pizza store; it’s weird"
Defending the move was Calgary Board of Education's Cathy Faber with the classic, "they also serve salads", argument. Ms Faber calls it a,
"turn around story for us, because we're starting to see with this increased traffic that there's actually a potential for a return on our investment"
Because apparently dollars matter more than nutrition and health for the Calgary Board of Education.

What would you do if your kid came home and told you the local pizza joint just took over their school cafeteria?

(And for my Twitter followers - I tweeted in December that I'd been sent the stupidest school nutrition policy I'd ever heard of - amazingly this isn't it. Look for that one in the next week or so)

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Tuesday, January 15, 2013

Why I'm Absolutely Thrilled Coca-Cola is Addressing Obesity in its Superbowl Ad

It means that they're incredibly desperate.

For a corporation that makes as much money as Coca-Cola does in selling sugar water to admit, however indirectly, that drinking a great deal of sugar water might affect weight, is clearly a Hail Mary pass.

I've blogged before about the writing on the wall for big beverage - but this definitely takes the proverbial cake.

Sadly though, I'd bet it succeeds in its two main aims. Firstly it will further reinforce the erroneous belief that you can out train a bad diet. Secondly it will provide Coca-Cola ammunition with which to fight industry unfriendly legislation by suggesting it's working hard to be part of the solution.

Coca-Cola's job is to sell products. As many as they possibly can. That's it, that's all, and there's nothing wrong with that - it's the way our society is built. The aim of this advertisement is to do just that because soda taxes or policies that restrict sales will be far worse for business than an ad designed to deceive the public into believing that Coca-Cola's part of the solution and that you can out run your glassful of sugar.

Writing's clearly on the wall. Now just a matter of time. We just need to keep up the pressure.

Here's a sneak peak of what might be the thrust of their Superbowl ad, or perhaps ad itself (email subscribers, visit the blog to watch):



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Monday, January 14, 2013

Did Britain Just Draft the World's Toughest Weight Loss Advertising Guidelines?

Wow!

Check this out. In the UK their Committee of Advertising Practice (CAP), the folks who write and maintain UK's advertising code just published new guidelines regarding the advertising of weight loss products and services.

What's no longer allowed?
  • Claiming that people can lose a precise amount of weight in a specific period of time.
  • Claiming that spot reduction exists.
  • Advertising weight loss products or services to minors.
  • Implying that weight loss will be permanent.
  • Implying that weight loss will be easy.
  • Implying that a person can eat whatever they want and still lose.
  • Suggesting certain foods can help you lose specific amounts of weight.
  • Making claims about services or products not supportable by means of evidence.
  • Utilizing testimonials that suggest more than 2lb/wk weight loss.
  • Utilizing products that purport to "bind fat".
  • Implying vitamin or mineral formulations are beneficial to weight loss.
  • Implying that a product or procedure will remove "toxins" from the body.
And lastly there's this amazing statement,
"Obesity is frequently associated with a medical condition and a treatment for it must not be advertised to the public unless it is to be used under suitably qualified supervision."
Though it doesn't describe what "suitably qualified" means, I can only pray it will be used to shut down some of the snake oil salespeople who prey on the vulnerable by selling hope in place of help.

Wish we could see this sort of care and consideration here in North America (but please don't hold your breath).

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Saturday, January 12, 2013

Saturday Stories: Big Food, Good Science vs. Bad Science, & Overweight Health

Food lawyer Michele Simon with a great piece on how the food industry is preying on our children and why you shouldn't hold your breath for anyone to do anything about it.

Science journalist Julia Belluz in a great piece on how to tell good science from bad science.

Professor and nutrition rock star Marion Nestle on whether or not overweight is good for you.

[And if you don't follow me on Facebook or Twitter, here's my weekly column for US News and World Report - are you already struggling with your New Year's resolution?]

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Friday, January 11, 2013

True Facts About Sloths

While today's Funny Friday is indeed a nature video, unlike the ones that used to be on Saturday and Sunday mornings, this one shouldn't be watched with your children.

Have a great weekend!

(email subscribers head to the blog to watch)



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Thursday, January 10, 2013

Diet Book Review: The Parisian Diet

[Full disclosure: I was sent a free copy of the book by a publicist]
Dr. Jean-Michel Cohen's The Parisian Diet: How to Reach Your Right Weight and Stay There is my last diet book review for at least a few weeks and for me it was something of an enigma.

I truly enjoyed reading much of Dr. Cohen's diet's preamble. He preaches mindful eating of 3 meals a day with 20 mins allotted to each (just for the eating part), and at least on paper, he talks about how overly restrictive diets are part and parcel of long term diet failure.

He presents a formula of sorts for something he's called, "Right Weight" which if followed may well help to set more reasonable number goals for folks. The formula's straight forward and here are the variables:

A. How much did you weigh when you were 18 without dieting
B. How much did you weigh at your heaviest (excluding pregnancy for women)
C. How much did you weigh at your lightest after age 18 with or without dieting
D. What is your current weight.

"Right Weight"={[(A+B)/2)]+[(C+D)/2]}/2

For eg. Age 18=180lbs. Highest ever=243lbs. Lightest after extreme dieting at 32= 147lbs. Current weight=243lbs. "Right weight"=203.25lbs.

Dr. Cohen's recommendation is to use his plan to reach your "Right" weight, then to stay at that weight for 6 months and then to re-calculate your new "Right" weight and continue to repeat this process until your BMI is in the "normal" range.

Once you reach your desired BMI you're then supposed to slowly start adding "unrestricted meals". However, and this is in bold in the book,
"continue eating 5 low calorie meals a week. There is no other way to maintain your weight loss"
The book's nutritional recommendations seem fairly solid. A big more saturated fat phobic than perhaps the literature would warrant, same with eggs, but those quibbles aside, the food involved seems healthful.

So what of the dieting part?

This is where I became rather confused. Despite alluding to the fact that overly restrictive diets are part and parcel of long term failure his diet starts with an exceedingly restrictive, albeit optional diet phase. It's called the Cafe phase and it's 10 days long with promise of you losing up to a lb a day. Dr. Cohen warns you not to do it if you're not in "good health" and that you need to take a multivitamin as you won't be eating enough to meet your nutritional needs through food.

Ok, so the Cafe phase we're warned is highly restrictive so perhaps not a huge surprise that when I crunched numbers I came up with a minuscule 719 calories a day. That's an incredibly small number. In fact it's a small enough number of calories that many would suggest it should only be undertaken under an MD's supervision (who would be monitoring for hypokalemia and/or adjusting medications as needed).

Next up is the Bistro phase which is meant to be followed for 2-3 weeks promising an 8-11lbs loss. It's described as "very restrictive" and Dr. Cohen recommends,
"you should take multivitamin and magnesium supplements to avoid fatigue and cramps and drink plenty of liquids throughout the day".
So how many calories did I calculate for a Bistro phase day? 753. Again, an almost insanely small number and not without albeit distant but potential risk.

Lastly there's the Gourmet phase which according to Dr. Cohen is,
"designed for pure enjoyment and consists of delicious menus that make it easy to stay on course long term"
So how many calories make up a day designed for "pure enjoyment"? 1,080 if Day 1 is a measure.

Honestly I really enjoyed Dr. Cohen's writing and I had great difficulty reconciling the reasonable and thoughtful preamble to his dieting recommendations with his actual dieting recommendations.

If you plan on picking up this plan from my perspective the calories are simply too low. An easy fix for women might be to double the recipes and recommendations of the first two phases and increase them by 50% in the Gourmet phase. No doubt you'll lose less weight and more slowly, but at least you'll stand a chance at enjoying life through food some.

For men, I'd nearly triple the recommendations for the Cafe and Bistro phases and double the Gourmet. Again expect lesser, slower loss, but a life you might actually sustain.

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Wednesday, January 09, 2013

Diet Book Review: The Shred Revolutionary Diet

[Full disclosure: I was sent a free review copy by the publisher]
Written by physician Ian K. Smith I have to say, I was a touch concerned from the get go as before the book even begins is a "Note to the Reader" which includes this statement,
"The author has endeavored to make sure it contains reliable and accurate information. However research on diet and nutrition is evolving and subject to interpretation and the conclusions presented here may differ from those found in other sources"
This book works by means of a very simple philosophy. It's a 6 week meal plan. Follow the plan and lose weight - no thinking required which certainly will appeal to many,
"Each day is thoughtfully planned out so that your need to think about what works and what doesn't is kept to a minimum."
Though the bulk of the book is made up of the various menus, there were a few times when the text reminded me of Dr. Smith's note to readers. First was something he called "Diet confusion" - a concept I've certainly not come across (and one I'm not aware of the literature supporting or refuting),
"The second thing that could theoretically happen is that by eating the same food all the time, the body becomes acclimated to eating those foods and more efficient at processing them"
And then came toxins,
"All of us, even those who eat as healthfully as possible - accumulate some level of toxins in our bodies. We want to eliminate these toxins as efficiently as possible. Sometimes livers can be overwhelmed, so occasionally it's beneficial to give them a little boost in carrying out their jobs"
Rather than wade into toxins myself, I'll steer you to my friend, pharmacist Scott Gavura's take, but at least no pills or potions are being recommended,
"The SHRED cleanse has you eating particular foods and drinking certain beverages that nautrally activate enzymes in the liver to enhance the detoxification process"
About halfway through the book I came across this statement,
"Think about the last three weeks as a descent into a cold dark pit. Each week you went deeper into the pit. At the end of week 3, you hit bottom."
Sure doesn't sound particularly inviting to me and perhaps as a consequence, before I started crunching caloric numbers, I was expecting to see that the Shred Revolutionary Diet was highly, highly, restrictive.

It actually isn't.

I calculated the calories provided by Day 1 of each of the 6 weeks of Shred's program. Here's what I came up with:

Day 1, Week 1: 1,781 calories
Day 1, Week 2: 1,621 calories
Day 1, Week 3: 1,426 calories
Day 1, Week 4: 1,406 calories
Day 1, Week 5: 1,276 calories (this is the "detox" week)
Day 1, Week 6: 1,572 calories

In fact those numbers up above are middle of the road numbers. Shred offers quite a few mix and match style options and I'd bet if picking the highest calorie options many days will easily clear 2,000.

Dr. Smith shares my belief that preventing hunger is crucial to success and recommends regular meals and snacks so as to reduce our physiologic drive to eat. He also advocates for significant amounts of exercise to supplement his meal plan. If followed carefully expect to exercise between 3 and 3.5 hours weekly.

At the end of the day, interesting "interpretations" and warnings of cold dark pits aside, of all the diet books I've read this New Year, the meal plans included in Shred, except perhaps for the "detox" week, are actually pretty reasonable.

If you're a woman of average height, this plan might in fact be a good one for you - that is assuming your preference would be to follow a meal plan carefully and include regular exercise. But you'd better follow it carefully because if you're not accurate with your measurements and you don't include the exercise, this plan might easily lead you to consume more calories than would lead to weight loss.

If you're a man of average height, if followed carefully this plan might well leave you hungry and if you're following it make sure you add in higher calorie solid options.

Both men and women following - not sure why Dr. Smith is so fond of juice. Much more sating to eat calories than to drink them - would adjust your days accordingly.

Remember though - whatever you do to lose the weight, if you stop doing it, you'll gain it back. Dr. Smith recommends when you see the weight starting to climb if you've reverted to your old lifestyle post Shredding, that you simply re-initiate the program or week/s of your choice.

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Tuesday, January 08, 2013

Diet Book Review: The Dash Diet Weight Loss Solution

[Full disclosure: I was sent a free review copy by the publisher]
According to author Marla Heller, MS, RD, the Dash Diet Weight Loss Solution's approach is derived from the lesser known lower-carb version of the DASH diet and therefore it is not in fact the fairly well studied DASH diet. Of course you probably wouldn't guess that given the title and the jacket cover that includes this red dot that tells prospective buyers that the Dash Diet was ranked the #1 best diet overall by US News and World Report.

In a word I'd sum up this book's promises as hyperbole as the book repeatedly refers to the diet helping to, "reset metabolism", "turbocharge weight loss", and specifically target, "muffin top fat". That's a real shame as one of the main problems involved in modern day dieting are non evidence-based statements made by health authorities, as those statements misinform people from positions of trust. Take spot reduction. Spot reduction is sadly impossible yet a respected health authority repeatedly tells readers in this book that her diet will lead to preferential abdominal fat loss. Honestly, if you remember one thing from this post remember that the second you come across someone or something promising spot reduction your skeptical Spidey sense should start tingling.

Some of the book I found truly strange. For instance healthy weights were defined as the,
"weight at which you have no health problems"
as if weight somehow were blamable for everything that ails you and that loss would fix all. Exercise recommendations included literally walking in place in front of your television or walking around your office a few times before you sit down. Readers were also told that sugar-free jello is a wonderful replacement for fruit and that
"Eating burgers without the bun will become a habit"
The first two weeks involves a pretty standard low-carb induction phase and is billed as,
"2 weeks to Reset Your Metabolism, Turbocharge Weight Loss and Shrink Your Waistline"
No alcohol, starchy food (defined as bread, pasta, potatoes, rice, etc), fruit, sugar or milk. Heller warns that adherents will feel less energetic, get cranky, bored and may experience a "mini-meltdown". Sounds awesome. She notes that during the first two weeks your body will flush out "excess fluids", but really they're not in excess, they're just the fluids your body stores along with its carbohydrates, and yes indeed, when you're not consuming carbohydrates and you deplete your liver and muscle stores of glycogen you'll probably also liberate 10lbs of fluid (which will return just as quickly if you bring the carbs back into your life).

The book provides very specific meal plans and so I took the time to calculate the calories of the first day of the induction phase and the first day of the rest of your life to see what readers might be getting themselves into.

Day 1 of the first two weeks clocked in at 1,120 calories, while the first day of the rest of your life rang up at 1,250.

In my experience it's an exceedingly rare person who is happily satisfied on an average of 1,200 calories a day.

As well Heller notes that once you get to where you want to go weight wise you're to start bringing back dessert, potatoes and grains. But if you lose weight with a particular intervention (like for instance avoiding dessert, potatoes and grains) and then you stop that intervention, whatever weight you lost consequent to that intervention is likely to come back.

On the plus side for this book, the recommended foods are healthful and there's an emphasis on cooking from scratch. If you do choose to pick this one up, I'd encourage you to increase the portions provided until you feel satisfied as weight loss through white-knuckled 1,100-1,200 calorie hunger simply isn't going to stay off. Personally I'd much rather you ate more and lost less and stayed there than to crash your weight down with overly aggressive restriction only to gain it back again because like the rest of our species, you weren't up for a lifetime of unnecessary suffering.

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Monday, January 07, 2013

How Do 3 Biggest Loser Alumni Feel About The Show's Inclusion of Kids?

Who better than the folks who've been there to weigh in (sorry) on whether or not The Biggest Loser by its very nature puts kids in harm's way?

Last week I interviewed three former Biggest Loser contestants - Kai Hibbard and Ken Coleman from Season 3, and a third contestant, who placed either first, second or third in their season, who wishes to remain anonymous but who I'll be calling Linda for the sake of this post.

Kai, known to be an outspoken critic of the show, is concerned,
"I think putting children in this position is super, super, harsh.",
and she wonders what their parents were thinking in allowing them to be included on the show,
"Putting your child in that psychological position to be picked at, to be analyzed, to be mistaken for somebody else and to have a level of fame, but not a level of protection from it that money and power might provide is irresponsible, so even without the weight loss, reality TV is dangerous."
Next I asked her if the show's pressure to lose led her as an adult to struggle and what impact it had on her and her fellow contestants,
"I know my own self-image suffered extensively. I felt, and I know that two of the other female contestants on my season alone felt the same, the more weight we lost, the less we liked ourselves. The less we liked looking in the mirror because it wasn’t enough, and it didn’t look good enough."
To this day, 7 years later, Kai still reports being scrutinized by strangers and that she worries it'll be worse for this season's kids,
"I think it’ll be 10 times worse because they’re adolescents. I’m a grown adult, and it’s been almost 7 years and literally less than a month ago I had a complete stranger come up to me in the grocery store, look at my cart, and ask me whether I should be buying the ice cream that’s in it. I can’t imagine what they’re going to endure and let’s be honest, beyond the regular every day being picked on, they’re going to get the, “oh you think you’re so special, you think you’re so cool, because you’re on reality TV - adults even do that so kids will be 10x worse."
Ultimately Kai feels that the show teaches participants (and viewers) that it's just about willpower,
"Not only are you instilled with “if you just want it bad enough you can lose weight”, but that the only barriers are that you don’t want it enough and hey, you’re lazy. That’s honestly the attitude",
and at the end of the day she doesn't think that attitude, or this show is a place for children,
"I see this show doing harm both physically and psychologically. It scares me, it scares me for the kids."
Kai's former teammate Ken isn't on the same page. Ken isn't worried about the kids getting picked on more consequent to their involvement,
"kids are already being picked on, it’s a living hell for them",
but he readily agrees with Kai in that the scrutiny from strangers even long after the show is very, very real,
"I still have that happening today. Yes, 7 years and it doesn’t change. I do speaking engagements, I have people that come in to speaking engagements and the only reason they came, they don’t want to hear what I have to say, they just want to see if I gained the weight back"
Ken feels the kids on the show will be kept safe by the show's psychologists and psychiatrists who'll be there to help them through the journey, though when I asked him whether or not that support would still be there for the kids once the cameras stopped rolling, or once the next season's children were the stars, here's what he had to say,
"Well none of the contestants from NBC have been that lucky"
All told, Ken does think the show will be a positive experience for the children, but only if NBC steps up and provides these children with far more extensive and longer term supports than have been offered to the show's adults to date.

The last call I made was to Linda. Right off the bat she didn't mince words,
"It is a horrible idea. A horrible idea. I have professional experience working with children near to the ages of those on the show, and they are in such a fragile mental emotional physical state at that age that kind of rigorous workout and body change and self reflection I think is damaging"
When I pointed out to her that it'll be different for the children, that they won't be facing elimination or regular weigh ins she was unfazed,
"regardless of if they’re doing weigh-ins both that kid and the producer and their family and their trainer know exactly how much they weigh, exactly how much they need to lose and that’s always in your head."
And what does having that in your head do?
"It was a total mental battle, all of the time. It’s so much pressure that you put on yourself. I was taking sleeping pills to get through the night because I was so freaked out weighing myself daily. It was so much pressure. It was unbelievable"
And echoing Kai and Ken, Linda reports the pressure and scrutiny consequent to being on The Biggest Loser simply doesn't end,
"You are constantly scrutinized. I remember after the show aired I was in the grocery store and somebody was looking in my cart and scrutinizing, and still to this day, even though my show was a bunch of years ago, I am still worried about what is in my cart because god forbid if somebody recognizes me"
Going back to the safeguards being put in place for the children, Linda couldn't be reassured,
"remember, regardless of whatever safeguards they’re putting in for children this is a TV show, and they do this for ratings, and they want a reaction, and the only way you’ll get a reaction is if you get an extreme results. So these kids are going to go to be one day 50lbs overweight, and they’re going to wake up 6 months later at a normal weight and they’re not going to recognize themselves. So what is that going to do to an already fragile psyche?"
She even recounts bullying consequent to her success where people said things to the effect of
"Oh what, you had to go on a tv show to lose weight? It was a lot of why go to this extreme, what’s wrong with you that you had to go on national tv to do this?"
Linda also validates Ken's comments on the lack of long term support. In fact she goes further in that not only did the show not offer support, but according to her they also ignored her cries for help,
"One of the things that hurt the most through this whole biggest loser process is I gave the show everything and they dropped me. After the show was over, when I reached out, when the weight started to come back on I reached out and I begged and I pleaded and I said help me and they wouldn’t even respond to me. I felt terrible. I don’t think there are words to describe the defeat and the rejection I felt after the show."
Linda gained all of her weight back, as did other finalists from her season. I asked her how regaining has affected them consequent to their show created visibility,
"We still know that people look at us, people who know the show and we feel such shame because we had this opportunity that everybody wants, and we didn’t keep it off"
What I also learned interviewing these 3 former contestants is that The Biggest Loser alumni, perhaps due to their shared trial by fire, keep in fairly close touch. Consequently I asked each of these three what percentage of folks from the Biggest Loser keep the weight they lost off.

Kai answered,
"I’d say one quarter to one third - and not all of it"
Ken stated,
"85-90% of the contestants on the show have regained all their weight"
And Linda,
"Maybe 10-20% are keeping it off"
Linda summed up her experiences succinctly,
"If I would have known where I would have ended up after the show I would have stayed 300lbs"
And regarding kids, again, she didn't mince words,
"Kids are cruel and kids will take any opportunity they have to berate and belittle each other, that’s what kids do, and I think they're setting these kids up to be bullied relentlessly.

I’m so appalled and disgusted with it. It’s one thing to mess with our heads, but then they go to kids. I’ve been battling with this for many years, and I can’t even imagine, I can’t even imagine what it’s going to do to kids.
"
Are you also appalled? If you are, feel free to sign the petition, and/or better yet, join and promote the advertisers' products boycott.

[If there are any other former contestants who'd like to go on record, pro or con, anonymous or with attribution, feel free to contact me at yonifreedhoff over at gmail, or in a comment on this post]

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Saturday, January 05, 2013

Saturday Stories: Happiness, Misinformation and Guns

Roger Law with a fabulous piece on cultivating happiness.

The Columbia Journalism Review on the media's provision of a daily diet of misinformation consequent to "personal health" journalism.

The New England Journal of Medicine with a free full text editorial on how guns in America kill twice as many children as cancer, 5 times as many as heart disease, and 15 times as many as infections and provides us with the evidence supporting their regulation.

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Friday, January 04, 2013

Wee Little Fake Mouse vs. Teenage Male Weightlifter

Today's Funny Friday video's a short one. You know what's going to happen, but it still made me laugh.

Have a great weekend!

(email subscribers you need to visit the blog itself to watch)



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Thursday, January 03, 2013

"First Do No Harm" and The Biggest Loser's Children


The Hippocratic oath is the oath physicians either literally or figuratively take when embarking on their careers in medicine. The original of course is rather old and is written in Greek but I found a line from its translation to be especially apropos to The Biggest Loser's inclusion of just barely teenagers on this season's show,
"I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice."
It's the latter part I'm interested in, the "harm", and, "injustice".

So there are 3 children on the Biggest Loser this year. Two 13 year olds and a 16 year old, and before I type anything else I want to make it exceedingly clear - I hope they find the healthy lifestyles that they're looking for through their involvement with the show and that the show's teachings help them to live long, happy, and healthful lives where the only outcomes of being on the show are incredibly, unbelievably and undeniably positive.  I imagine that's what they're hoping.  Probably their concerned parents too.

I just worry that they won't be.

But for a moment let's assume only the very best. That the show's incredibly gentle, ethical and evidence based. That none of the nonsense (both in terms of messaging and in terms of approach) the show typically  throws at their adults trickles down to the kids. That all of the kids lose weight, improve their self-esteem, and develop healthy relationships with food.

I'd still be worrying about the "harm" and "injustice" of their inclusion on a weight loss reality show. Having spoken to more than one adult contestant I know that simply being on the show opens them up to a world of criticism, scrutiny and unbelievable pressure. The kids may well have it worse as their worlds will include the harsh and often exceedingly cruel realities of adolescence.  Given the horror stories the former adult participants have recounted to me about the judgments and comments they experienced with adult strangers and even loved ones directly consequent to their involvement with the show, I shudder to think of the taunts, pressure and pain that the show's children will face as this season progresses, let alone if they, like the vast majority of the show's contestants, regain once it's done.

And most do regain.  According to the multiple Biggest Loser contestants I've spoken with (who keep in touch with one another through private social networks), the show's success rates for long term weight maintenance run from a low guess of 10% to a high guess of 33%.

Which brings me back to the involvement of pediatrician Dr. Joanna Dolgoff. While Dr. Dolgoff and I have publicly disagreed before on the merits of formally putting children on diets, here we're at odds on whether or not putting children on an incredibly popular and heavily watched weight loss reality show is really in the children's best interests. I'd posit that simply being on the Biggest Loser puts these kids, regardless of their short and long term weight loss outcomes, at incredible risk of harm due to the pressures of simply being so completely in the public's eye, an eye which isn't kind to adults, let alone the public eye of young teenagers - an eye that's quite frankly is too often, and in the specific case of weight regularly, dramatically and inherently cruel. Add to that the incredible statistical likelihood of regain and I'd say their involvement represents one hell of an injustice.  Consequently I think Dr. Dolgoff has failed to uphold her seminal obligation to protect her patients.

[If you're appalled by the Biggest Loser's inclusion of children - do something about it.  Visit my blog post from the other day and join the advertiser boycott]

[Stay tuned on Monday (though it may be over on the Psychology Today blog), when I'll be posting some of the thoughts conveyed to me by former Biggest Loser contestants, including at least one winner, on why they're "horrified" by the show's inclusion of children.]

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Wednesday, January 02, 2013

So Long as the Biggest Loser Exploits Children, I'll be Boycotting Its Advertisers' Products

If you haven't already heard, this Sunday's 14th season premiere of the Biggest Loser will see the show's latest twist unveiled - the inclusion of children. This year there will be two 13 year olds and a 16 year old losing weight before a prime-time audience. They won't be competing for any prize money, they won't be weighing in, and they'll only be on the ranch periodically, but they will be part of a television series which assuredly will be watched by all of their friends and relations.

No doubt many will see this as something laudable, something along the lines of, good for the Biggest Loser for helping out those poor kids.

But is it really a good deed?

As far as the treatment of obesity in the pediatric population goes we know that there has yet to be a behavioural weight management intervention proven to have a long lasting benefit. As far as the the Biggest Loser itself goes we know it cultivates hateful weight bias, and we know that the rapid weight losses it generates destroys participants' metabolisms in a manner far more dramatic than would be expected by the losses themselves.

And as far as the Biggest Loser's approach to the kids goes - assuming it's roughly the same approach provided to the adult participants - it will involve a huge amount of exercise (4 hours a day minimum is what the adults are doing), coupled with highly restrictive diets, and the pervasive insistence that if you just want it badly enough, you'll be able to make it happen - the corollary of which of course is that if you aren't successful it's your own damn fault you lazy, weak, loser.

To their credit, many of the Biggest Losers' past participants have maintained dramatic losses, but according to one former contestant, the majority have not. We might then fairly presume that one or more of the children involved will regain the weight that they're about to so publicly lose, and given the nature of the show's teaching, will likely hate and blame themselves for doing so. They may even gain back more than they lose in the first place consequent to the impact the show's approach will undoubtedly have on their metabolisms.

And here's where my knickers are in a knot. The adults - well it might be argued that they have the maturity and insight to know what they're getting themselves into. The same can't be said to be true about the children and I would imagine that the psychological devastation of weight regain in any of these children will be far more damaging to them, and far more likely to be ridiculed by their peers and even complete strangers, than regain in any adult participant.

As far as blame goes - I don't blame the children for wanting to be involved (their parents I'll cover tomorrow) - the show's messaging is incredibly seductive. I do however blame the producers as no doubt they understand the implications of these kids being in America's cold, hard, spotlight and however well intentioned they might claim to be, ultimately what they're doing is exploiting children for the sake of viewers, and I believe, putting children in true harm's way.

A few days ago I signed a petition calling for the Biggest Loser to not include children, but I don't expect it to actually have any impact. On the other hand, what might have an impact is a boycott of the Biggest Losers' advertisers products.

Consequently so long as children appear on the Biggest Loser, and so long as their parent companies continue to buy advertising time during the show, I will not be purchasing the following products:

  • Quaker Oats
  • Brita water filters
  • Wrigley's Extra gum
  • Yoplait yogurt
  • Subway
  • Jennie-O meats
  • Bodymedia (they make FIT exercise trackers)
  • Cybex exercise equipment
  • Planet Fitness
  • Weight Watchers
  • Sprint
  • Ford



  • And as I watch the show this season, I'll be adding advertisers to the list, and periodically reblogging this.

    If you'd like to come on board with this boycott, please share this post with your Twitter feeds, Facebook pages and personal email lists. The greater the number of people who've shared this post, the more likely it is that the Biggest Losers' advertisers will take notice. Moreover, if you'd like to send an email to a member of the sales or PR teams of the aforementioned products, click here and an email will be generated for your approval - I imagine if they were to receive hundreds or thousands of emails, it might at least give them a moment of pause. Ultimately if anyone has the power to stop this madness it's the show's advertisers - money always talks.

    [Click here and you can read my thoughts as to why regardless of outcomes or approaches, The Biggest Loser is putting children in harm's way and why I think the show's paediatrician is breaking her Hippocratic oath.]

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    Tuesday, January 01, 2013

    PETA Couldn't Care Less About the Ethical Treatment of Women

    Hope you're enjoying this holiday season! This week is traditionally my blog-cation and so instead of writing new posts, here is a favourite of mine from back in 2009.
    My sister received this invitation from People for the Ethical Treatment of Animals (PETA) last week. It invited her to a veggie dog lunch hosted by two Playboy "playmates" clad in lettuce bikinis.

    Sadly PETA has a long tradition of objectifying women to promote their message and I feel that PETA's campaigns do more to contribute to body image issues among women and normalizing their objectification for the population and other advertisers, than actually promoting such things as vegetarianism.

    I think the message PETA's trying to convey is that vegetarianism is sexy, and if you feel that nearly nude playmates and porn stars epitomize both sex and health then maybe they are doing a good job. Judge for yourselves. Head over to their youtube channel and you can watch plenty of videos with scantily clad young women in their "sexy celebrity videos" section which also include endorsements from porn stars and another with women in bikinis making out. Interestingly, of the 25 "sexy celebrity videos" only three involved men and of those, only one was scantily clad (Dennis Rodman).

    PETA, I'm not buying it and frankly I can't imagine that the best way to promote the ethical treatment of animals is to objectify women.

    I decided to write to Ashley Byrne from PETA to hear what they had to say for themselves.

    Perhaps not surprisingly I have yet to hear back from her.

    Here's my letter and right below it is a video from the event my sister was invited to. Watch the video and let me know if you think that those women in lettuce bikinis did anything for the promotion of PETA's cause.
    Dear Ashley,

    My name is Yoni Freedhoff and I’m a physician in Canada with a special interest in nutrition and obesity. I’m also a blogger and currently I’m writing a piece about your recent event held at the Rayburn House Office Building and the advertisement featuring a lettuce clad Playboy Playmate and of course a meet and greet with Playboy’s Playmate of the Year.

    My concern of course is how events and advertisements like these serve to objectify women and in turn contribute to disordered body image in the population. Did you know that studies in the United States have shown that almost half of girls aged 6-8 want to be thinner (1), that stigmatization based on weight and looks can begin as early as the age of 3 (2) and that body image distress is one of the strongest predictors of developing an eating disorder (3)?

    Frankly I find PETA’s use of objectified women in their campaigns to be surprising given your mandate and I’m wondering if you might have a comment regarding why the ethical treatment of women is seemingly not of consequence to you?

    Sincerely,

    Dr. Yoni Freedhoff, MD CCFP Dip ABBM
    Medical Director, Bariatric Medical Institute
    575 West Hunt Club, Suite 100
    Ottawa ON K2G5W5

    1. Dohnt, H., Tiggerman M. (2006) Body image concerns in young girls: The role of peers and media prior to adolescence. Journal of Youth and Adolescence 35(2):141-151
    2. Cramer, P., Steinwert, T. (1998) Thin is good, fat is bad: How early does it begin? J App Dev Psychol. 19: 429–451
    3. Striegel-Moore RH., Bulik CM. (2007) Risk Factors for Eating Disorders. Am Psychol. Apr;62(3):181-98.


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