Ever Wonder What it Would be Like to Get Hit by 1,000s of Pies?

I find Japanese television to be both spellbinding and jaw dropping.

Here, for Funny Friday, is a 3-part video of a Japanese television show which from what I can gather involves an unfortunate gentleman who for some reason has agreed to spend an entire day getting hit by cream pies.

The clips are lengthy, the humour builds slowly, but boy did I enjoy them.

I especially liked it in the first clip when the man tries to make himself some toast and one of the cream-pie ninjas throw a pie in his toaster. I also liked the third segment when the man while trying to sleep is awoken by an older woman coming out of his closet and then eating the cream off the pie guy's face (this scene potentially not for younger eyes).

The pies begin at the 2:06 mark in the first video and then they just don't stop.

Clearly I'm a simple, simple man.

Have a great weekend!

"Just Like Home" Quobesity

Perhaps this should be a "Obesimage".

Saw this in our Toysrus flyer today.

It's called the Just Like Home Deli shop play set.

Looking at the picture I see hot dogs, hamburgers, onion rings, potato chips, doughnuts, chocolate milk, juice, ketchup and mustard, white bread, pancakes with butter, cookies and bacon.

Wanna argue with me and say, "Come on Yoni, it says it's a deli shop play set, you're twisting the picture".

Fine, here's the same company's Just Like Home 60 piece food set.

Pizza, doughnuts, cola, cookies, hot dogs, orange juice, ice cream, waffles, cheesecake, french fries, bacon, chocolate and perhaps a butter tart?

I think the vegetables are thrown in so the parents who buy the kit can say,

"Come on Timmy, you can't play with your french fries until you finish playing with your carrots!"

..... Just like home.

Do Restaurants Trigger Binge Eating?

Hot off the Reuters newswire is a story about how perhaps eating at restaurants triggers binge eating.

The story builds off a paper by Dr. Gayle M. Timmerman from the University of Austin Texas who published a study on the matter in the Western Journal of Nursing Research.

In the study Dr. Timmerman utilized food diaries to track the dietary intake of 71 self-reported binge eaters and 46 dieters who don't have a bingeing history. They then tracked calories consumed in restaurants by bingers and non-bingers and concluded that binge eaters were more likely to binge in restaurants.

I have two major problems with the study.

The first is the fact that food diary work is notoriously inaccurate in terms of intake, but more importantly, food diary work is often extremely stressful and difficult for patients who truly suffer with binge eating disorder. The fact that only 3 of the 117 food diaries were excluded due to questionable content to me suggests immediately that something's up with this study because there's no way that if you asked 117 folks to keep a food diary, that 97.5% actually kept them, let alone kept them accurately enough to be worth inclusion into a study.

The second problem I have is that what was not included in the analysis was daily caloric distribution.

One of the primary triggers for binge eating behaviours is hunger. The most common cause of hunger in our society is meal and snack skipping. While the study did control for total daily calories, not discussing caloric distribution to me makes it impossible to interpret the results.

One of the most commonly adopted backfiring strategies for many dieters involves the notion that if they know they're going to go out for dinner, they'll cut back on their daytime calories to compensate for those they'll consume at night. Often this will involve skipping meals or skipping snacks or purposely having very light meals that day.

This of course then leads to hunger and combining hunger with a restaurant and a predisposition to binge eating is a recipe for.......you guessed it, binge eating.

Dr. Timmerman concludes that,

"Restaurants provide ample delicious food cues which when coupled with negative emotions provide a high risk environment that challenges non-purge binge eaters' control of food intake."

I would likely want the data reanalyzed for frequency of meals, distribution of protein and I imagine the conclusion that would then be drawn would look something like,

"Restaurants provide ample delicious food cues which when coupled with meal skipping, snack skipping and hunger provides a high risk environment that challenges everyone's, especially binge eaters', control of food intake."

As I've said many times before - you don't crave green leafy salads when you're hungry.

Best advice I can give is the same advice I give my patients:

Never sit down to any meal, especially a restaurant meal, hungry.

Overweight? Don't Blame Suburbia

I've had a bone to pick for a long time with folks who feel that our rapidly growing waistlines are attributable to a lack of exercise.

I have an even bigger bone to pick with those who say our lack of exercise is due to growing rates of urban sprawl.

Fact is, the numbers for me just don't add up.

It's a very unfair thing - the number of calories burned through exercise isn't anything to write home about. Therefore I struggle with the notion that weight in society is going up due to a lack of exercise let alone a lack of simply being able to walk to your corner store.

Many studies have reported that the less walkable neighbourhoods of suburbia contribute to obesity and they conclude that by reporting that the percentage of those who are overweight or obese are higher in areas of urban sprawl.

The problem with that argument is that we really don't know if it's cause or effect.

That is perhaps, until now.

In a paper that came out of my alma matter, Lawrence Frank at the University of Toronto has published a very nice piece of research. In a paper entitled, Fat City: Questioning the Relationship Between Urban Sprawl and Obesity he does just that (question the relationship).

Basically what Dr. Frank hypothesized is that perhaps weight in fact impacts on choice of neighourhood, rather than neighbourhood impacting on weight.

He and his team took data from the very unsexily named Confidential Geocode Data of the National Longitudinal Survey of Youth 1979. They followed 6,000 individuals during a 6 year study period. They tracked these individuals' residential addresses and weights over time. What they were looking for was whether or not individuals gained weight when they moved to a more sprawling neighbourhood or lost weight when they moved to a less sprawling one.

To summarize a fairly complicated paper is Dr. Frank's conclusion,

"Overall we find no evidence that neighbourhood characteristics have any causal effect on weight"

I also agree wholeheartedly with their statement,

"It follows immediately from our results that recent calls to redesign cities in order to combat the rise in obesity are misguided."

That's not to say there's no value in improving the "walkability" of neighbourhoods - I'm all for that, but I'm for it to encourage fitness, a very important determinant of health. What it won't do is affect weight.

The math's just not there.

Operation Play-Doh a Great Success!

Hope everyone had a great Halloween.

I did my own experiment this Halloween.

I had read an article in the Journal of Nutrition Education and Behavior that suggested kids would be just as happy choosing toys as they would candy on Halloween.

My wife and I put that to the test last night.

We offered kids the choice between sugar-free gum and Play-Doh. The Play-Doh came in these individual packs and we bought 50 of them for $15.

I'd say 80% of the kids chose Play-Doh and virtually 100% of the parents were thrilled we weren't handing out more candy.

The best line of the evening came from a 7 or 8 year old goblin. When offered the choice between Playdoh and gum he asked,

Umm...the Play-doh, can you eat it?

When we told him no, he chose the gum.

The picture by the way, that's me and my beautiful daughter. Sorry it's blurry. One of my patients actually made me the Burger King costume.

I think it's a fitting costume...after all, Halloween's supposed to be scary.

The Incredible Eating Reminder Gizmo

One of the most basic tenets of successful weight loss and weight maintenance is that if your life includes hunger, success is going to be a huge challenge.

Hunger is one of the most basic human drives. Hundreds of millions of years of evolution have taught us to eat when we're hungry, and guess what, it's also taught us what foods have calories. We don't crave green leafy salads when we're hungry.

One of the best and easiest ways to minimize hunger in your life is to ensure that you practice pre-emptive eating. Eat before you get hunger and you'll have a much easier time controlling portions and choices.

Problem is, there's no internal cue to tell you to eat before you get hungry.

I've often recommended to patients that they buy watches that beep at them when it's snack time (I recommend no more than 3 hours between meals and snacks). Only thing is, those watches are kinda ugly.

In comes a patient with a brilliant solution. She bought a vibrating alarm pillbox. It's got five alarms and it's easy to set. She keeps hers in her pocket and when it vibrates, she eats.

I found one on Amazon.com for $14.95 and it's linked here:

Great idea!

Big Food Quobesity

Here's a doozy. In fact, it's such a doozy, it'll take up two quotes.

They're from the Director of Public Affairs for Refreshments Canada and they took place this past September in the Legislative Assembly of British Columbia during a meeting of the Select Standing Committee on Health. The meeting of course was to discuss the issue of the growing rate of childhood obesity in Canada.

The Director was painting a rosy picture of the refreshments offered to school children. There's water, juice, milk, sports drinks, diet beverages, juice drinks (read sugar drinks), and was also bragging that the serving sizes were capped at 355ml....one serving of which of course would exceed the American Academy of Pediatrics recommendations on juice consumption by 27%.

Anyhow, here's why it's a good idea to have larger servings and non-nutritional beverages in our schools,

We believe that offering students a variety of beverages, while encouraging the shift toward nutritious and low-calorie options, will help them develop positive attitudes toward healthy eating.

AND

Dietitians we consulted supported the expanded choices in the high schools, saying that high school students need the opportunity to use more sophisticated critical-thinking skills. They also told us that high school students need to develop an awareness of how their food and other health choices may impact health later in life.

So come on everyone, they're just trying to help our children with their critical thinking!

They're good people.

Telegrams for Beyond the Grave

So I was all excited to have launched a new feature - Funny Fridays and had a great clip up of Steve Carrell from the Daily Show getting his daily vegetables from "all-vegetable" Crisco.

Unfortunately last night Comedy Central decided to lawyer up and all of their clips on youtube are gone.

So I had to find something else.

In honour of Halloween, here's Afterlife Telegrams.

For just $5, a "terminally ill volunteer" will memorize your telegram and deliver it when he dies.

I'm not making this stuff up.

Team Hoyt

Maybe you've seen these folks before on the blogosphere. I hadn't. I came across them at one of our web developer's blogs

Reading about them on his blog, I thought it must be a hoax.

It's not.

I'm going to do what virtually everyone who's blogged about the Hoyts have done - paste an article in its entirety into my blog. For good measure, I'm also going to throw in two remarkable videos.

To call them inspirational would be an understatement.

Never say, "I can't" again.

(Article from Rick Reilly, Sport Illustrated)

I try to be a good father. Give my kids mulligans. Work nights to pay for their text messaging. Take them to swimsuit shoots.

But compared with Dick Hoyt, I suck.

Eighty-five times he's pushed his disabled son, Rick, 26.2 miles in marathons. Eight times he's not only pushed him 26.2 miles in a wheelchair but also towed him 2.4 miles in a dinghy while swimming and pedaled him 112 miles in a seat on the handlebars — all in the same day.

Dick's also pulled him cross-country skiing, taken him on his back mountain climbing and once hauled him across the U.S. on a bike. Makes taking your son bowling look a little lame, right?

And what has Rick done for his father? Not much — except save his life.

This love story began in Winchester, Mass., 43 years ago, when Rick was strangled by the umbilical cord during birth, leaving him brain-damaged and unable to control his limbs.

"He'll be a vegetable the rest of his life," Dick says doctors told him and his wife, Judy, when Rick was nine months old. "Put him in an institution."

But the Hoyts weren't buying it. They noticed the way Rick's eyes followed them around the room. When Rick was 11 they took him to the engineering department at Tufts University and asked if there was anything to help the boy communicate. "No way," Dick says he was told. "There's nothing going on in his brain."

"Tell him a joke," Dick countered. They did. Rick laughed. Turns out a lot was going on in his brain.

Rigged up with a computer that allowed him to control the cursor by touching a switch with the side of his head, Rick was finally able to communicate. First words? "Go Bruins!" And after a high school classmate was paralyzed in an accident and the school organized a charity run for him, Rick pecked out, "Dad, I want to do that."

Yeah, right. How was Dick, a self-described "porker" who never ran more than a mile at a time, going to push his son five miles? Still, he tried. "Then it was me who was handicapped," Dick says. "I was sore for two weeks."

That day changed Rick's life. "Dad," he typed, "when we were running, it felt like I wasn't disabled anymore!"

And that sentence changed Dick's life. He became obsessed with giving Rick that feeling as often as he could. He got into such hard-belly shape that he and Rick were ready to try the 1979 Boston Marathon.

"No way," Dick was told by a race official. The Hoyts weren't quite a single runner, and they weren't quite a wheelchair competitor. For a few years Dick and Rick just joined the massive field and ran anyway, then they found a way to get into the race officially: In 1983 they ran another marathon so fast they made the qualifying time for Boston the following year.

Then somebody said, "Hey, Dick, why not a triathlon?"

How's a guy who never learned to swim and hadn't ridden a bike since he was six going to haul his 110-pound kid through a triathlon? Still, Dick tried.

Now they've done 212 triathlons, including four grueling 15-hour Ironmans in Hawaii. It must be a buzzkill to be a 25-year-old stud getting passed by an old guy towing a grown man in a dinghy, don't you think?

Hey, Dick, why not see how you'd do on your own? "No way," he says. Dick does it purely for "the awesome feeling" he gets seeing Rick with a cantaloupe smile as they run, swim and ride together.

This year, at ages 65 and 43, Dick and Rick finished their 24th Boston Marathon, in 5,083rd place out of more than 20,000 starters. Their best time? Two hours, 40 minutes in 1992 — only 35 minutes off the world record, which, in case you don't keep track of these things, happens to be held by a guy who was not pushing another man in a wheelchair at the time.

"No question about it," Rick types. "My dad is the Father of the Century."

And Dick got something else out of all this too. Two years ago he had a mild heart attack during a race. Doctors found that one of his arteries was 95% clogged. "If you hadn't been in such great shape," one doctor told him, "you probably would've died 15 years ago."

So, in a way, Dick and Rick saved each other's life.

Rick, who has his own apartment (he gets home care) and works in Boston, and Dick, retired from the military and living in Holland, Mass., always find ways to be together. They give speeches around the country and compete in some backbreaking race every weekend, including this Father's Day.

That night, Rick will buy his dad dinner, but the thing he really wants to give him is a gift he can never buy.

"The thing I'd most like," Rick types, "is that my dad would sit in the chair and I would push him once."

Way to go Hoyts!

Legal Seafoods' Food Porn

Here I go stealing again. This time from the Center for Science in the Public Interest - perhaps my favourite group of non-profit nutritional advocates.

They've coined a term in their fantastic newsletter Nutrition Action. The term is Food Porn. It refers to foods that may well be enjoyable and tasty delicious, but either from a nutritional or a calorie perspective...not so hot.

It's going to be a new periodic feature on the blog.

Today's is example was on the menu last night at Legal Seafoods.

It was a special. Surf & Turf for two. Wanna know what was in it?

A 32 ounce steak, a 2.5lb lobster and 2 side dishes of our choice.

My estimated number of calories - 8000, not including drinks or dessert.

Yum?

It's Nice to Meet one of your Heroes

It's even nicer when they're nice.

When I was first considering changing my professional direction to obesity medicine I did a lot of reading.

One of the first books I came across was Dr. Walter Willett's Eat, Drink and Be Healthy. It's an evidence-based approach to examining what was healthy to eat and why.

I adored the book (it's of course linked on the side).

I read a lot, and continue to read a great deal.

It amuses me how much I look up to these men and women. The ones who do remarkable research, write elegant and intelligent journal articles. The ones who further our understanding of science and medicine.

When I see them in conferences I'm thrilled to be around them. I've even played with the idea of bringing their books and articles to be signed...but then I thought that would be too creepy.

A few days ago I had the pleasure of meeting Dr. Willett and you might say I had the pleasure of stalking him first.

He had a cloud of groupies like me hovering around him after a lecture. I waited and waited to speak with him, but the cloud didn't dissipate. Finally the cloud disappeared but he walked back into the lecture hall.

Following him and trying to look non-threatening, I sat down behind him. At the end of the lecture I asked him if I could have a moment of his time.

You see, Canada's Food Guide is about to be re-released and to my eyes, it is not even remotely reflective of our current best understandings of the role of diet on the prevention of chronic disease.

I've said as much in the House of Commons, but I'm not sure how loud my voice is.

I asked Dr. Willett if he would be kind enough to review the draft guide and offer his expert opinion. After all, in the world of voices on nutrition, there are not many, if any, louder than Dr. Willett's.

He agreed to do so and within 24hrs. had provided a thoughtful review of the Guide.

His conclusions I'll share with you another time (he didn't like it so much), I don't want to spoil this post with data.

This is just a thank you post.

Thanks Dr. Willett.

Penn & Teller's Bullsh!t does NAASO!

So what would you do?

One of your favourite "expose" shows wants to interview you, but the reason you love the show is because it's so entertaining due to how great the hosts are at skewering those dumb enough to be interviewed by them?

Guess I'm pretty dumb.

I love Penn and Teller's Bullsh!t show and when some guys with a camera asked me for an interview and told me they were freelancing for Bullsh!t...well surprisingly it wasn't a dilemma so we'll have to watch in March or April when they do their obesity expose and see if I got on.

As some of you may know, the NAASO - the Obesity Society's annual meeting is probably the largest obesity conference of the year. 5 consecutive streams of presentations with over 2,000 attendees from all over the globe.

Small wonder Bullsh!t came here, because with that many people some of them are bound to put their feet in their mouths.

Thing is I didn't mind being interviewed because I believe in what I'm doing with every fibre of my medical being.

Hopefully they won't make me look any stupider than I actually am.

Hey wait a sec...

My First Million Dollar Idea

Again I'm stealing from bookofjoe. I can't help it. He's a great blogger. He often offers up his million dollar ideas for free to the first person willing to build them.

Well, here, up for grabs, is my first million dollar idea.

Sitting in an obesity conference all day long, you get to thinking about obesity.

Certainly one of the problems with regards to the development of obesity is the fact that if it sets in before the end of childhood, the likelihood is, it's going to stick.

One of the problem with childhood obesity is that the children are themselves consumers. And while you and I hopefully make health a priority in our lives, kids are dramatically swayed by marketing, with corporations preying on our children's unholy attachments to folks like Dora and using her simply to sell the pre-requisite Dora cereal and in general encourage children to consume highly refined, less nutritious foods.

I believe it was Dateline (or maybe 60 minutes...it was one of those shows) that showed children were in fact more likely to choose a rock with stickers of Sponge Bob on it for a snack, than a poor old banana.

Seeing that picture of the laser etched fruit got me thinking....

Why can't we laser etch Sponge Bobs and Doras and all sorts of cartoon characters onto our fruit and vegetables?

Now I know that this isn't going to in and of itself do a heck of a lot to stem the tide of obesity, but hey, if it'll help promote nutrition in our children, and at the same time generate profits for fruit and vegetable growers (both from increased purchase and from folks like Nickoledeon) it certainly can't hurt.

Probably a lot more than a million bucks for the person who can present Disney, Nickoledeon and others a means to market their cartoons on actually healthy products.

It's easier to die than to win at McDonald's!

Hat tip to Fast Food News for their expose on just how unlikely you'll win anything good playing the returning McDonald's Monopoly promotion.

To win even the smallest prize (a small McFlurry, a medium fries or a breakfast sandwich) your odds are 1 in 7.2 (that's seven nutritious trips to McD's!)

It gets more fun when we forget about the food and move on to the bigger ticket items.

Your odds of winning a Sony home theatre and flat panel HDTV are 1 in 91,697,000!

Your odds of winning a trip to Vegas are 1 in 114,621,250!

Your odds of winning a $50,000 prize are 1 in 3,500,000,000!

Your odds of winning the $5,000,000 grand prize are 1 in 41,497,391,309!

To put this in perspective for you I turned to the National Safety Council.

Buckle your seatbelts; you are 4,994 times more likely to die in a car accident this year than win the TV.

Hold onto that bannister; you are 625 times more likely to die falling down stairs this year than win the trip to Vegas.

Maybe drinking's not so fun; you are 4,729 times more likely to die from accidentally choking on your own vomit this year than win the $50,000.

and lastly....

Maybe move to Slovenia; you are a staggering 2,529,865 times more likely to get murdered this year than win the $5,000,000 grand prize.

Ain't stats grand?

Calories from your toolbar!

Readers of this blog will know that I'm a strong believer in knowing about calories.

I don't believe in good calories or bad calories, I just think they're a good thing to be aware of.

The fact is, the currency of weight is calories. While certainly every single body is different and there are genetic differences in the ways people gain and lose weight, there's no doubt that in order to lose weight you need to eat fewer calories than you burn and that in order to gain weight you have to eat more calories than you burn.

For those reasons, I think it's a good idea to know calories. The analogy I like to draw upon is money.

Before I slap down my credit card, I like to look at the price tag of whatever it is I want to buy. Doesn't mean that price is the only thing that affects whether or not I'll buy something, but it definitely will factor into my decision making process.

Same thing for me with calories.

Knowing the calories in a food before I consume it factors into my decision as to whether or not I think it's worth it.

Calorie king, a brand and a website is a great place to look up calories, and I recently discovered that they've got a toolbar that installs with both Firefox and Internet Explorer where you can look up calories right off your toolbar.

Thanks Calorie King!

Hurray for Disney!

Wow, never thought I'd utter those words!

Today Disney issued a press release stating that by 2008 it will have placed voluntary limits on trans fats, added sugars and remarkably calories in not only its theme parks but also its licensed and promotional products.

This is fairly remarkable stuff considering Disney has a very lengthy history of helping sell fast foods, sugared cereals and more and they have capitalized for literally decades on the inherent trust with their brand name.

Kelly Brownell, in his excellent book Food Fight (linked on the sidebar), recounts a story one of his colleagues told him about their four-year-old daughter at the supermarket seeing Betty Crocker's Disney Princess Fruit Snacks with Cinderalla, Snow White and the Little Mermaid on the box.

Daughter: "I Want that."
Mother: "What is it?"
Daughter: "I don't know."

Bottom line, Disney's got a lot of clout in the Supermarket.

Good on ya Disney.

Don't Drink the Cough Syrup!

A patient asked me yesterday how many calories were in cough syrup. She'd been sick for a week and figured that she's been going through close to 8 teaspoons a day.

You know, I'm not usually surprised by calories.

This time I was floored. 15 calories per teaspoon!

Doesn't sound like much to you?

Drop per drop cough syrup has ELEVEN times the calories of Coca Cola!

To put that in perspective, my patient, by having the recommended maximum of 8 teaspoons a day, was drinking the equivalent number of calories of 1.2 cans of Coke.

There is some good news. There are sugar free cough syrups out there. I found one from Robitussin. I love their description of the product, it's almost a Quobesity,

"Robitussin® Cough Sugar-Free DM is specially formulated for diabetics, and health conscious consumers"

I can't completely disagree with them.

What they're inferring of course is that if you're not health conscious, feel free to choose their other cloyingly sweet, ridiculously high in calorie, products.

Quobesity

Last week was my wife's birthday and as per our family's tradition, she picked her dinner of choice.

Just because I practice obesity medicine certainly doesn't mean I'm a perfectly healthy eater, nor do I preach to my patients that they need to be. It's about living the healthiest life a person can enjoy, not living the healthiest life there is.

I believe that one of the worst things someone trying to lose weight can do is to irrationally restrict dangerous foods. Doing so creates what I call "forbidden foods" which in turn have been shown by Christopher Fairburn to be very common triggers for binge eating (His book, Overcoming Binge Eating is linked on the sidebar and is certainly the best self-help book for binge eating disorder ever written).

What can happen to folks with forbidden foods is that when they do finally decide to have some, not knowing when they'll get some next, they tend to binge on it. Often post-binge guilt is tremendously demoralizing and may lead a person to in fact binge more due to the now severe emotions, and those binges can sometimes lead a person to abandon their weight loss effort altogether.

In my practice I've literally written prescriptions for chips, chocolate, ice cream, pizza, chinese foods and more so as to get rid of the notion of danger foods.

There's a simple question to ask yourself about any high-calorie food, "What's the least amount of ______ I need in my life to like my life".

We ordered from a local place that truly makes great Chinese takeout.

Today's Quobesity comes from the front of the menu.

I highlighted it to help you read it.

It reads,

Healthy, low fat foods, cooked in 100% vegetable oil

Let me tell you, that food was dripping with health!

Should you Weigh Yourself Daily?

Yesterday's New England Journal of Medicine reports a study conducted by one of the biggest names in weight maintenance research - Rena Wing.

Rena heads up the National Weight Control Registry along with another fella named Jim Hill. The Registry was established in the 90s to help flesh out the factors involved in successful weight loss maintenance. To get into the registry you must have lost 30lbs and kept it off for 1 or more years.

The article in NEJM looks at the application of a maintenance program delivered either via telephone, the internet or face to face.

Not surprisingly, those with more face time were better at maintaining their weight loss.

The media however has picked up on another statistic from the article - those that weighed themselves more frequently seemed to keep the weight off better.

Having heard Rena present her findings at last year's American Heart Association Obesity Lifestyle and Cardiovascular Disease Symposium (which by the way was one of the best basic overviews of obesity I've ever been to and it's available online here for free!) I asked her what I thought was an important question.

What I wonder is whether or not success leads to daily weighing or whether daily weighing leads to success?

What I mean of course is I would imagine that those folks doing well with their lifestyles, would be more likely to use the scale to reinforce their successes, while those doing poorly may in fact be reticent to step on a scale for fear of what it might tell them.

Where there's no doubt is the fact that nipping weight regains in the bud is integral in successful weight maintenance.

What I would also like to point out is that while you're losing weight, I'm not a fan of daily weigh-ins. The fact is that weight fluctuates quite dramatically due to water retention, constipation and clothing and therefore daily weighing can at times be incredibly demoralizing as you might feel you're doing everything right and the scale shows you're up in weight.

I usually recommend that during weight loss, weigh once weekly, stark naked, Wednesday mornings (so as to provide a buffer from the weekend), and while I still don't know who's the chicken and who's the egg with daily weights during maintenance, I do recommend to my patients that once they've stopped losing weight, stepping on the scale daily and watching the trend can be very helpful.

I think it just keeps a person's head in the game, the fact is if you've got a body that has the genetic gift of being able to store calories for the future, it's not a terrible idea to track where you're at.

Put your Health Check where your Mouth is!

I don't know if the Heart and Stroke Foundation folks read my blog, but if they do, this post won't be news to them.

Over one year ago now, I first met with some of the great folks over at the HSF to discuss their obesity platform.

The HSF has done a bang-up job of getting involved in educating the public about the risks of obesity, and likely has steered some to seek help with weight loss.

The good news stops there.

Problem is that without any guidance on where to go for help with weight loss, and with so many unethical, non-evidence based, commission paying, product pushing, weight loss scams and snake-oil salesman, likely the HSF is helping to market consumer fraud.

Even worse, because most patients tend to blame themselves for their failures at weight maintenance (even if the blame lies with the program), the HSF may actually make it less likely for people to effectively treat their weight as they may see their most recent failed attempt as their last.

It's been a year since I presented my arguments to the HSF. At the time they seemed very genuinely interested in discussing the potential use of the pre-existing Health Check program (currently being used to identify "healthy" foods in groceries and restaurants) to weight loss programs - that way consumers could look to see if the weight loss program they were considering was ethically and scientifically sound.

They invited me to come and speak at one of their policy planning meetings, but then a month prior told me that I got bumped to the next meeting, I then got bumped again and I haven't hear back from them.

Next I took this idea to the Canadian Obesity Network and again received a great deal of interest and in fact they ran a straw poll where over 75% of respondents thought it was a good idea for them to provide weight loss program ratings.

Unfortunately nothing has happened since then.

I find it very confusing that public health agencies and nutritional advocates make such strong (and often scary) statements about the risks of obesity and then do nothing to help guide patients to responsible weight loss programs.

Someone has to step up.