Monday, January 24, 2011

Study Suggests Health at Every Size is Supported by Scientific Evidence; Weight Loss Focus is Ineffective and Harmful

University of California, Davis, January 24, 2011 - Dieting and other weight-loss efforts may unintentionally lead to weight gain and diminished health status, according to two researchers, including a UC Davis nutritionist, whose new study, Weight Science:Evaluating the Evidence for a Paradigm Shift, appears in the Jan. 24 issue of the Nutrition Journal, an online, open-access scientific journal.

Rather than focusing on weight loss, the researchers recommend that people focus on improving their health status.

HAES book cover 2nd Ed
In the new study, co-authors Linda Bacon, an associate nutritionist in the UC Davis Department of Nutrition, and Lucy Aphramor, an NHS specialist dietician and honorary research fellow at the Applied Research Centre in Health and Lifestyle Interventions at Coventry University, England, cite evidence from almost 200 studies.

"Although health professionals may mean well when they suggest that people lose weight, our analysis indicates that researchers have long interpreted research data through a biased lens," Bacon said. "When the data are reconsidered without the common assumption that fat is harmful, it is overwhelmingly apparent that fat has been highly exaggerated as a risk for disease or decreased longevity."

Bacon noted that the study findings do not support conventional ideas (or popular myths):

    Myth = Weight loss will prolong life.
    Myth = Anyone can lose weight and keep it off through diet and exercise.
    Myth = Weight loss is a practical and positive goal.
    Myth = Weight loss is the only way overweight and obese people can improve their health.
    Myth = Obesity places an economic burden on society.

"The weight-focused approach does not, in the long run, produce thinner, healthier bodies," said Bacon.

"For decades, the United States' public health establishment and $58.6 billion-a-year weight-loss industry have focused on health improvement through weight loss," she said. "The result is unprecedented levels of body dissatisfaction and failure in achieving desired health outcomes. It's time to consider a more evidence-based approach."

Aphramor added: "It's the unintended negative consequences that are particularly troubling, including guilt, anxiety, preoccupation with food and body shape, repeated cycles of weight loss and gain, reduced self esteem, eating disorders and weight discrimination."

Health-focused alternative
Concluding that the weight-focused approach to health is unsupported by the scientific evidence and has in fact been detrimental and costly, Bacon and Aphramor suggest the health care community should adopt what they say is "a more ethical, evidence-based approach toward public health nutrition" -- one that instead encourages individuals to concentrate on developing healthy habits rather than on weight management.

The researchers stress that evidence shows that changing health behaviors can sustainably improve blood pressure, blood lipids, self-esteem, body image, and other indicators of health and well-being, independent of any weight change and without the negative aspects of weight-focused approaches. While weight loss may result, the goal is self-care rather than weight loss, they say. This weight-neutral practice has become known as Health at Every Size.

"It is clear from our review of the data that body weight is a poor target for public health interventions," Bacon said. "Instead, the health care community should shift its emphasis from weight-management to health-improvement strategies, for the well-being of people of all sizes."

Bacon is the author of the 2010 book, "Health at Every Size: The Surprising Truth About Your Weight," based on previously published research. She also is the founder of Health at Every Size Community Resources

Financial Disclosure: Aphramor received financial support for this study through a West Midlands Nurses, Midwives and Allied Health Professions research training award. Bacon and Aphramor are both Health at Every Size practitioners and sometimes receive financial compensation for writing and speaking on this topic.
Quick Links

Kelly Bliss answers Rachael Ray: You lost weight doing what?

In Today's show, Rachael Ray and Linda Evans commented on how awful it is for very thin people to have to "give up themselves" to maintain that painfully thin weight.  I had to write the show.  The only topic that I could find was the one below, and so this is what I wrote to Rachael:
Topic:  You lost weight doing what?
Subtopic:  Today Rachael and Linda Evans talked about people who are very thin having to “give up themselves” in order to maintain that weight.  There are people of all sizes who would have to live painfully regimented lives in order to maintain a weight lower than their natural set point.  And some of these people are medium and some are plus size.  Please consider doing a show on “HAES”, health professionals and activists who focus on health… at every size

Now back to the main topic to illustrate my point:  You lost weight doing what?
** At age 13 I lost weight by not eating anything at all for a week.
** At age 15 I lost weight by only eating grapefruits for a month.
** At age 19 I lost weight by eating only 1000 calories per day
** At age 22 I lost weight by participating and then teaching “Safe Slimming” 
    (A Pennsylvania State University program much like Weight Watchers™)
** At age 23 I lost weight by throwing up 6 times a day and ruined my health.
** At age 24 I lost weight by running 3 hours a day and ruined my feet.
** At age 25 I lost weight by running a marathon and damaged my knees for the rest of my life.
** And then I vowed never to try to lose weight again and reclaimed my health and fitness.

In the 1980’s I became a personal fitness trainer and psychotherapist who focuses on health, not weight.
In the 1990’s I recovered from a serious head injury where I learned to talk and think all over again.
In 2011 I participated in the New Year’s ReVolution with a focus on Health At Every Size 

Please consider doing a show on the choice to focus on the ACTIONS of healthy living and body appreciation, instead of weight loss.  Please!  Nobody should have to live obsessively and give up themselves to maintain a lower weight which is not natural to them.  Thank you so much for considering this.  If you want to read more about this HAES concept, check out:

Sunday, January 16, 2011

4 Moves for Better Knees ...

Wow! Yesterday's personal fitness training group was a GREAT workout!  I was so happy with how much better my knees felt.  I have been doing extensive training to strengthen and tone my quadriceps and it is paying off.  While it is true that I have bone on bone osteoarthritis (that began at age 25 from running 3 hours a day), I have been able to reduce the pain by staying fit. 

You see, when my thigh muscles are toned that means the individual muscle cells remain contracted, even when at rest.  This keeps my thigh muscles more firm and helps increase the space between femur (upper leg bone) and tibia (lower leg bone).  This prevents my bones from "grinding" into each other even though I have very little cartilage left.  If you have knee pain, keep your legs strong and toned.  This will help you too.

Here is HOW I maintained and increased my leg muscle tone even when my knees were very injured by connective tissue tears and I could not walk.  I tell you this because you may know someone who also has mobility issues and needs movement that is extra gentle yet effective.  This is the work I have been honored to do with many clients who went from not being able to walk to walking quiet well.  (You may enjoy this story of going from wheel chair to dancing.)

The starting position for all of these is to Sit in a chair in good posture with your feet flat on the floor.

#1.) Heel Presses:  While sitting in good posture, press your heels down.  Can you feel your thighs and buns contract?  Good for you!  Now do as many as you can until your muscles are fatigued.  Take a break and then do it again.  You will enjoy this more if you put on a good song.  -  Continue this for a week or so, a few times a day, until you build strength enough for ...

#2.)  Almost:  While sitting in good posture, reach your arms out in front of you as a counter weight, and ALMOST get up out of the chair.  Just put weight on your feet and lift your butt so it almost lifts off the chair.  Then sit back down.  Go as slow as you need to feel knee stability.  Continue until your thigh and butt muscles are fatigued, then rest and repeat.    -  Continue this for a week or so, a few times a day, until you build strength enough for ...

#3.)  Little Bit:   While sitting in good posture, reach your arms out in front of you as a counter weight, and get up out of the chair a LITTLE BIT.  Maybe lift your butt an inch or two and then sit back down.  Go as slow as you need to feel knee stability.  Continue until your thigh and butt muscles are fatigued, then rest and repeat.    -  Continue this for a week or so, a few times a day, until you build strength enough for ...

#4.)  Get on Up and Do It Again!:  While sitting in good posture, reach your arms out in front of you and GET UP, then sit back down.  (This was a song in the 1980's by Suzy Q.  It has a great beat for this workout.)  Continue until your thigh and butt muscles are fatigued, then rest and repeat.    -  Continue this for a week or so, a few times a day, until you build strength enough for ... LIVING WITH BETTER MOBILITY AND LESS KNEE PAIN!

P.S. When you shop online, please use my links on www.PlusSizeYellow because this helps me get closer to affording to put all these exercises on video and post them for you!

Friday, January 7, 2011

Weight Watching is an ANXIETY, not an action...

Why does almost all dieting result in yo-yo dieting?  There are many reasons.  Scientists clearly do not know much about the human set-point or weight regulating mechanism.  However, we do know this mechanism exists.  There are scads of studies that demonstrate the power of the set-point**.  We also know from studies and experience that serial dieting causes increased weight over time.  There are many things that effect our weight over which we have no control.  But there are also many things that effect our WELL BEING that we can influence.  Let's look at how the common choice to focus on weight loss sabotages our self-care.

I had the misfortune of watching a few minutes of Dr. Phil yesterday.  He had some guy on with a 14 day plan (or was the magic number 17 days).  They said that people who are trying to lose weight always plateau (that is the set-point asserting itself).  To break the plateau, this diet monger says we need to change the formula for the way we eat every 17 days. Count calories.  Change your count on different days.  Some foods are forbidden. Keep track.  Focus.  Pay close attention to every mouthful (that is the only way to get an accurate calorie count).  Excuse me, but this sounds like eating disordered thinking to me.  This kind of obsessive playing with food and concentration on rituals often accompanies eating disorders.  Indeed, it requires eating disordered thinking to push past the body's set-point.  In order to achieve a temporary, cosmetically desirable weight, people will do the darnedest things.  

When you focus on weight, it is likely that you will end up eating less than you could maintain long term and exercising more than you could sustain for a lifetime.  This Herculean effort can only be sustained for weeks, months, or maybe even years for most people.  Then when normal life resumes, the body resumes its normal weight.
There is a better way to improve your health, reduce joint pain, level out blood sugar, improve energy, and feel better about your body.  Try focusing on the ACTIONS OF HEALTHY LIVING, instead of the scale.  Engage in problem solving so that you build a life that really meets your needs.  (Instead of spinning and spinning on the next weight loss scheme.)

When you focus on your nutrition, enjoyable movement, stress reduction, and sleeping better ... all INDEPENDENT OF WEIGHT, you can make choices that are livable.  Without the pressure from the scale, you can choose a reasonable amount of exercise and develop quality, tasty nutrition that you can live with for a lifetime.  Because your changes will be gentle and doable, you can maintain them even when life stressors happen.  And life stressors always happen.

Watching your weight is an ANXIETY, not an action.  Self-care is an action that can stay with you for a lifetime.  Self-acceptance is a journey that sometimes takes a lifetime.  It is worth the trip.

** Studies that show the power of the weight regulating mechanism
Journal of the American Medical Association 295 #1 (2006): 39-49.
Journal of the American Medical Association 297 #9 (2007): 969-77.
NEw England Journal of Medicine 338 #1 (1998): 52-54.
International Journal of Obesity 22 (1998): 89-96.
International Journal of Obesity 20 #1 (1996): 47-55.
International Journal of Obesity 18 (1994): 145-54.
American Journal of Clinical Nutrition 70 (1999): 965-73.
NIH Technology Assessment Conference on Methods for Voluntary Weight Control (1992).

Monday, January 3, 2011

I started using trekking poles because my knees hurt ... from fat prejudice.

OMG!  You will not believe how cool these trekking poles are.  First, they REALLY take the pressure off of your knees when you walk.  But mostly they are FUN!

I started using trekking poles because my knees hurt ... from fat prejudice.  Yes, that is what I said.  My knees did not hurt from my weight, but rather from fear of fat (when I was younger) and fat prejudice in our culture.

Back when I believed the cultural myth that anyone could be lean if they just exercised more and ate less, I used to run three hours a day.  That is the amount of compulsive, eating disordered exercise that was necessary to keep me less fat.  (Even at that level of exercise I still counted as "overweight" by the ridiculous BMI charts.)  While running three hours a day my knees began to hurt.  What did the doctors tell me to do for my hurting knees?  They told me to lose weight.  So I ran more.  I ended up running a marathon at age 25 and being diagnosed with osteoarthritis of the knees when I was 26 years old.  So you see, my knees have hurt most of my life ... from fat prejudice.

Back to trekking poles:  Whether I am walking through the Lansdowne, PA streets or hiking in one of our many parks, when I use my trekking poles I am sharing the work between my arms and legs.  It really reduces the stress on my knees and gives me a great workout in my arms too.

When I work with Lifestyle Coaching clients who have knee problems or balance issues, I often recommend they try this fun way to go walking.  I have gotten many rave reviews from those who have taken my suggestion.

When you go to this site and enter "trekking poles" in the search, you will find several selections.  The price range is from about $20 to $80.  I also made some poles that worked pretty well out of bamboo stalks.  But I had to keep replacing he rubber tips so often and repairing my homemade hand grips that I just bought a pair of real trekking poles.  The real ones are MUCH better to use.

Sunday, January 2, 2011

The truth is that people of all sizes get OSA (obstructive sleep apnea).

After being on a special super-high-fat diet for my epilepsy, I was at my lowest weight in decades.  That is when I was diagnosed with OSA (obstructive sleep apnea).  I mention this because people falsely assume that only fat people get sleep apnea.  This is a dangerous assumption because it can prevent lean people from getting tested even when they show symptoms.  And it can prevent fat people from getting tested because they feel guilty that their fat caused the problem.  The truth is that people of all sizes get OSA.

I was determined to find a treatment that included self-care and self-acceptance ... not the party line that includes a recommendation to lose weight.  Losing weight is NOT AN ACTION!  Eating healthy and exercising are actions ... and I already was doing those.  I was not going to go on a restrictive, deprivational diet and exercise compulsively to be smaller than my natural weight.  Yo-yo dieting was not going to help my OSA.  And all dieting is likely to be yo-yo dieting.  I wanted to find a real solution to my health issue.

I was unable to tolerate the CPAP for many reasons.  I really tried.  As  matter of fact, I am so good at resolving issues with CPAP that I often coach clients through the process until they can use their own CPAP comfortably.  For myself, I simply could not use this option because the CPAP gave me a constant headache 24 hours a day.  Even my most ingenious problem solving did not help.  I kept searching for alternatives.

I am happy to tell you, that after years of research, I found a simple treatment solution that completely resolved my OSA.  Instead, I wear a little oral appliance that moves my jaw forward and I had my soft pallet stiffened with Pillar Implants. Each one improved my breathing substantially, but did not give complete relief.  Both of them together totally resolved my severe OAS.  I was thrilled when my sleep study confirmed ZERO apneas per hour!!

It turns out that many people never get tested for sleep apnea because they simply do not want to use the CPAP.  50% of those who are prescribed CPAP do not use their machines.  We really need better means of treatment.  If you have or fear you might have OSA, please do the problem solving so that you can wear your CPAP or look into these alternative treatments.  Please check out my site where I have written up the process for getting your own oral appliance and soft pallet implants.

Self-care means getting treatment for those illnesses or conditions that effect your life.  Instead of embarking on a yo-yo diet experience, participate in problem solving for your self-care and self-acceptance.  My quality self-care paid off on this one.  It was a long and arduous process.  If my journey can save you some time and effort, I am honored to share my story.

Saturday, January 1, 2011

Have you seen the New Year's Revolution?

You must check out  the New Year's Revolution!  This concept may change your life.  At this time of year, we are pummeled with body attack ads that promise our whole lives will be better if we only lose weight.  

Don't fall for it.  You can make your life better right now, independent of weight.  Give yourself a better day today with self-care and self-acceptance, and you will be one day closer to a better life.  (If you fall for the hype and begin a diet, you know where you will be?  You will be one day closer to your next binge or your next yo-yo diet heart break.)

What makes it so scary to let go of dieting?  Fear.  The diet industry has spent billions of dollars to convince us that the opposite of dieting is overeating and "letting yourself go".  That is bunk!  Overeating and giving up on your self-care are reasonable REACTIONS to the frustration of watching your weight.  They are the other side of the coin to dieting, not the opposite.  

If you want to get off the body hate and yo-yo dieting merry go round, then embrace self-care instead of weight loss goals.  Appreciate your body instead of criticizing it. A new study published in the journal Obesity, suggests that weight stigmatization can lead to avoidance of exercise.  Yes, when you embrace the cultural hatred of fat bodies, then you are setting yourself up to avoid some of your important self-care ... movement and exercise for the pleasure of it.

When you focus on Health At Every Size℠, you are not letting yourself go.  You are committing to self-care.  Look at these 5 principles of HAES℠.  

1. Accepting and respecting the diversity of body shapes and sizes.
2. Recognizing that health and well-being are multi-dimensional and that they include physical, social, spiritual, occupational, emotional, and intellectual aspects.
3. Promoting all aspects of health and well-being for people of all sizes.
4. Promoting eating in a manner which balances individual nutritional needs, hunger, satiety, appetite, and pleasure.
5. Promoting individually appropriate, enjoyable, life-enhancing physical activity, rather
    than exercise that is focused on a goal of weight loss.
That IS healthy living.  This year, join the New Year's Revolution, instead of yo-yo dieting!

I'm coming out ...

I will not get sucked into the body hate and diet industry this January.  Instead I will focus on my self-care and self-appreciation.  For my PERSONAL New Year's Revolution, I am coming out. This is difficult. I used to say I was "Fit and Fat". I used to consider myself an example that helps show the fat people can be healthy.  I did lots of TV, radio, and news interviews.  I enjoyed defending fat people against the prejudice and hate that is so often directed at us.   I was shocked by the amount of hate emails I got as a result of that interview.  I think it was fear of that hate that kept me in the closet these past few years.
So now, I am out of the closet ... I am not healthy any more. The Universe is teaching me that health is a fleeting thing (for people of ALL sizes!) So for the new ...year, I am coming out of the closet as a person with health issues. I may be fit and fat. But I am also coping with epilepsy, OSA, PLM, osteoarthritis, and something that is melting my tendons in my wrists and knees. Gees, I feel silly, but I am sitting here crying over this. I have been pretending and hoping all this would go away.  I kept waiting until I had my health issues solved and then I was going to write on it.  I cannot wait any longer.  People need the information I have gathered.  It is scary to come out, but today I am.  I am coming out as a fit and fat woman who also has health issues.
Guess what?  People of all sizes have health issues.  I realized as I was working with my Lifestyle Coaching clients that both fat and thin people need to do problem solving regarding health issues.  The information I have learned on my own journey toward wellness is important to share. The information I have learned from my clients as we participate in their problem solving process is important to share.  So check back often as I talk about problems and solutions to all sorts of health issues.  And thank you in advance for your acceptance as I come out of the closet.  Maybe we all can become more appreciative of and loving toward our bodies.  After all, this is the only body we've got!