Ms. Harrison is right about the failures of fat shaming, but her response to the last comment is a stretch. Can making a 350-pound teenager feel bad about the weight really be what causes the joint damage? Is it coincidental that the rise in so many ailments has corresponded with the rise in weight?
I still have a few of the cereal bowls that were part of the china set my mother got as a wedding present in 1952. They're minuscule compared to any you'd see today.
The best diet advice I ever got was from a Chinese man I knew while living there in 1985. Mr. Wong, thirty years my senior yet with a physique and energy level superior to mine, said this: "Better to always be a little bit hungry."
30
@Bridgman
There's a saying in Japanese: "eat till you're 80% full." It's the same basic idea (though actually even smarter, because it recognizes that there's a time lag between eating and feeling full, so by aiming for 80% you end up feeling full instead of overfull 20 minutes later).
5
@Bridgman The early, very athletic Hollywood actor Douglas Fairbanks was asked how he stayed in such great shape; he said he always got up from the table still hungry.
“Intuitive eating” makes as much sense as “intuitive heroin use”. We have millennia of privation driving our lizard brains in this very recent era of caloric over abundance.
9
Funny...and correct.
These comments are really depressing - willful or feigned, or worse, just plain real ignorance about what intuitive eating means. Such dismissal with scorn.
I agree it sounds a bit buzz wordy. I don't like the slick look of the website the author is linking to. But there is nothing intuitive about eating past the point of satiety. Intuition doesn't equal desire. Intuition means listening to your body's cues about how hungry it is. It may further mean trying to discern WHAT it's hungry or not hungry for - for example if we're in a carb coma, or if that salad wasn't satiating so maybe we should have added some protein or fat.
It's NOT about listening to the brain's cues about what would be fun or comforting or interesting to eat. It's a physical consideration, not an emotional one.
I feel very concerned that so many people may be so divorced from their being that they would dismiss the concept with such hostility.
21
@Sarah Fat shaming is wrong, being mean for any reason is wrong, but some of us here truly believe that it’s unhealthy to carry too much weight. Some of us have years of professional observation of the adverse effects of obesity; we’re not just flapping our gums simply to see our comments in print. Any advice that ultimately gives severely overweight people implicit permission to keep all that weight on strikes us as terribly wrongheaded, as does any suggestion that no one — no health care provider, no friend or family member — should ever bring up the issue of someone’s severe overweight, that that person’s self esteem is always more important than their physical well-being.
11
@Frank - No one needs to give severely overweight people permission to keep all the wieght on. They're going to keep it on anyway. That is the point - short of surgery, no one has figured out a way to make more than about 10 % of obese people become and permanently remain thin.
10
@Frank -- then what's the solution, Frank?
Diets haven't worked. Shaming doesn't work.
Medical treatments are incredibly expensive, in great part because insurance companies deny treatment on the basis that obesity is simply a "lifestyle" disease that you can solve by eating more salad and taking a walk once in a while.
What's the answer?
2
I know christy does not promote weight loss or having a standard BMI body as a goal. I get that.
But—I think the best way to raise children with non-overweight BMIs is to follow ellyn satters division of responsibility and model intuitive eating and body acceptance yourself. A child who eats when hungry, has pleasant family mealtimes with tasty food, and doesn’t become neurotic around food—will also, most likely, be a child who isn’t overweight.
I do think your work is so important. And as a parent, I am working very hard never to exhibit my lifelong diet culture mindset around my child. A work in progress but one I hope will lead my young daughter not to waste her precious youth on diets and pointless self hatred.
24
Maybe it's just that a healthier society raises healthier kids. As a kid from the 60's-it was safe enough to play outside all day. We came home when it got dark. As kids we walked everywhere adult-free. When we got hungry-we ate fruit from each other's yards in the neighborhood. You don't miss it til you lose it.......
25
I am sad to see the mischaracterization of the Kurbo app which was acquired by Weight Watchers. I was a Partner at a large benefits consulting firm for many years and am familiar with the challenges around weight loss and the many solutions that are out there on the marketplace.
There is no body shaming involved in the Kurbo app. Maybe people feel that way about weight management but it’s not a characteristic of the solution. And the goal of the app is not to get every kid tracking their food. It’s really to help a subset of children who are becoming overweight learn how to eat in a more healthy way. The concept of intuitive eating that Christy talks about is wonderful but many of those struggling with weight don’t have access to that type of intuition.
The red-yellow-green system within Kurbo is not about good and bad; it’s a simple gamification approach to guide kids to eat more of the green foods, only a little of the yellow and less of the red foods (soda, chips etc). In fact the system does not stigmatize any type of food, this was one of its major selling points. You can actually eat everything, you’re just encouraged to eat more of the greens and less of the reds.
Employers that I worked with implemented Kurbo, and the feedback from employees was very positive. In fact we had adult employees asking for access to the app as it was initially rolled out only to kids. If you have access to it I would urge you to use it yourself and draw your own conclusion.
21
@Sharmila The problem with the app is that it puts the responsibility for a problem that was created by adults on the backs of children as young as 8. It's one thing for teenagers who choose to do WW to use it. But it's awful to give this to young children. Children do not buy the food for the household. They rarely cook it. They don't portion it out. Unless the parents take responsibility for the food being served and the portions it is served in, the problem will not go away.
9
A pediatrician put me on my first diet at age 7 and now at 65 I can say I have essentially lived on a diet ever since, a war with food occupying far too much of my life. I am slim but at what cost? I wrestle with the idea that this natural way of eating could possibly work but applaud the healthier way of living that could be the result.
16
I have struggled with my weight as an adult, though I was an average-sized child. I've been thin and I've been overweight and even briefly obese. I hear my mother's voice in my head (she's been gone for 11 years) telling me that if I eat like that, I will be fat, as though that is a fate worse than death.
I have always thought that it made more sense to eat whatever I enjoyed in reasonable portions than to put any healthy foods off-limits. When I do this successfully (I have to keep a food diary), I lose weight and keep it off.
But please, don't shame me for being fat or for being thin, which also happened to me when I was a normal weight for my size. My weight is really no one else's business.
19
@Barbara I have no idea how much you weigh so I won’t comment on it. But the health condition of anyone affects everyone.
Thank you for the first op-ed and this follow up article. I have weight cycled for all of my adult life. When I finally learned about and then studied intuitive eating my life changed. I was able to truly evaluate all those crazy diet rules and restrictions that had become part and parcel of every meal I ate. I am not totally free of that voice telling me about good and bad foods, but I am getting there. I am now eating healthier and exercising by choice because I know that no food is off limits. You will get a lot of people hating this article, but please keep letting us hear your voice.
20
Have you tried changing to a low carb diet and not paying attention at all to calories?
2
@Dan
Sorry Dan but I LOVE my dessert and am not a meat lover. It works much for me to eat what I want in moderation. I had a rocky period in my marriage where I lost over 20 pounds since I had no appetite. I ate anything I normally ate just far less of it. One quarter of a sandwich, a small serving of dinner, a sliver of dessert. Guess what? The weight melted off and I wasn't really overweight to begin with, just at the upper range of recommended weight. I started at 125lbs and ended at 103. No magic diet, just less consumption. We eat TOO much. If we consume less of everything we lose weight. It's not rocket science and no food is taboo.
Good for you that keto works, but it's not for everyone. Some of us just have to have our pasta, our homemade bread with a smidge of butter or a modest slice of heavenly dessert!
My father was type two diabetic. He controlled his diabetes completely by diet and lived to 85 with no high blood pressure, no neuropathy, no medications. He ate anything he wanted in moderation, his favorite being Kayem Old Time Franks. But instead of eating 3 he ate one. He never changed his sedentary lifestyle, taking his daily snooze on the couch. All he changed was the amount of food he ate. His body became used to less food and he never felt deprived. No keto, no Atkins, no cabbage soup diet. Just good ole common sense.
4
I love food. All kinds of food - french fries just as much as cauliflower rice. I have always been an intuitive eater, and have been LUCKY to have weighed within /- 5 pounds of a healthy weight for 35 years, since puberty. I raised my 2 daughters to eat intuitively, from the time they were breastfed, then added fresh produce, fish, dessert, fast food, etc...Our entire family was also physically active and we all maintained a healthy BMI - until my oldest’s 14-yo checkup: At that appointment, the pediatrician told her to snack less and avoid junk, and thus threw her into the depths of an eating disorder...She started as an orthorexic (obsession with healthy eating) and ended 4 years later in an inpatient ED ward. In a society where kids live on their smartphones, the idea that an app can warn them of ‘dangerous’ foods is horrifying to me; I’m relieved that the ED community is speaking out against it. Childhood is a time to develop core body image and self-confidence, and a healthy relationship with food and our bodies. Genetic diversity gives us different metabolisms and mental health, and this translates to different body sizes and mechanisms for dealing with anxiety. My daughter is in active recovery from anorexia now, working with a nutritionist and hoping to re-learn how to eat - intuitively. She dreams of living someday without constantly thinking about food... I want desperately to believe that intuitive eating works for all, but how can we be sure?
25
@Sad Mom-The doctor must have thought your 14-year-old was getting heavier than was healthy. Did you expect the doctor to ignore a health problem? Telling her to cut out some junk food is a pretty benign comment. The fact that your daughter became orthorexic and then anorectic is part of your daughter's personality, the doctor was not the cause. By today's standards, everyone has an eating disorder. People are damned if they eat a healthful diet and damned if they don't.
8
@S.L., in fact, my daughter was exactly on her growth curve, an athlete so very active, and whose health was dependent on the nutrition she was intuitively consuming. Her doctor simply didn’t believe in intuitive eating, and advocated for a more “controlled” diet. You’re right that my daughter’s personality turned this challenge to control her intuitive cravings into an eating disorder. You’re also right that, by today’s standards, nearly everyone has “disordered eating” (very different from an eating disorder). However, it’s exactly because of this that our health care providers need to be much better educated in how to manage this in each of their patients - one unique patient at a time.
13
@sad mom-This was my experience exactly except it was the middle school nurse and my daughter was 12. As is typical she began “filling out” (hips, breasts) just before getting her period and growing 5 inches in 18 months. But the damage was done. Her sophomore year of college was spent in a PHP (Partial Hospitalization) program for eating disorders with a months long waiting list.
Her struggle was compounded by college requirements that for her first 2 years she 1) live in a dorm with a roommate and 2) be on the expensive meal plan that offered horrible unhealthy cafeteria food or every fast food you can imagine.
The neurobiology behind eating disorders is alarming and widely unknown among health care practitioners. Also many widely prescribed anti anxiety meds frequently given to teens are known triggers of EDs. When I shared the latest research about ED diagnosing and treatment with my MD nieces they were amazed at the change in protocols from when they were in med school just 8 years ago.
5
This is my intuitive eating: eat all the food.
This is completely ridiculous. The problem is the poor quality of our food in the US due to industrial farming, the use of chemical pesticides, fertilizers and hormones in all our food, and processed food. When I'm on vacation in, say, France, I eat whatever I want and never gain an ounce.
Children are fat because there is very little good, nutritious food available. Organic food is very expensive, and working parents often have little choice but to use processed food that is quick to prepare. Many Americans live in food deserts where snacks and processed, prepared food is all they have.
Our food situation and obesity are another failure of Regulation, and another victory for the rapaciousness of corporate America. They have poisoned us with pesticides, chemicals and hormone disrupters, because we want inexpensive food and they want profit. Quantity over quality in America, every time.
Does anyone even know what a tomato should taste like? That's the problem.
29
@Ellen Tabor Absolutely, spot on, THANK YOU! The American food supply, from the soil to the livestock, to the supermarket shelves, all have been corrupted, adulterated, and/or depleted all in the name of money. I order to eat a chicken that tasted the way I remember it did 50 years ago, I need to buy a kosher organic chicken for at least $20.00. Absurd. Organic produce in Whole Foods Market, although superior in quality, costs about 3 times as conventional, sulfite-ridden pesticide -crammed produce. Disgraceful. Low-income families can't afford to eat wholesome food because our food supply system won't allow it. Unconscionable.
7
@Ellen Tabor
You are completely right, 100%.
The “food substitute” industry is evil, and profitable.
And that “USDA Organic” sticker is nothing but a tax stamp. We pay extra to eat real food, and people have trouble affording it.
10
"Eat when you're hungry; stop when you are full." That's the only thing that works for me after a lifetime of diets.
Yes, it takes a while to reset your appetite, but it feels completely natural and right once you get used to it. No food is off-limits, but you get to a point of conscious moderation and true enjoyment of food!
24
I know you mean well, but I am really confused. in the 8/26 op-ed by D. Mozaffarian and D. Glickman "Our Food is Killing Too Many of Us", they write: "Three in four adults are overweight or obese. More Americans are sick, in other words, than are healthy." Yet, here, you write "most health professionals in this culture (myself included) have been taught that being at the higher end of the body mass index chart causes poor health outcomes. Unfortunately, that just isn’t true".
So which is it? Is it possible to be healthy and obese, or is obesity itself a harbinger of poor health? Or is the science simply not settled?
29
I taught a class for years called Environmental Health to my 4th grade and 4/5/6 classes. I loved it and so did they. The core curriculum was written by a psychologist who specialized in eating disorders. As a new teacher, I realized that I was surrounded by girls who had internalized the dieting mentality from their parents. It had disastrous results for these kids. Through beautifully written lessons focused on what constitutes healthy eating, self-image, why diets don't work, "fun foods", and all sort of interactive activities on heredity, building self-confidence, puberty changes, peer pressure and bullying- well, we had so much fun with it. I added in other aspects for them: Exercise and racing about outside every hour, volunteers who accompanied them once a month to work in the local coop, creating low-cost healthy meals at home, food scarcity and anxiety, fat vs. sugar and big ag, having each child craft a healthy meal for their families- and make it and having their parents involved with weekly notes on our involvements. Most of my class was always a low-middle class to a very poor one. Many on SNAP benefits and free and reduced lunch and breakfast at school. I even worked with the food-service aspect of the Minneapolis Schools to support the amazing changes that happened there. We un-stigmatized the whole lunch process and did taste tests with the head of the Culinary Center. Did it work? Yes, it did because I had these kids for three years and so I saw the changes.
33
There seem to be lots of comments on this thread to the effect that no one seems to know what intuitive eating is or how to do it. Everyone also seems to be angry with the author for either not explaining intuitive eating or not explaining how to eat intuitively. So here’s my explanation, based on a lifetime of unconsciously eating intuitively and contrasting that with 30+ years of observing my in-laws eating habits.
Intuitive eating means paying attention to how your stomach and your body feels as you consume food. It does not mean counting calories or weighing the food or obsessing over portion sizes. It means being aware of when you feel “full”, and then stop eating when you feel full. Many people don’t stop eating when they feel full, especially when they are eating something that tastes good and they want to keep going just to enjoy more of that taste. Consciously, or unconsciously, they continue to take “one more bite” for the sheer enjoyment of the food (taste, texture, smell, etc).
For intuitive eating to have it’s maximum effect, you have to eat slowly. Your stomach sends signals to your brain to tell it that you are full. This takes time. If you eat too fast, by the time your brain tells you that you are full, you have already eaten past your natural limit. Eating slowly allows the stomach to signal the brain and the brain to register the signal and tell you that you’re full. By the time people who “shovel it in” feel full, they have already overdone it.
1
I have no idea what "intuitive eating" is and honestly tend not to care. The answer to what small kids eat is very simple...what their parents give them. I'm 59 and come from a time when most of what you ate came out of your home kitchen and was dictated by your Mother. Not much in the way of snack/junk food was ingested because it wan't purchased. Somewhere along the way, we bought into the myth that everybody had to be busy all the time . That along with the ability to cook falling by the wayside, and the decline of physical activity, has led to where we are now.
41
Yes! Well remembered and well said.
7
@H Silk
"The answer to what small kids eat is very simple...what their parents give them."
How delightfully naive. I have five kids and cook every day - I really enjoy it. I eat literally everything except liver. I seriously can't think of anything I don't like besides that. My children were exposed to everything in the first years of their lives. I have five children and five different eating habits. One eats everything, and plenty of it. Another eats close to nothing (chicken, bread and sweets every day would make him happy). The other three are somewhere in between. As for their weight? They're all skinny like everyone else in my family. I suspect this weight thing is mostly genetic luck.
3
As a parent, I'm confused by the idea that I'm not supposed to make any foods off-limits. Am I really supposed to give my young children easy access to processed foods to prevent them from getting hung up on them? That sounds like a recipe for kids eating goldfish crackers all day and not being hungry for more nutritious foods. My kids eat lots of good healthy food, and they get small daily desserts, birthday cake, and the occasional ice cream cone. Bringing soda and chips (products carefully designed to be hard to resist) into the house just seems like it would stress all of us out, and be bad for their teeth. For the record, I grew up eating home-cooked meals and maintained those habits as an adult. Did I drink soda at a friend's house once or twice? Maybe, but daily habits win out in the end.
37
@nell I don't think anybody is advocating for you to fill your pantry with junk food. The point is how you talk about these foods: "demonizing those types of foods actually tends to lead to greater consumption of them, overall." Kids are always interested in what's forbidden/off limits.
It sounds like you're doing a good job offering healthy options and creating good habits. As you point out, you had the same growing up, and you turned out OK, so keep doing what you're doing. :-)
14
@nell the author Virginia Sole Smith writes about this often and has a very helpful podcast called “Comfort Food.” It’s very thoughtful and interesting and I recommend it! Ultimately, I think her message is that kids really do have a lot of inner wisdom around food and that fighting them on choices makes it harder for everyone involved.
3
@Z That makes sense. Actually, I don't talk about junk food at all with my kids. Why would I, when I'm not giving it to them? It would just make them feel like they were missing out. Little kids are sensitive about stuff like that.
4
An opinion is "we shouldn't shame people." A fact is "obesity is a major cause of many chronic health conditions, and chronic health conditions account for over 60% of what we spend on health care in the United States." Obesity is bad for the individual and bad for the herd.
38
I went to school in the sixties and seventies, and I hardly remember any overweight kids. I am sure there were some - I just don't remember them. What I do remember was we had breakfast at 7:00 am, lunch at noon and dinner at 6:45 pm, in our house, sitting at the table, almost everyday. We had a bowl of apples, some white Sunbeam bread and a jar of Peanut Butter if we got hungry between meals. We didn't eat processed food and the only fast food in our town was a restaurant that served meat and vegetables. We played hard everyday and if there was no ring of dirt in the bathtub at night it represented a bad day. Food was fuel - nothing more, nothing less. Food is killing us.
57
@Mary Johnston you must be about my age - 61. I remember obese kids at my school, and obese family members. What is different is not that there weren't fat kids and relatives (there certainly were and I remember their struggles as my sister was one of them), but that the sheer numbers of overweight and obese kids have increased.
7
@Mary Johnston
This is very similar to my upbringing in the same time period. I was always a healthy weight and unaware of food issues until I hit high school and Twiggy was all-the-rage. Plus my mom had an obsession with weight, which I then began to internalize. The result was pretty much ups and downs in weight for most of my life and getting stuck in the dieting craziness.
I totally agree with you that the processed food (fat, salt, sugar!) and soda IS a core problem but also agree with Ms. Harrison that getting back to "eat when you're hungry; stop when you're full"--coupled with getting up off the couch--is the correct answer.
5
@Mary Johnston You know that white bread and the peanut butter they served in the 70s is highly processed, right?
20
Christy,
Thank you so much for the research and hard work you've put into your career advocating against weight loss diets and the harms of weight stigma. I have greatly benefitted from your work and have loved the articles you wrote for the NYT. The comments on your articles shows that we have a long long way to go as a culture. This is such a huge paradigm shift and diet culture is so incredibly pervasive. Please know that your voice and your work that you're putting into the world is making significant positive impacts.
As a professional therapist who specializes in trauma, I have incorporated intuitive eating and the heath at every size paradigm into my practice and I have watched my clients' lives improve (less anxiety, more compassion and acceptance, improved depression, healthier relationship with food and their bodies). So, thank you for all you do!
59
@Hannah couldn’t have said it better myself.
12
I tried intuitive eating. I couldn't tell when I was hungry and when I was full enough. I wondered what was wrong with me that I didn't know how much food I needed. Now I know why. I'm insulin resistant, which causes me to crave carbs and overeat them.
I'm following a ketogenic diet now, which is not zero carbs. It's low carbs. Everything has reversed. I know when I'm hungry. Not only do I know when I'm full, I can't eat too much. My body says, "Stop eating, you've had enough." That's totally life-changing. I can trust myself. But if I eat the carbs, I get that same craving thing and overeat them. Feel horrible when my glucose spikes and tanks. I don't do that anymore.
Nutrition is not simple. There's no one size fits all nutrition plan for everyone except: Don't eat refined, processed junk food. That's the one admonition that every type of dietary advice agrees on. And it's a great place to start.
In order to find your best diet, you have to know your health needs, which change as you go through life. So, it's important to make adjustments as you need to in order to remain healthy. Not everyone needs a ketogenic diet. Or a vegetarian one. Or a carnivore. Or the standard "everything in moderation" advice. We all have specific needs that work best for us. The trick is to stop listening to everyone who tells you that what they do is what everyone should do and find the best path for you.
71
@mamarose1900 I second a keto or low carb diet. It's about changing your diet, not being on a diet. Low carb foods (meat, cheese, etc.) are very satiating. A low carb diet is not at all a form of deprivation. It's just a much better way to eat, and once you do it, there's no going back because, as you said, as soon as you go back, you feel terrible (nauseated, weak, dizzy, etc.). Everyone should stop counting calories and instead pay attention to carbs.
9
@mamarose1900
To all on those low-carb diets: my experience has been similar to yours. I reduced or eliminated grains and sugar, but made sure to get plenty of fruits and vegetables. I had a small serving of carbs, say a half-cup of rice, about twice a day. I found that eating more protein made meals more filling, and also noticed that I was only ravenously hungry after having the occasional sugary treat. However, my blood pressure started rising after I switched to low-carb eating. I looked up the DASH diet recommendations and the only thing I wasn't doing was eating whole grains. So I've added them into my daily meals, and will ask my primary care doctor (a cardiologist) about appropriate diet at my next checkup. I don't know if adding whole grains will help reduce my blood pressure, but it's worth a shot.
3
@somanybooks
Please keep in mind there are many factors that are associated with elevated blood pressure:
1. Exercise. Moderate extended cardio is best.
2. Reducing or eliminating tobacco, alcohol and (excess) sugar intake.
3. Weight (regardless of what the author says, thousands of research studies show that in most people, getting closer to ideal weight is good for reducing BP - and she's wrong about the stats - at least 10, some studies say 15% of those attempting to lose weight can do so and maintain the weight loss for years)
4. Stress reduction - this appears, from the research I've seen, to be an issue for only 25% of those with high BP, but that still is quite a lot. the FDA has approved a $300 device to help you monitor your breathing, "Respirate."
I've written several times to the Respirate company to ask if they've done controlled studies comparing their device to doing breathing exercises on your own. They have studies comparing their product to relaxation, but so far, not to specific breathing.
So, if you want to try this, it usually takes a minimum of 4 weeks to know if it will work for you:
Learn to exhale twice as long as you inhale - a good goal is about 3 seconds in and 6 seconds out (that's 6 breath cycles per minute). Do it 4x a week for 15 minutes.
Here's a video that can help: http://www.remember-to-breathe.org/2-to-1-Breathing-Video.html
(the videos are only a few minutes - after you learn how to do it, it can be fine to do them on your own)
3
"I can empathize with your desire to help your patients, and I know that most health professionals in this culture (myself included) have been taught that being at the higher end of the body mass index chart causes poor health outcomes. Unfortunately, that just isn’t true. As you stated yourself, we have a host of issues associated with high B.M.I.s. But correlation doesn’t prove causation, and there’s a significant body of research showing that weight stigma and weight cycling can explain most if not all of the associations we see between higher weights and poor health outcomes."
I am frankly shocked that this is getting published in the NYT uncritically as advice from an "expert." It is just *wrong* on the most basic of levels. It is simply *not true* that there is no causal relationship between being extremely overweight and having all sorts of serious health problems.
At the very least, this body of supposed research the author claims to show that it's really stigma that causes 400 pound people to have, for example, knee and back pain should be linked in the answer so people can look at it and decide for themselves if the author is accurately summarizing it (hint: they aren't).
This is the equivalent of having a Q&A with a flat earth creationist and uncritically allowing that person to assure everyone that actually the earth really is flat and 5,000 years old and there is "significant research" to show it.
119
Obesity is a much more serious threat to public health than eating disorders are. That's a fact. So it makes sense to draw attention to obesity. Yes, some people end up with eating disorders, but there are fewer of them, so obesity takes precedence. That is just how it is.
Some studies show only a correlation between obesity and certain illnesses, but other things are unambiguous: weight puts stress on organs and on joints, brings about arthritis and joint injuries, makes it harder for the heart to pump blood, puts dangerous pressure on lungs when you lie down, makes it hard to exercise... the list goes on.
There ARE bad foods and good foods, and it's time we stopped treating bad foods as rewards. That only romanticizes them. Stop associating sugar with every celebration. Stop giving cereal, bagels, sugary yogurt, and orange juice to kids in the morning --- in class, they have their heads on their desks an hour later due to the sugar crash. There is just no need or justification for these foods. Stop laying them out at every conference and buffet. They are just bad.
18
Diet culture is insane. Thanks for speaking with a voice of sanity, Christy!
Thanks, NYT, for publishing this alternate view.
1
This dietician needs to better understand how weight loss is extremely critical at the point when obesity is causing health problems, joint pains, muscle pain and back pain. The concept of ‘large body’ is dangerously misleading and wrong as our body are meant to be small because we are erect most of the time and we are naturally active due to the way our body is formed and functional as opposed to the other species on our planet. Our body is not made to be obese as women even though men are in fact larger and they require different amounts type of foods. Women are smaller than men and typically the body anatomy are smaller than men so women actually consume less food than their male counterpart.
2
It's hard to reconcile (the totally. unscientific) concept of intuitive eating with the evolutionary reality that we are adapted to overeat when possible and to store the extra calories as fat to get us through times of food shortage.
The availability of sweet fruit in the fall, just before the lean times of winter, gave our pleistocenic ancestors insulin spikes that caused them to store fat which they gradually burned off over the next few months.
We are programmed by our DNA to over eat. Just as with so many other aspects of our nature, we need to teach children to reshape their natural impulses with regards to the kinds and amounts of food they eat.
1
I agree, the intuitive eating notion presumes that people are born nutritionists whose impulses represent deep understanding about all their needs. It just does not survive close observation.
2
Two words: Robert Lustig.
He’s a pediatric endocrinologist at UCSF. Google him. Watch his videos. Read his books, including “Fat Chance.”
Guy’s a hero.
1
Food “scientists” who work for Big Food spend their careers and talents concocting and perfecting “food” that is highly addictive with the aim of creating and maintaining millions of consumers who are addicted to their products. So saying it’s all about will power is bogus for the many food addicts. Go to a Overeaters Anonymous 12 Step meeting and see and hear all about it. Food processors and marketers need to be viewed in the same light as Johnson & Johnson and Purdue Pharma and held accountable for their role in the eating disorder and food addiction industry. When that happens we will start to see a shift.
4
Will power is knowing the alternatives and making rational choices until this becomes habitual, it’s not the ability to resist temptation. Anyone can do it but it takes effort. Weight control requires habits that simply produce the desired outcome. If one eats too much, one will store a lot of the excess food as fat. That’s the way our bodies have worked since we had the ability to appreciate them. Keep your dietary to what is needed, and one will only be overweight as one chooses.
Any time a person focuses upon ignoring something, that’s about what that person will think. Think about not eating a delicious food and one will think about eating that delicious food. Think about doing something long enough and one is more likely to do it. Fighting against urges brought forth by trying to ignore them is self defeating.
“Health at Every Size” makes sense to me. But there are maladies that will be moderated by weight loss, e.g., arthritis (less weight bearing down on those joints will help) and for which a conscious weight loss effort I’d think would be advisable. There should have been at least a brief mention of these sorts of conditions.
1
Some clarification about “intuitive” vs “indulgent” eating: After a lifetime of driving on the right side of the road in the US, say you’ve taken a trip to England and have to get used to driving on the left side of the road.
At first, you have to think carefully about every lane change. Then, rules become “instinctive” and intuition can take over. Having an instinctive sense of how to navigate lanes and turns, and having a clear sense of the rules, you can now make those decisions (when passing someone, when an animal darts in front of you) that are difficult to predict ahead of time using purely intellectual “rules.”
Here’s a food example: I read recently that a small amount of carbs is a good way to get some energy before exercising. So one day I ate around ¼ banana – it felt great.
What if I stuck to a purely analytic approach? I’d eat the ¼ banana every day, no matter how my stomach is feeling, or what my energy needs are.
What if I indulge my desires? I may think, “hmm, this is good, I’ll eat a whole banana today.”
But what if I develop an intuitive sense of what my body needs? I may realize I need something less sweet, and grab a ¼ apple. Another time, more fatigued, I can intuitive sense a small slice of pineapple might be better. Yet another time I might realize it’s better not to have anything.
This has implications for virtually every moment in life, which can be lived cut off from the wisdom of experience, or mindfully, intuitively connected.
1
@don salmon
Some of those implications:
Dealing with physical pain:
Emotionally: I'm in a state of almost constant resistance, depression, frustration, wholly focused on wishing the pain to go away, without really ever experiencing clearly the actual pain sensations
Mentally: I may take the analytic approach - study up and learn all I can about physical pain, carry out all kinds of "exercises" (breathing, physical therapy, etc etc), once again, not paying attention to the actual pain sensations
Now, a mindful intuitive approach (which, along with cognitive behavioral therapy, is one of the most highly recommended approaches in pain clinics around the worold)
I can
(a) recognize my emotional reactions without judging or fighting them, just calmly noting a natural emotional response
(b) I can notice the tendency of my mind to want to control and 'fix" the pain by analyzing it
(c) I can begin to notice, with a kind of "immersed" attention, the actual sensations. As I do this, I can directly, intuitively discern a distinction between the pain sensation, the emotional reaction, and the mental/cognitive "story" about the pain ('story' being "this is not good, i shouldn't have dug that ditch, this will last forever, etc)
Extensive research has shown that this kind of intuitive awareness of the pain not only dramatically reduces the negative subjective experience of pain, but results in measurable physiological changes as well.
www.remember-to-breathe.org
Sorry, but saying things like we can treat fatty liver disease and diabetes is something no health professional should be saying. While I agree totally with the obsession about being thin, and with 'dieting' and the like, and yes it is very easy for some drip living in Marin county to be telling people it is easy, you just eat organic produce and meals you make yourself as if everyone can do that, I think claiming that the problems associated with obesity aren't real.
Diets are not the answer, because they focus on weight loss, the real answer is on health. Diabetes is not some mysterious disease you treat with insulin, type II diabetes is caused by insulin resistance and that is tied to body fat. When obese people through healthy eating have their body fat % drop, the diabetes often disappears. Fatty liver disease likewise is a function of body fat, and has direct ties to cancer, and yes, obesity is correlated to cancer as well, likely because of the foods the person is eating to get obese, not the obesity itself.
I think the emphasis should be on healthy eating more than losing weight, to work with what the person has available to them. I don't think there should be fat shaming, but I think that we also cannot pretend that excess weight/body fat has no consequences or that health issues are caused by the weight loss cycle, that is simply untrue.
3
I have to disagree with the response to the person's comment re 350 lb 16 year olds. While I have gained back some of the weight lost at WW, I have retained two things learned at meetings; exercise & listening to my body when I eat.
One of the things my body was telling me when I was 20+ lbs heavier? I'd have dreams of having to move ached on my knees because they hurt so much when I walked. I also know, from watching my mother die of complications from heart disease and my struggle with high blood pressure, that being overweight does affect your health.
I'm trying to get to a healthier weight because I know it helps me feel better, and is better for me.
4
I agree that if we were all able to provide only healthy, unprocessed food without judgement to all children from the time they were able to chew, and allow them to eat intuitively we’d have far less obesity in the future. However that wouldn’t solve the problem at hand which is that we are a nation of overweight people at risk for health issues. Unfortunately, there is no one size fits all solution for this. It helps to support people to set small achievable goals such as increasing vegetable intake or adding short sessions of exercise, or yes, limiting sugary sodas. Will this magically make someone size 2? No. But the point is to help people adopt healthy behaviors they can maintain rather than judging them about their size.
3
@GeriMD --
Is part of the problem that we have such an unrealistic idea about what "healthy" looks like at both ends of the spectrum? Is part of the problem that we insist on measuring health by clothing size or weight, rather than by other objective measures?
To me, a substantial issue that people refuse to accept is that people can change their behaviors, but they cannot necessarily control how their bodies will respond to those changes. Particularly if you start with a person who is morbidly obese -- there are only so many calories they can cut and so much time they can spend exercising before it becomes unsustainable.
What do you do with a person who reaches loses 100 or 150 pounds, but still has a BMI of 30? How many calories is reasonable for the long term? How many hours a day of exercise?
Too many people seem to think that eating salad and walking will turn fat people thin. Others seem to think that people should literally be starved into thinness. But the one thing I know is that the hostility and anger toward fat people that comes through in many of these comments seems impossible to stop.
2
What we really need is for everyone to just start weighing and measuring their meals, realizing how many calories they are eating. We think in terms of eating normally, eating better. I just had an acquaintance tell me that the medication we are talking about causes weight gain. Eating more calories than you need causes weight gain. The reverse is also true. Its that simple. An adult man needs about 2500 calories. If you are eating that much and you are gaining weight, cut back the calories a bit and visa versa. Its not a mystery.
The problem is that most Americans have no idea of the calories they are eating. We have all this food out there that is scientifically designed to trigger us to eat more and its not natural food. Potato chips are not a reasonable food. A single meal, not supersized, at a fast food restaurant is not a reasonable meal. Super size it and you just ate all the calories you should have in a single day. That’s it. No more food for the day.
I used to be fat, I’m not. I used to measure my fats for the day using cups, now I measure my fats for the day with teaspoons. Most luncheon meats? They add sugar to it. I had to realize that what I think is a normal portion of food, isn’t. I had to start weighing and measuring. And if you eat the number of calories you should be eating, don’t eat anything with sugar in the 1st 5 ingredients and soon, a week or two, and you won’t get hungry. You’re body will return to normal. Normal appetite, normal size.
6
@SMcStormy
Measuring and weighing is something that won't work for most people, it is why diets fail. You read "eat 1 piece of chicken breast, a tablespoon of nut butter, a handful of peas" as a meal, and it is going to fail long term. It may have worked for you, but calorie counting inherently fails because for one thing, it may not work for some people, lowering calorie counts can cause people to gain weight in some cases, it is complicated.
Unfortunately as you point out, it has gotten harder and harder for people because of lifestyle, where people don't have the time to cook any more, and they aren't aware of what is out there. You pick up a loaf of bread, and it has sugar and unhealthy fat in it like soybean or palm oil. You look at that 'healthy' pre made meal, and you realize it isn't. That meat you are eating is fatty, lacks omega 3's, and likely was fed hormones and anti biotics...and the list goes on. Chicken is promoted as being healthier, but it isn't, studies have confirmed that one. A large part of the problem is the food industry as a whole and the government that promotes it, we are creating food that is cheap, loaded with empty calories, and then wonder why health care costs soar.
1
Obesity is a North American problem. And yes, it is a problem.
Millions of children throughout the world struggle with malnutrition because they do not have enough to eat.
Why is a registered dietitian making excuses for the North American habit of overeating?
7
@Flaneur Thank You! I can't believe a registered dietitian is, to my reading, "making excuses" for the overeating habits that they should be guiding people away from.
3
My kids were always very small. My daughter always ate small meals but was hungry every three hours. I followed her lead and always tried to make every calorie count. We didn’t know why she had so many gI issues...pain in her stomach, vomiting, nausea...doctors thought she looked great. Well after a summer of testing at Chop we learned she has Waldmanns disease and she cannot eat fat. Fat causes her edema and other issues. We are still learning how to address and moving to more testing as she will have to manage a low fat diet for the rest of her life. But what is really interesting is that she has always chosen small meals, low fat and high protein because it made her feel better. Because she ate healthy she was more difficult to diagnose because she didn’t present with the swelling most people with this condition have.
3
@Deirdre
I am glad you found out what happened with your daughter, and it highlights something I think is important, that everyone is different. I would bet that one of the keto advocates would tell you "eat keto, and she will be fine", and for her it would be disaster (keto is in general, but that is another story). It goes beyond disease, there was a study done in the UK involving identical twins, and they found that even among identical twins what worked for one didn't work for the other, that one would eat fat and their blood cholesterol would spike, the other one it barely budged, one would eat a sugary food, and their blood insulin reacted in a steady way, the other one spiked.
1
Christy, you still have not really explained "intuitive eating." We understand what it is not--calorie counting and faddish diets. But what is it? Eat what you want, as much as you want, when you want? That is how people get fat--and unhealthy.
One dietary rule that seems incontrovertible. No matter the kind of food--proteins, carbs, sugary drinks, chips--eat less.
Excessive caloric intake leads not only to weight gain, it introduces more toxins inside the body and stresses the organs, which affects health and reduces longevity.
5
@Vox
I would agree except for one thing, that eating less is the answer. eating 2000 calories or less a day might promote weight loss, but eating 2000 calories that is all high fat/high sugar (besides likely failing, because it would be hard to eat <2000 calories), is going to cause problems. If you were eating green vegetables, you can gorge and not get anywhere near 2000 calories, eat a small sandwich with deli meat and mayo and you might be near that limit.
It is not just limiting calorie intake, it is what you eat, and the key is being aware of what you are eating. Part of the problem is that foods that you could consider healthy when made at home, if you eat commercial food is likely loaded with all kinds of bad things, like salt, sugar, and chemicals designed to make you eat more.
1
I find it alarming that children can’t even go to the local playground without an array of snacks.
4
I am never on a diet. I have a diet.
My diet has lots of fruits and vegetables, not a lot of carbs, the ones I do eat are whole grain. I eat a small amount of meat and never limit healthy fats, I don't crave sweets. I cook.
I don’t eat manufactured foods, our country gained the weight we are seeing now because of the fat scare, the snack wells, etc., I never step foot in a fast food joint. Never drink soda.
The pressure from the food chemists is hard to resit if you eat their offerings. We all have the capacity to become addicted to their products, the best way to not get addicted is to not ever eat any of it. We might as well be mainlining heroin eating their manufactured sugar concoctions.
7
I'm an exerciser and intuitive eater. Makes perfect sense to me. But still, a heaping portion discipline is necessary.
5
Agreed! I am also an exerciser but intuitive eating doesn't work for me because of how much discipline and active thinking it required. Eventually, I picked up macro tracking. It works much better for me. Plus, I can eat all the garbage I want as long as I balance it out throughout the day.
1
Again, Ms. Harrison nails it. And again, we see more of the sad, misguided comments in which the writers absolutely itch to punish people for their weight(s). More and more health practices are dropping weight-centric paradigms and are focusing on weight-neutral, patient-inclusive protocols instead. "Health at Every Size" means that all patients should and can have access to evidence and science-based healthcare, whatever they weigh. Many health practitioners now understand that dieting/starving/weight cycling leads to eating disorders, immune system impairment and weight gain. Welcome to the 21st century, people. Please leave your weight-based bigotry at the door. You and your kids will benefit.
10
@Frannie Zellman
Sorry, but while I agree about dieting (it doesn't work), that doesn't mean that the health issues we see aren't caused by poor eating and yes, excess weight or more importantly, excess body fat. While I have no doubt the cycle of eating and dieting causes problems, and the fat shaming that doctors especially still do is not the way to go, the idea of accepting that body fat is not a problem is not the answer either.
Excess body fat is the direct cause of type II diabetes, in study after study people who change what they eat and lose body fat, generally see the diabetes go away, and there is a simple reason for that. excess body fat causes insulin resistance, it doesn't allow insulin to work. Likewise, excess body fat put a strains on the heart, and also is tied to higher rates of cancer.
And to be blunt, one of the reasons people are overweight isn't excess eating, it is what they are eating, often when you look at what people who are severely overweight are eating, it is a diet high in fat and sugar, and with fat not healthy fats, and that kind of eating causes all kinds of problems.
Sadly, the real problem is that the food industry is poisoning us, and I think that the fat acceptance movement is hurting things, too, in that it is basically saying that there are no consequences to being way overweight, and that isn't true.
3
@Frannie Zellman
By "weight-based bigotry" you seem to mean even personal interest in being healthy.
Actually, It *is* possible to eat healthy foods in amounts that do not make one fat. It really is.
That is not "bigotry".
You do have the right to eat till you burst. I have the right not to. You have the right to think that fat is perfectly fine and ... you guessed .. I have the right to my opposing opinion.
"Health at Every Size" is not possible. Perhaps you mean "Treatment at Every Size".
"Evidence and science-based healthcare" *is* available whatever you weigh; health is not something that is possible at every weight.
Science based evidence shows that fat is generally less healthy than not fat. It also shows that medical problems increase with degree of obesity.
Facts - not bigotry.
3
Everyone is on a diet.
There are weight gain diets, weight loss diets, maintenance diets, muscle building diets...
It makes a lot of sense to teach our children about healthy diets, and helping them develop a sense of pride in maintaining a healthy body.
Physics fact:
If you consume more calories than you burn, you will gain weight. Consume fewer calories than you burn, and you lose weight.
Weight control is a matter of commitment and self-discipline.
People who gain weight back after they lose it, do so because they just go back to the habits that got them fat in the first place.
The author is making excuses for these people, implying there is some physiological reason that people can't keep the weight off.
8
@Raz Another real issue is that our food is produced by for-profit, publicly-owned transnational corporations. The people running these companies have a fiduciary (legal) mandate to generate as much profits as they can. In the US, the gov regulatory bodies that are supposed to be protecting the public are staffed and managed by so-called “ex-industry” personnel. All these people come from high paying jobs or leave for them or both in the industry that they are supposed to be policing. The FDA is tasked, officially, with promoting the meat/dairy industry and public safety and public health. These two conflicting goals when combined with the above revolving door situation means that public safety and public health is an afterthought, at best.
Drive by a school yard at recess. When I was growing up there were a few kids who were “fat.” If you look at groups of kids today, primary school children, you’re jaw will drop.
How are these for-profit food companies allowed to produce “food” that is specifically and scientifically designed to be addictive? The answer is in the above and it is just one of many things we need to fix.
5
@Raz
It is all about healthy eating, but claiming this is a problem with self discipline is the old Puritan "wages of sin" nonsense. Your physics fact leaves out, for example, that not all calories are equal, and that you could eat less than let's say 2000 calories a day and still gain weight, in part because a <2000 calorie a day diet with high sugar content causes the body to put on body fat from the insulin rush. More importantly, it also leaves out that when you cut down calories, your body goes into famine mode and lowers metabolism (people actually can gain weight on a restricted calorie diet).
The reason people gain weight after dieting is simple, because instead of learning how to eat healthy for their body type, they follow a rigid, formulaic diet, which eventually is going to be fail. Good nutritionists teach nutrition, they teach people what can be eaten in larger quantities, what should be lower, and that eating healthy doesn't mean not occassionally having something that is an indulgence. Diets are not nutrition, diets are a formula that fails in the real world. Does that person know, if forced to eat out, what to eat? Does the person know to look at a bread wrapper and see how much fat is in it, and also if there is sugar and exces salt in it? The key to good nutrition is not following a formula, it is learning to be aware of what we are eating.
1
@Raz --
Human fact: people are not Bunsen burners and don't consume calories at a constant rate.
Human fact: metabolisms evolve to become more efficient when they are put through period of calorie reduction.
Human fact: some people's metabolisms are genetically programmed to be more thrifty.
Human fact: some people have genetically programmed metabolisms that send signals to eat more when calories are restricted.
Human fact: those with both of those genetic inheritances get a double-whammy when they diet: their metabolisms ramp down and they are getting hormonal signals to eat more.
Human fact: self-discipline has virtually nothing to do with weight control for people who are extremely overweight.
You can chose to ignore the science and remain part of the nasty, scolding problem. Or you can accept the science and become part of the solution. Simple as that.
4
How to avoid earing disorders in children, as taught to me by Camp Green Cove, when I was a counselor there in the 70’s:
(1) Serve 3 meals a day, family style, nothing but well balanced nutritionally rich, varied foods at each meal.
(2) No snacks ever. The camp kitchen was locked up tight between meals.
(3) Allow the children (the campers at your table) to eat as much or as little as they want of anything served. If they want to eat nothing but bread, let them. If they want to eat nothing but meat, let them. Just potatoes? Fine. Just green beans? Fine.
(4) Don’t force a child to eat any particular food. Don’t force them to “clean their plate”. Don’t force them to “eat at least one bite” of everything that has been served. If a child won’t eat anything, that’s fine. Children will not allow themselves to starve to death. If they don’y eat today, they will eat tomorrow. If they refuse to eat breakfast, they will eat lunch.
(5) No fighting or arguing with a child about food.
(6) If the only thing you serve a child is nutritious food, eventually they will get hungry enough to eat some of it.
(7) If a child spends 8 to 10 hours a day at camp engaging in numerous activities, most of them involving physical activity, they will eventually get hungry enough to eat some of what is served at meals.
(8) If a child is not pressured to eat certain foods, or certain amounts of food, over the course of several weeks they will eat enough to keep their bodies going, even the “yucky” stuff.
16
Please NYTimes, consider the message that this Op-Ed is sending. High BMIs are causing every part of life to change & productivity suffers from each added pound. Instead of needing 1 fireman leading 10 healthy people through a narrow path to safety in a fire, it takes 3 firemen to carry a fat person out. 4 people are highly endangered whereas it is a really easy thing getting 10 regulars out.
I was once a lifeguard and WSI but I would not do it again as I could not follow the law. The law requires these people to help people regardless of their sizes & I don't endanger me for people who have decided to be too large. I am not being heartless, just reasonably self protecting.
Personal productivity is inversely proportional to size after a certain point with each additional pound draining away. Vehicles have to be larger, all seating has to be larger, portions of everything has to be larger and each year, the ability to satisfy that is lessened. The ultimate is when families have to supplement govt with obese family care. Think about it, do you want your family to lose their home trying to care for you because you are too large and there is no other way? Don't put them in the position of having to choose.
No fireman, EMT or other public servant should endanger their lives trying to salvage the really big person. We all know that these are the choices of eating and exercising habits.
Please become a positive contributor to all society, get healthy.
8
@WorldPeace24/7
I was also a lifeguard and WSI. The law requires lifeguards to help - it does not now and never has required anybody to commit suicide. Lifeguard training also teaches how to escape a drowning person's clutch as well as how to avoid it in the first place.
Not to mention that obese people are very buoyant!
@WorldPeace24/7 --
Please become part of the solution and recognize that "personal accountability" has been completely unsuccessful in making fat people thin.
While physical activity is a good thing, pushing kids into competitive sports for which they have no talent may leave them even more alienated from their bodies than they already are. It certainly had that effect on me when I was growing up.
What worked for me was finding physical activities that I enjoy, especially dancing.
6
Intuitive eating works a lot better if the only food readily available in simple, nutritious, not overly processed. If the snacks available are apples and carrot sticks, in my experience, kids (and their elders) won't usually binge on them. If there's soda and potato chips, that's a whole different story.
The worst of the worst are sodas, because people will grab a can of soda when they aren't even hungry-- just thirsty.
Not having junk food around the house makes it vastly easier to maintain a reasonable weight without worrying about it much.
9
@Eleanor
That makes a big difference, one of the reasons the op ed writer doesn't mention is that these days people are eating so much more processed food, and it is a disaster. I see what people have in their shopping carts, families with kids, and I realize just how much processed food people are eating...and I live in an affluent area. The sad truth of our food supply is that healthy, nutritious food is not available to everyone and thanks to the food industry and our stupid politicians who see only greed is good, we support a food industry whose goal, while maximizing profits, is turning out cheap food that is unhealthy..and sadly for many people that is what they can afford. A big mac meal today costs less than a big mac did in the 1970's when I was growing up, and I am not talking real dollars. Go into a supermarket in a working class area and you will see tons of packaged foods that are cheap, what produce they have will be expensive and not of great quality.
I don't understand how you think people can just not eat junk food in the house. For myself, it is an impossible temptation, and after 20 years of chips, and treats, I became obese and diabetic. My doctor said no sugar or flour or I will die or have kidney failure. The idea of a serious illness is enough to get me to stop eating sugar and flour (most of time), but otherwise, I would still be chasing after sweet treats.
2
@Claire, it’s easy to avoid eatings chips and sweets inside the house if you don’t have any chips or sweets inside the house. Just stop buying them. When I was growing up, our family (both my immediate family and my cousins) never had chips and sweets in the house. It wasn’t a conscious decision as far as I know; my mother just never bought that stuff. Neither did my aunt. In my house, we literally never had dessert except for Thanksgiving, Christmas and Easter when someone brought a pecan or pumpkin pie (for Easter it was peach pie). Except for those three holidays, we never ate pie. We never had cake or ice cream except for someone’s birthday. Maybe it had something to do with my mother and my aunt growing up during the depression, or maybe because we weren’t rich, I don’t know. But if you just stop buying that stuff, you will stop eating it. And eventually, you will wonder why you ever were so obsessed with it.
7
Obesity is an effect as much as it is a cause and in many people it is genetic.
In both Australia and America obesity is the effect of overeating, in many people but not all. Heavy marketing of convenience food is a big part of the issue among an increasingly time poor population.
Convenience food is designed to be palatable but it displaces "healthy" food because healthy food is often distasteful and difficult to prepare - brussel sprouts anyone, nearly raw?
If you regard obesity as one extreme of eating disorders then the shaming and discrimination can be removed and treatment becomes less judgemental.
2
@Philip Brown
Obesity isn't genetic per se in most people, while there are people who are outliers, the cause of obesity is because of poor nutrition, often not people's fault. The obesity rate has gone in the past several decades from 15% to 40%, and it is no coincidence, during the past 40 years packaged foods and fast foods have become a significant portion of what people eat.
3
@music observer --
A substantial reason for the increase in obesity in recent years is a change in the definition, that moved millions from overweight to obese overnight, without gaining a pound.
Calories are cheaper now than they've ever been. People are required to do less physical labor, both in employment and at home. Smoking rates are considerably lower. All of these factors would have affected the ability of people to become fat, even if they had a genetic predisposition to do so.
We can see in virtually every country that as it develops, as calories become cheaper and physical labor is reduced, that weights increase.
Saying that "obesity isn't genetic" ignores the reality that the environment in which our genes lived has changed tremendously.
I just do not understand or believe ANY of these explanations.
Why were people in 60s and 70s all slim and NOW everyone is fat?
I think it is a change in the quality, and quantity, of food consumed.
And back then a lot of the food was horrendous.
Full disclosure: Naturally slim from family genetics..
5
@Ivy
The answer is complex, some of it is societal , people are working longer and harder than past generations, kids are overscheduled to an ounce of their existence, so people are relying more and more on packaged foods, for one thing. Another reasons is the food industry has turned from producing relatively simple products people used to make meals, into producing these packaged meals that are loaded with fat and sugar and all kinds of foul stuff to make it cheap.
The reality is in the US today food of poor quality is cheaper than good, nutritious food. And with a government whose business is promoting huge food businesses, rather than in having a healthy food supply, it isn't at all surprising. The government screams and yells about the cost of health care with one hand (the GOP answer? "People are using too much health care because it is too cheap") while on the other they are promoting the very cause of much of those health care costs, the number of people with diabetes and heart disease and cancer is increasing, even while things like smoking are in decline.
2
@Ivy -- how about this:
Because in the 60s and 70s, food was relatively more expensive. People had to engage in more physical labor at home and at work. Houses were colder in winter and warmer in summer. Many more people smoked.
Full disclosure: I've got pictures of my fat great-grandparents from the 20s and 30s. The notion that no one was fat in the past is simply preposterous. It's just that fewer people could afford to be fat in the past.
I think that kids on a diet is a ridiculous idea. But even more ridiculous is the notion that you can be healthy and beautiful while obese. Sorry but this is not a matter of “prejudice”. Standards of beauty are not random; they derive from evolutionary psychology and are largely uniform across cultures. Sure, some cultures prefer plumpness while other valorize slenderness but no human being in their right mind can believe that dragging around hundreds of pounds of flab is attractive. Cries of “fat-shaming” are the last-ditch defense of those who know, in their heart of hearts, that they have made themselves ugly and sick by overindulgence in junk food. Teach kids to eat only when they are hungry and to avoid junk, and they won’t need either dieting or tortuous self-justification.
14
start by saying what "soda, juices, Gatorade, chips, candies and desserts" really are.
They are NOT food!
Food, is what nourishes our bodies (fruits, vegetables, legumes, grains).
When we start to understand "food" is very easy to follow the advice of a wise man - Eat food, not too much, mostly plants"
Follow his "diet" and you will never have to diet.
21
@c
The only problem with that is assuming that is what is causing obesity is eating junk foods or soda and the like. The real problem is what is being sold as food is as bad as outright junk food, those frozen meals, processed foods, and the meals they sell in markets these days are a disaster area. Much of that processed food is designed to make you eat more, and it extends to basics like bread. Pick up a loaf of bread in a supermarket bakery, and you will see it has sugar, oils, you name it in it (I go to my local italian bakery, and ingredients are bread, flour, yeast, salt and water). That supposedly healthy granola is full of fat and sugar, it is amazing what passes for food. The meat people are buying is loaded with fat, and not the good kind (omega 3's), but unhealthy omega 6's, not to mention the hormones and antibiotics.
The real problem is we allow food to be sold in this country that is full of empty calories, and worse, thanks to so called food scientists who should be brought to trial at the Hague for war crimes, they are engineered to make you eat more, the way cigarettes were engineered to make you smoke more.
>"most health professionals in this culture (myself included) have been taught that being at the higher end of the body mass index chart causes poor health outcomes. Unfortunately, that just isn’t true."<
So there is no connection between the obesity and diabetes epidemics? Please. I agree that fat shaming etc. is damaging and not productive, but just saying there are no health consequences to obesity is MADNESS.
24
Intuitive eating makes sense to a certain degree. When I follow my body's cues I feel better because I eat eat healthy foods (nobody feels great after eating a plate of fries) in moderation (stop before I'm stuffed). However, many people still get bad cravings, like for that 3pm sugar boost from a bag of M&Ms. It's not fat shaming to point out those M&Ms are a bad choice, and instead I should drink a glass of water and have some grapes.
Also - it is absolutely absurd to argue that obesity does not have negative health impacts. My aunt needed hip replacements at age 50 because she was so obese. 100M Americans are diabetic or pre-diabetic according to the CDC. This is not normal!
Being fat doesn't mean someone is a failure at life - fat people can still be funny, lovable, hardworking, generous, and kind. But excess fat elevates one's risk of chronic health problems and early death. It's a fact, not a prejudice.
14
@Ophelia my mom needed a hip replacement at 50 and she was never obese, not even "overweight"
@Nicole
So that means...what? Your mom might have needed a hip replacement at 50 because she had psoriatic arthritis, she might have had a congenital defect, etc. Arguing that your mom needed a hip replacement and she wasn't obese doesn't negate what the person said, any more than the hillbilly deriding the health effects of smoking saying 'my grandpappy smoked 2 packs a day and died at 90' shows that smoking isn't a problem. Skinny people can get diabetes, can get cancer, can get heart disease, but the reality is they get those diseases at rates much less than people who are obese, the same way that obese people need things like hip and knee replacement surgery more often then people who are more normal weight.
3
I call it the "max 5 of 5" approach, and kids can participate using burgeoning reading and arithmetic skills.
Fill the grocery cart with your family's weekly haul. Among the contents, check for every individual item containing 5 or more ingredients. If you find more than 5 such items, put the rest of 'em back on the shelf.
3
"Intuitive eating" sounds a lot like encouraging people to forgo real birth control and rely on the rhythm method to prevent pregnancy. Neither will work well, except a small percentage (let's say single digits) of extraordinarily fastidious people.
12
When my son was four I became a dorm director while my husband was in graduate school. We had a minimal sweet house where occasional homemade cookies and plain yogurt with honey and cashews were big treats. The first supper in the dining room, my son's eyes lit up at the desserts and he choose four or five of them. I thought, I'm going to see how this plays out before we have to have a nightly struggle. He ate them all. The same night the same thing. I don't think he had another dessert all year. He was in middle school before someone told him you put sugar on cereal. We had lots of homemade desserts, but not always. He was a very active, very fit kid. I wonder what it would have been like if we'd fought over the desserts. I will say he was a very high energy kid who ate LOTS, so I didn't need to worry about what he was eating: if I thought he was short of something I just put that in front of him first and he'd wolf it down.
7
How odd that this writer, and the New York Times, chose to use yet more column inches to promote her view on obesity. When statistics show that there are vastly more obese people in the United States than there are in other nations, including other developed nations, something needs to change. It isn't promoting "intuitive eating." It's ensuring the dissemination of information about the strong links between obesity and early morbidity and mortality. Fat children often become fat adults, and that is bad for everyone involved.
18
@Mary Chapman Because diets are so successful, right? The only people who benefit from your POV are the big wigs in the billion dollar weight loss industry.
2
@Mary Chapman
Obesity is soaring all over the world, the rate of obesity is soaring in China and India, for example, the same is true of Europe. The reason is pretty easy to track, the mega food industry, the Nestles of the world, the fast food restaurants, have made massive inroads in other parts of the world. The Chinese have more obese people than in the US and it isn't just because they have 4 times the population, the amount of obese people isn't just statistical noise based on a larger population.
1
I am so with what this writer is saying. I wish every kid could grow up eating the way my siblings and I did -- food in our house was real and delicious. Our parents never talked about weight or diets. Nothing in our kitchen was fake or low fat or artificially sweetened. I believe that because food was more satisfying, and because there was no atmosphere of weight panic or deprivation, none of us has ever been overweight. All of us raised our own kids this way, and none of them have been overweight either. I'm convinced that one way to prevent weight issues is to serve your kids delicious, real food and break the psychic connection between eating and weight. Show kids they can eat what they want and stop when they're full. That's much easier to do when you know that there will be something else good at the next meal, rather than a cycle of guilt and recrimination.
10
@Elizabeth There is another possbility here. You are talking about a family--ie people who share a genetic background. In my family there is a pair of elderly identical twins. They eat differently (one more along health food lines than the other) but they have maintained almost identical low weights throughout their lives and are very similar in things like cholesterol and blood pressure.
4
I would have loved to grow up in your family! I hope my children got as much of that behavior as I could offer ( not having it modeled for me).
1
I have read many times that only a minority of Americans exercise regularly and consistently. Surely this is related to the problem. I have read all the research insisting that exercise will not burn off excess calories. Yes, but if you exercise regularly you feel yourself getting heavier and cut back sooner. You sleep better generally and a lack of sleep appears to be connected to weight gain. Our lives , as Americans, cause us to gain weight. We work too many hours. Most of us drive to work. We drive everywhere else as well. When I'm waiting in an airport I'm always surprised by the large numbers of people who sit for hours. They could walk for 30 minutes...But also I think it is the high fructose, the fast food, the large portions. And this starts in childhood. The advice to cut your restaurant meal in half before you eat it is such good advice. Take it home and have the other half tomorrow. Just don't have the other half at midnight ! If your child is becoming chunky tune in. Do not be judgmental but start walking, swimming, doing chores. Take better care with ingredients. Sometimes they fill out before they get taller. Observe whether this is their pattern and restrain the panicky, counterproductive remarks. Get them off the phone and off the couch. Some of them now cannot tolerate being outdoors. It's tragic and weight gain is only one of the results. Pretending it does not matter though is not for the best.
8
Try to lose weight without exercising or to control blood sugar, it’s pretty hard. Exercise really is as necessary as sensible eating.
2
18 years ago my yoga practice made me body aware enough that I started paying more attention to my needs. Without following any diet I have lost 55 pounds and kept it off. I have always exercised regularly but I increased my exercise when I retired 16 years ago. The principles outlined on the author's web site seem well thought out. I am a retired M.D. and the author's program seems reasonable to me especially since there aren't many successful alternatives. Eating well is an intuitive skill. Your body doesn't want you to eat candy bars for breakfast. You'll be hungry by mid morning.
9
I cringed as I watched my 12-year-old great grandson dive into a plate of 6 beignets with two containers of chocolate sauce on the side at a Olive Garden restaurant Sunday. I made a soft disclaimer and his mother, my granddaughter, reminded me that he plays basketball and will run it off. Of course, I didn’t go into the details of allowing him to even create a liking for this kind of negative eating. My son is a healthy 6’5”, 58, and has Type 2 diabetes...it runs in our family. Two of my siblings died of it’s effects. I eat healthy and organic and exercise EVERY day! Healthy eating should be natural, not something learned. To all of their benefit, my granddaughter, when she was a kid, would go to McDonald’s and order a salad and so do her children....!
2
I prefer to get my dietary advice from someone who is not selling anything other than their time.
6
Ms. Harrison, thank you for this article. As the comments show, it will take a huge amount of time and effort to change many people's minds. Thank you for putting in the work. Maybe a few readers will actually take the trouble to learn what intuitive eating is - and isn't - and gain the important benefits of it.
9
While I appreciate the author’s emphasis on intuitive eating, the biggest problem remains the American culture. I can pick out Americans easily off the cruise ships...they are almost often heavier than others and far less fit. Until communities embrace walking and riding bikes as a form of transportation, not just recreation, and mealtimes become a time to reconnect with friends and family and talk while lingering over dinner, instead of rushing in and out, or eating in front of the TV, Americans will always have an unhealthy relationship with food.
10
Ah, those poor souls stuck with the professional role nutritionists focused on weight control. They are trying to move mountains with a plastic spoon. While many contemporary populations have experienced average weight gain in the last 40-50 yrs, some have not. For example, in Finland BMI has not budged in 30 yrs. We live in a sick society where "you are what you consume" and we are eating in excess to make the food industry rich. All of these psychological and "revolutionary" techniques are going to fail . . except for that lucky 5-10%. Like climate change, this is not at bottom an individual problem, it's a structural problem related to profit incentives and absence of capacity to make and implement social policies. These "new theories at minute" are gimmicks, just like phone app's. If you flood the society with opioids, some percentage of the population will become addicted. If you create a "you must consume" food culture, a much larger proportion will become obese. I'm sure there is no "one size fits all" solution for individuals, and of course most people with addiction quit on their own and recover, but we blowing smoke to think that one or another approach to eating will make a difference for a large proportion of the population.
5
I think your advice is wrong and harmful. Excess weight has lead to an epidemic of diabetes, heart disease, GERD, and an increase in esophageal cancer. It’s not correlation, it is in fact causation. Please keep your harmful ideas to yourself. Americans eat too much.
27
Health at Every Size is just the latest fad.
And it ignores reality. How many actors and actresses are obese? It's because a trim body style is more sexually attractive.
Of course there are the exceptions, but in general people are attracted to trim and fit people. To ignore this basic reality tells people that to be healthy they have to be unattractive to most people.
Some message.
We go to a lot of places where physical activity is required: this includes organized bike rides, ballroom dances, the swimming pool, hiking in the mountains and desert, etc. We do all of these, so see hundreds of others who do them.
Except very rarely you don't see obese people! You see fit people. Almost without exception.
Health at Every Size is how to be "healthy" in front of your television. And with nobody hitting on you except desperate people.
10
@Travelers Look around you. There are many couples who are not among the trim and fit. There are many couples where one is slender and the other is not. One of the greatest pieces of nonsense is that heavier people will not find partners or that being heavy equals not having a good job. Here is the reality: almost everyone who wants a partner finds a partner.
I'm not defending obesity; there are many reasons to avoid becoming obese, but the idea that because you think fat people are ugly and spend all their time in front of a TV is not a reason to become thin.
10
And so the pendulum swings.
My two daughters are now fat as can be. And it is thanks to a year of your theoretical eating fad.
Yes fad.
Both my girls are young adults with PCOS
You are killing them and their cultish adherence to your groovy non stress eating is destroying their health and I can no longer reach them. Both felt so proud of their efforts and normal appearance as healthy.
I am not happy.
And WW is a great way to eat well and healthy for families.
13
Getting people to give up dieting or weighing themselves? Fat chance.
3
Ms Harrison has all kinds of criticism and no facts to back up her feelings. That’s nice and it feels good but that’s why obesity has become the number one health problem in America, feelings over facts is what’s killing us. We need solutions, not this kind of emotion-based babel.
9
This opinion sounds like Magical Thinking by a pseudo scientist looking to sell snake oil. Real, actual scientists say obesity causes cancers among other illnesses. Google it. Prevention is better than cure right? Christy Harrison doesn't seem to care about either one, just telling addicts what they want to hear for money. It's malpractice and lack of standard of care for a nutrition pro to conduct themselves like that.
13
I agree with not fat shaming kids, but when we drive to the fast food place and load up on junk and never use our legs to walk anywhere and just spend all our time staring at our phones NO WONDER WE ARE FAT!!
And I think "intuitive eating" is just the latest diet scam to make money of off others misery.
8
No mention of the massive amount of advertising of high sugar, high fat, empty calorie foods that we are bombarded with daily. Sorry, intuitive eating without knowledge and understanding of the connection between diet and health is a fantasy.
9
We have to call out junk food for what it is: a fun snack for occasional consumption. But clearly people are eating it as a staple food not a treat. For those who venture to the grocery store - look at what is in people's carts. A typical grocery cart often has 10,000 calories of pure sugar in the form of breakfast cereal, soda pop and cookies etc... and maybe a bag of lettuce. People need to judge the quality of nutrition before they eat too much junk. Education and good judgement are what is needed - not another phone app!
4
Ms. Harrison, I'm glad you read the comments. I suffer from compulsive overeating and have addressed my issues through a twelve step program called OA (Overeaters Anonymous). My food meter, like I suspect many others is broken. It can no longer tell me when I'm hungry. Therefore, I must remain abstinent from my compulsive foods (sugar, and processed carbs, and starchy vegetables) and compulsive food behaviors. The problem with telling families to encourage kids to eat intuitively is that kids develop food addictions pretty early on if their parents buy and give them money for sugary processed and fast foods. These foods are highly addictive and easy to abuse. Parents should not be buying sodas, cookies, ice cream, juices, or any other addictive substance and placing it in their homes. I truly feel that the number one thing a parent can do is keep these substances at a minimum in the house and educate their children as to why they are unhealthy. These products should have labels on them like cigarettes. Most children today know that cigarettes kill but they don't know that sugary cereal kills more.
11
I spent 15 years in OA. I was very 'successful'. I was an 'old timer'. I did high level service. And I took the idea that food is the same as alcohol/drugs as being solid science. However I found in the long run that for me food is not alcohol. It is a neutral substance required for life. Alcohol is not required. 12 step programs that create a substance out of a biological necessity and then label it 'addictive' are walking on thin ice. This is evidenced to me by OA meetings having very few old timers where as AA has a much higher rate of retention over the long term. Please do not be discouraged from OA if you are happy but I caution that if you hit the wall please know that it's not the end of the road. People who once identified as Compulsive Overeaters have found peace with all foods as neutral life giving substances that don't require permission to consume (and don't spiral into endless binge eating). I don't regret OA but I never achieved the peace and neutrally that I desired using an ethos that "I am broken so something outside me needs to control me". I found peace with Intuitive Eating and I have moved on to pursuing life without the baggage of food plans, food police, fat phobia, binge-purge behavior, food morality, and the siren call of shame.
6
Kids are overweight because they eat too much sugar. Sugar and refined carbohydrates are the cause of most weight gain.
4
@Marc A When I was growing up, I consumed huge quantities of sugary candy all day. And yet, I remained rail thin, probably because from the end of school until it got dark, weekends, summers and holidays I was outside running around, biking or swimming.
7
@HKGuy
It was different sugar then.
1
I wish the emphasis was on cardio - pulmonary fitness. The trick is to find something fun. It does not matter what, but if it is fun, the person will do it. Get the cardio and the shape does not matter as much.
The way the article is written, exercise sounds like a boring chore.
3
I see people are having a lot of trouble with the idea of intuitive eating.
"Mindful eating" may be another way of understanding it - tuning in not to one's cravings, but noting what foods bring about a sense of harmony, ease and calm, vs sugary/processed foods that almost inevitable bring about a feeling of unease and agitation.
One of the most beautiful expressions of this kind of mindfulness comes from the Zen Buddhist tradition:
"When you read, just read. When you walk, just walk. Above all, don't wobble."
But of course, in our modern frenetic and "over-thinking" world, we can take even the simplest aphorism and turn it into a dogma, or something complex.
There's a story of a Zen teacher who was spotted reading the newspaper while eating. One of his students, quite familiar with the maxim stated above, began to take him to task: "What happened to 'When you read, just read'?"
He responded, "When you eat and read, just eat and read."
13
@don salmon
Darn! Got that wrong:>))
The original saying is, "When you eat, just eat. When you walk, just walk. Above all, don't wobble."
And the student said, "What happened to, 'When you eat, just eat'?"
1
Yes it is possible to be heavy and healthy but this is not the norm. The risk factors of obesity are higher blood pressure and higher glucose levels. Their hearts have to work harder to pump the extra blood through extra miles of blood vessels. While "whatever"-shaming has become a tired catch phrase, sometimes something needs to be said, especially by a parent or doctor.
As I said in my comment to the original column, Americans have lost track of what a portion should be. In addition, people stuff their mouths with more food than is healthy for good chewing and digestion. Heavier people take bigger bites. My question to people is, how many bites in a cake pop at Starbucks? The number of bites is usually inversely proportional to their weight.
4
@S.L. - "Heavier people take bigger bites". Huh? Do you have any evidence for this? (And most heavy people have neither seen nor eaten a cake pop at Starbucks. How many bites do you use to eat one?)
4
Nowhere have I seen any comments about what’s been done to food in our country in the name of food science. Any food except raw materials (by which I mean, fresh fruit and vegetables and simple ingredients like flour and oil) has been messed-with. It’s not just fast food, it’s not just junk food like frozen items that are microwaved then eaten. Even basic bread (not home-baked) very often has unpronounceable substances in it - oh, and sugar. Lots of sugar, often.
Food manufacturers know that the biggest profits come from the foods that are manufactured. (Simple ingredients carry thin profit margins.) And everyone I know who lives outside the US comments at each visit, how sweet even our “savory” foods are. We have been intentionally habituated to sugar in everything we don’t make ourselves, all in the interest of getting us to buy more manufactured food instead of cooking ourselves.
Sugar is a white powder. White powders are addictive.
Stop saying that it’s just willpower. It’s way more complex than that.
10
@Leelee There have been plenty of comments about processed food in this thread.
@Frank - yes, I know there have been lots of comments about processed food.
My remarks are about the food that does not appear harmful - normal-appearing bread, for one thing. My point is that sugar and sweetness (‘cane syrup solids’, etc.) have been snuck into formerly savory, innocuous places. Read the labels on tomato sauce and even canned tomatoes sometime just for a laugh. They have been sweetened. Surprise! So - sugar is everywhere.
1
@Leelee You have to work pretty hard to find even one processed food item without added sugars. Even in the toniest "natural" grocery/bakery in my upscale neighborhood you will not find a whole-grain sandwich bread without added sweetener.
Intuitive Eating works if you don’t have a weight problem. For the rest of us, eating according to our feelings and not the facts is how we got into this mess.
17
Eat real food, MOSTLY plants, NOT VERY MUCH. Michel Pollan
We evolved as omnivores.
9
Personal Anecdote: Over the course of 3 months in 2003, I lost exactly 15% of my body weight (from 200 to 170) and have not gained it back.
Scientific facts: The best research i could find indicates that approximately 10-15% of those who attempt to lose weight can do so, and additionally are able to keep it off for at least 5 years.
I would say the single greatest factor in being able to lose and keep weight off was intuitive eating. Whereas the initial 3 month period of losing weight was fairly easy (intuitive eating can be dramatically helpful if you have at least some sense of what it involves), it was at least 10 years before I really got the hang of intuitive eating.
I think a lot of people hear the word "intuitive" and think of some kind of blind, instinctive "feeling." Perhaps "mindfulness" might be a better term.
However, you may be one of those people with an aversion to the term "mindfulness." If so, think of it this way:
We all have a prefrontal cortex ("PFC" for short). The PFC is responsible for what scientists of the mind refer to as "executive functions" - planning, decision making, self-awareness, self-regulation, and perhaps most important, attention.
Modern society encourages a kind of attention which is detached from emotion, sensation, imagination, intuition, etc. By training attention, it is possible to integrate analytic, critical thinking with intuitive awareness.
This can inform not just eating, but every aspect of our lives.
10
Human beings are mostly creatures of habit--which is to say we learn to do such things as brush our teeth before bed not through intuition, reason, coercion or the law of the land, but because of endless repetition of this activity to the point that brushing our teeth before bed becomes second nature.
More, our habits are deeply tied up with imitation. To paraphrase Plato, we are what we imitate. People are overweight or skinny or whatever in good part because, during the earliest years, they imitate the habits of their parents, and then as they grow, they also imitate the habits of others--their peers, what they see in social media, movies, television and advertising.
All of which is to say the author's idea of "intuitive eating" doesn't strike me as a good way for most people to achieve a healthy way of eating.
7
This is advice is, frankly, overly simplistic and fundamentally flawed about the assumptions it makes about our circumstances. The author’s heart is in the right place as is her goals, but we were born drinking breast milk and at the mercy of what our parents were able to feed us. We didn’t know if we were healthy and meeting nutritional needs, only full or not full.
Even taking her advice of “intuitive eating” at face value, what is intuitive is not necessarily accurate since appetites change with under/over eating, nutrition, food type, and mood. Part of the work towards a healthful diet is slowly realigning what is intuitively filling which requires a multifaceted solution:
An internal locus of control with a goal towards the process of developing a healthful lifestyle rather than weight watching as the author suggests.
Developing access to an affordable variety of healthful foods by eliminating food deserts especially in low income inner cities.
Calorie counting geared towards avoiding excessive amounts if the lifestyle is less active and keeping above amounts low enough to induce starvation. Whatever else isn’t as important.
Eating smaller meals more often and staying in tune with/maintaining a regular circadian rhythm to boost metabolism. With meal prepping and slow cooked meals, even time pressured homes can find some benefit.
These factors are flexible tools, not rigid rules, but the one of the most beneficial first steps is not how you eat but how you think.
3
@Gary Thank you for making the point about what humans REALLY eat at birth, and about limitations on what parents have the resources to eat themselves and feed us once we're weaned.
Weight stigmas causes weight related health problems? What about all the pathological mechanisms triggered by the excess weight that leads to diseases such as diabetes and heart attacks?
Excess weight causes accelerated wear and tear of joints, so overweight weight people will have knee arthritis earlier and more severe unless they sit around all day. No amount of non-stigmatizing will prevent that.
8
You continually cite "a significant body of research showing that weight stigma and weight cycling can explain most if not all of the associations we see between higher weights and poor health outcomes." But I am confident that there's an even more significant body of research that shows that being severely overweight is the primary cause of poor health.
You seem to have selectively chosen research to assert your rather strange (to me) theory that the whole problem is that obese kids can't deal with criticism rather than the very real problems associated with childhood obesity.
35
Sorry, I don't buy it. I grew up in a home where good eating habits were modeled and no one was overweight or even talked about weight. Yet I'm still besieged by the temptations of overprocessed foods, especially those high in simple carbohydrates and sugars. Also, I've been the caretaker of two separate generations of cats, decades apart. Each generation (2-3 cats in residence) contained one who had an eating disorder. Each was a spayed female, and each could not stop eating as long as food was available, while in contrast her companions would walk away when their hunger pangs abated. One of these females grew tremendously fat, the other ate so much so quickly she threw up after every meal — until we devised ways to slow her down and limit the food available to her. I have two grown daughters who both enjoy vegetables of all shapes, sizes and flavors, eat meat in very modest portions if at all and like to cook from scratch, and yet each has had spells when their relationship to food has been troubled. Here's all I think I know: daily exercise and a diet rich in vegetables, whole grains and fruits keeps the innards feeling pretty good and the weight down. The hard part is living by those precepts.
26
@Sarah Exactly, and no one says it’s easy. The problem is looking for easy (no tears) solutions to complex problems.
1
@Frank If by that you mean not merely intuitive, Amen!
Our drives are beautifully in tune with the environment in which we evolved; scarcity. In that world, the drive to maximize consumption and minimize expenditure is the key to survival. Eating a lot and lying on the couch all day is *exactly* what our our bodies want us to do because are bodies are smart! In a few million years our drives will catch up to this world of plentiful calories and no external pressure to be move. Until then, we may need alternative strategies to "listening to our bodies".
6
This still seems like a lot of denial of the obvious to me. Bending over backwards to assert that high B.M.I.'s are only associated with negative health consequences, not causing them, is just intentionally ignoring the obvious.
The number one killer of Americans is cardiovascular disease. The primary reasons for cardiovascular disease are being overweight or obese, and having poor nutrition. Being obese is seen as a negative thing because it IS a negative thing, having damaging impacts on all sorts of aspects of life, and reducing lifespans. People get obese by eating too much food, unhealthy types of food, and getting not enough exercise. People can and do lose weight by committing to eating less, eating more vegetables and fruits and less processed sugary foods, and exercising more.
After quitting smoking, I gained 30 pounds over a year, by replacing the urge to smoke with snacking. Hit my highest weight ever, the doc told me to take it back down a bit, and he's right. And so far I'm down about 15 pounds from there, and I know I can take the rest off, permanently, with lifestyle changes like eating less food and doing more exercise.
I guess the upside to this notion of, don't body-shame, let people be as fat and lazy as they want, is that it's better for the world as a whole if humans don't live that long. So sure, if someone wants to be 400 lbs, that's good for the environment in that they'll use a couple decades less of resources.
9
@Dan Stackhouse Your last paragraph cracks me up. Why? Because you're about as jaded and over it as I am. Thanks for the laugh.
2
@Dan Stackhouse - What happened to you after you stopped smoking seems to have happened to society at large. In the mid 60s, about 45 % of adults smoked, now it is only about 15 %. As smoking rates decreased, obesity rates increased. Coincidence? I think not.
5
This is not true. Americans have been dying of heart disease DECADES BEFORE they became obese.
4
There also needs to be a discussion about eating habits. In my school district, lunch and recess in the public schools is basically being phased out because it is not counted as instruction time. After school, I see kids grabbing snacks at CVS (sweet drinks, candy, chips, and those things labelled 'cakes' which contain 23 polysyllabic ingredients). Then they get home, parents get home and with any luck, family grabs a meal together.
Whilst the quality of the food in this country is definitely lacking, there also needs to be time to eat slowly and deliberately. I believe it takes 15 minutes for the 'full' signal to be sent from the stomach to the brain (I know someone will correct me if I'm wrong). So, we need to be sitting at the table for much longer than the time it takes to chew and swallow a plate full of food.
Europeans eat much more slowly than we do and they do not have the same obesity statistics as we do in the US. When restaurants book a table in the evening they plan for the table to be used by one party for the whole evening. Here, restauranteurs want to turn a table at least twice, and in New York, probably 3 times!
Our relationship with food in this country is warped. We mistreat it in the fields (unless you know your farmer), and it is treated with no respect in fast food restaurants - which is where a majority of people eat out. Just think about the term 'fast food': it is so wrong.
There is no single solution.
10
@Judith
Your comment makes me curious -- if a European restaurant expects the table to be used by one party all evening, are the prices for eating out much higher? Are their costs much lower? Restaurants here definitely push you out the door to turn the table, but I wonder if they could stay in business if they didn't.
2
@Judith
Yes, intuitive eating has a close interrelation with eating habits.
@Judith - Does Ireland count as Europe? My group was kicked out of a restaurant there because we hung out at the table for too long.
1
It's not clear to me why the Times is devoting space to this unproven and potentially dangerous dietary program.
We evolved through ages when the only intuition required was to eat whatever was available. Our bodies adapted to seasonal variations and we didn't have to worry about getting fat; scarcity handled that issue.
So our natural intuition would be to eat whatever we could find.
What impresses me most is not the lack of empirical evidence, but the absence of any solutions. Let's not pretend that obesity, diabetes, and cardio vascular disease are not problems.
35
I am also wondering why the Times is devoting so much space to this theory.
4
Intuitive eating is not for everyone! Some people, especially people with a history of eating disorders, need strict guidelines.
Some, if not many, also need guidelines because they're drawn to junk food.
I, for example, could intuitively live on chili cheese fries and cake. But I don't....for environmental and health reasons.
8
WW-style dieting is incredibly hard to maintain, and the resulting weight swings are both demoralizing and unhealthy. However, it's not fat-shaming to acknowledge that obesity is unhealthy.
Plant-based eating has been shown to produce better health and, for many people, healthy weight loss. It does require a change to how one eats, but it does not require calorie counting, hunger, "points" or any of those horrid ways people try to eat a weight-loss diet. It's less expensive than buying all that meat and cheese, so it doesn't have to be elitist. Plant-based eating doesn't have to be 100%, either. I basically follow Mark Bittman's "VB6" (vegan before 6 PM, i.e. dinnertime) approach. I have friends who started that way and have moved further to the plant-based side of the equation. But all of us still enjoy meat and dairy, just in smaller portions at longer intervals. If I really want a cheeseburger, I eat one without guilt; I just try not to do it very often. All of us have lost weight without even trying. Our cholesterol and blood pressure have gone down.
Any change in how we eat requires some effort and discipline at first. A benefit to choosing a plant-based diet is that you can move into it at your own pace. It does take some effort to learn how to cook appealing and nutritious vegan food (there's a lot of brown mush out there). But for us, it has proved much easier than we expected.
7
Have you attended a WW meeting recently? It is now about lifestyle, being active, and making healthy food choices. One can follow a plant-based diet on WW; the program no longer dictates so many servings of meat, fruit, etc.
That said, in my mid20s with poor eating habits, the old exchange program helped me relearn how to eat healthfully.
4
@John Magee
Sugar is plant derived. So is corn syrup. So are bread, pasta, chocolate, potato or corn chips fried in plant oils, etc. A vegetarian diet can be quite high in carbs.
5
@Nikki
Agreed. We already are on a plant based diet and it’s made the population very unhealthy. Healthy whole grains and vegetable oils come from plants. In fact, almost ALL processed food comes from plants.
1
Obesity is a huge from in our country, both for adults and, increasingly, for children. Acting "acceptingly" serves no one's interest. We need to move toward a more plant based diet, for many reasons, and find ways to increase physical activity. Fat shaming, while deplorable, is a result of the problem, not a cause. And "intuitive eating" is really just a catchy sound bite rather than a solution.
9
You gain and lose weight based on the difference between the mass (weight) of what you ingest and the mass (weight) of what you excrete (urine, sweat, feces). Nothing else. That's it. You can't "make mass" and you can't "eliminate mass" except in a nuclear reactor.
Put less in, lots of fiber (non-digestible plant matter), create sweat through exercise.
Dieting for weight loss is simple; understanding the basic physics and sticking to the plan is difficult.
3
But you don’t understand the basic physics. When you put less in, your body burns less. When you sweat more, your body ramps up your appetite and compels you to move less in the interim. It makes a zero sum game, the dreaded plateau and no weight loss over time.
2
This article serves no purpose but to allow people to abdicate responsibility for their behaviors. I am not in favor of fat shaming, but to state that obesity does not cause ill health effects is not supported by medical studies. The reality is that the external characteristics of overeating (obesity and overweight) are clearly correlated to increased morbidity and mortality. Period. This isn't fat shaming, it is stating the obvious. We are genetically wired to overeat when possible to compensate for times of scarcity; it is the current period of abundance and availability of calorie dense foods that results in over consumption and resultant obesity. The only way to deal with this is to decrease our food consumption, and no amount of politically correct nonsense stating this is "fat shaming" will change the outcome for people that don't.
33
Stop eating so much SUGAR. Stop staring at your PHONE. Get outside and get some EXERCISE.
10
I literally saw the obesity epidemic start about 40 years ago in my small town grocery store. Having been raised in an earlier generation where all meals were home cooked, and we personally ate lots of fruits, and vegetables, small portions of meat, and little sugar, etc., I saw females who had just entered the work force, mostly at that time to escape the tedious nature of child rearing, as the costs of living were low, most families were intact, and the males made an adequate living. Too tired to cook, they threw dozens of frozen pizzas on the conveyor belt, with lots of pop, and their families ate this 3 or 4 times a week. Then, with more disposable income, people started eating out more, and when fast food restaurant chains made its way to the rural areas, people indulged in that. I, on the other hand, grew all of my own vegetables, fruits, etc. cooked from scratch, had a low fat, low salt, and hardly any sugar diet. I saved my two children, now 46 & 47, from weight problems, high cholesterol, etc. that ran on my husband's side of the family. Both of them look at least 10 years younger than their age. People have abandoned a simple lifestyle, and meal preparation at home for the fast lane, spending time commuting for hours a day to jobs, activities, even out to eat. The fact that it is shortening the lives of many people, as they get little exercise when they are in the car so long, and no joy from, and awareness of food preparation, what is there left to say.
8
So all the terrible health outcomes that are ASSOCIATED with being overweight are not CAUSED by being overweight? It is just a coincidence these things happen to obese people?
Maybe I'll take up smoking, as all the terrible health outcomes ASSOCIATED with smoking may also just be a coincidence.
It may well be that getting young kids to count calories obsessively is the path for some to a sense of failure and inadequacy. But to ignore the glaringly obvious consequences of obesity is an absurd reaction to that.
52
@Philboyd
Do you know no thin people who have heart disease? Who have Type 2 diabetes? Who have strokes? Who have high blood pressure and high cholesterol?
The causal connection between smoking and lung cancer has been proven. There is no similar causal connection between weight and medical conditions. None.
Don't you think that in all the years of looking for this kind of relationship, it would have been found?
7
@JM
This is simply not true. There is absolutely no doubt that being extremely overweight causes all sorts of health conditions. For example, do you really think it's stigma that causes 400 pound people to have huge issues with joint and back pain? You don't have to be a rocket scientist to figure out the relationship between weight bearing and joint issues.
You may technically have a point when it comes to things like diabetes - in humans. But there is extensive evidence showing obesity has a causal relationship to diabetes in rats. And absolutely no reason to think the same isn't true for humans. Nobody has definitively proven a causal relationship in humans because you can't force feed humans to make them fat to see if you can give them diabetes. The reason we can't prove it is because scientists have ethical standards and the sort of experiment you would need to do to prove a causal link can't be done in humans.
10
@Philboyd It has got to be more than 15 years since I saw the first research paper cross my then husbands desk, that explained how nascent Type II diabetes caused weight gain in a significant number of people. Despite knowing that as insulin creeps up to cope with insulin resistance, and that this would lead to obesity, we have chosen to ignore it for 15 years. Look up how you move from correlation to causation and go over the research, what do you see? I don't see weight causing diabetes but beginning diabetes causing weight.
7
Looking on the bright side, these choices show up in the mortality tables. Let’s learn from those who came (and went) before us.
1
Intuitive eating might work if you live in a hunter gatherer society with no access to processed and addicting (designed intentionally) “food”.
Babies and children do not intuitively eat. They eat what they are given. There is a reason that a responsible parent doesn’t offer their child cola over milk. What evidence is there that if a child can choose whatever they want to eat, that they will stop when “full” and move on to other things until they are hungry again? The only thing intuitive about children intuitively eating is how nonsensical it is. If the author was correct there’d be no harm in installing candy vending machines in daycare centers.
33
@Dan, excellent idea, I think you're onto something! But the machines would be too high, kids in daycare don't usually cary money let alone correct change, and even if they did the coins would be a choking hazard. Not saying it's a bad idea, just that it needs some tweaking. Maybe open baskets of candy at ground level (pretty much the same as the tech company where I work) and build the cost into the tuition. Love your out-of-the box thinking!
3
It’s unbelievable to me how many people would take the time to comment without actually reading the article. I beg you to consider that shouting on about the “obesity epidemic,” is making that ‘problem’ worse. As Christy already mentioned in the article, telling someone that their size is a problem leads to worse health outcomes. Instead, she offers the research that building “healthier,” habits (if socio-economically possible) leads to better health outcomes regardless of a person’s weight. If you all actually cared about this “crises,” you would consider the ways your language is making this worse. Stigmatizing and shaming people DOES NOT WORK. Christy has done so much research on this matter. Listen to her podcast and pre-order her book if you’re interested in “fixing,” this “problem.”
17
@Jessica I did read the entire article (admittedly with increasing disbelief); you and the author seem to believe that stating the obvious, without resorting to name-calling, is the chief cause of both the increasing obesity and any health problems obese people have, and that if everyone just stopped talking about obesity, except in a positive way, everything will be fine. No, it won’t. Go work in a hospital in one of our high overweight states then let us know what you think. (For starters, you’ll be astonished by how labor intensive bariatric care is, how many more staff members are necessary for even simple tasks, like helping the patient into a car for the ride home.)
5
All this talk of dieting and not a single word about exercise? Oh well. I'm going for a walk.
5
@Barbyr
There’s are many good reasons to take a walk, but weight control isn’t one of them.
9
@Peter Would you please cite the scientific evidence for that statement?
2
@Jurretta
Many diet-centric people discount the effects of exercise on appetitie and calorie-burning. It's kind of like climate-change denial.
2
Read the link to a summary of the research supporting this article. This makes so much sense. Weight is not a behavior, so it can’t be a target for behavior modification!!!
I’ve noticed that as I slowly increased the legumes in my diet, I’ve been feeling better. Cheap and good for the planet too.
5
@Diane Weight gain is tied to behavior, and it sounds like you’re modifying your eating behavior, with positive results!
@Frank -- you can modify your behavior.
You can't control how well your body will respond to that modification.
1
In my opinion, the obesity epidemic in the world is the result of the availability of fast foods, processed foods and artificial drinks. Period.
And it is not going to change as long as there are industries making a fortune off people eating junk non-foods. If it what you have in your hand has a list of ingredients, you shouldn't be eating or drinking it. Real food does not have the ingredients listed on a package. real food only contains one ingredient.
Michael Pollan has it right when he says eat foods your grandmother (maybe great grandmother now) would recognize.
10
Encouraging people to eat more healthy foods--fruits, vegetables, nuts, etc.--is effective. Encouragement in general is effective. You can do it!
3
"...have been taught that being at the higher end of the body mass index chart causes poor health outcomes. Unfortunately, that just isn’t true."
This is nonsense. At 57 I have pelvic organ prolapse with many associated problems, arthritis in hips, knees and ankles, plus sleep apnea which contributes to major depression. All related to my body carrying more weight than it is intended to. Don't tell people that high body weight doesn't cause poor health outcomes. Celebrating "curvy" women as the new norm is fine for 20-somethings, but go back to them in their fifties and sixties and ask how things are going. Pain and limited mobility are in their futures.
85
@Evergreener Thank you for your helpful corrective, and I hope for an improvement in your condition.
4
@Evergreener
How do you know it's your weight that has caused these problems? I have many of the same issues you're experiencing and am 46, 5' 8" and have never weighed more than 120 pounds (except during my pregnancies when I went up from 112 to 142.) Some people are just luckier than others when it comes to health outcomes. I have bothersome aches and pains daily. My 80 year old mom and my 240 pound best friend are chugging along just fine.
7
These comments make me sad. They're all me, me, me. When comments like "no one wants to be fat" are made, I can only imagine how that feels to someone who's fat. Your experience is not everyone's experience.
15
@tina
I appreciate your compassion for how fat people may feel. But I ask you: Do fat people really WANT to be fat? (That's what your statement implies.) I'm not talking about people who are larger than Victoria Secret models -- which is 99.9% of us. I'm talking about people who are obese and suffer joint and cardiovascular problems because of their weight, which is about 50% of America currently.
Do you believe that obese people want to be fat? Or do you think that they want to be a healthy weight?
Do you want to be paying for their health problems as their knees and backs degenerate and they have to go more and more frequently to hospitals to control their blood sugar and kidneys? Pay for their amputations from diabetes? You pay for this through your taxes. We all pay for this through diminished quality of life with our overweight loved ones.
3
My six-year-old daughter has been grabbing food, helping after helping after helping since she was 10 months old. She does not have intuitive wisdom about it. We give her carrots and fruit and popcorn but she cries and moans about needing third helpings of dinner every day.
I’m not gonna shame her, she’s just going to be heavy. She and I apparently have intuitive panic eating as some sort of genetic holdover from tougher times. Embracing it as best we can but not interested in blanket statements about wisdom.
11
@Sarah there's no protein or fat in carrots, fruit or popcorn so it's no wonder she's always hungry. Also, corn is highly inflammatory and almost all of it in this country is GMO, so it's not a good choice. Try feeding her meats cooked in good fat.
11
@LogiGuru is there any evidence that GMO corn is unhealthy? Peer review research only.
6
@Sarah-this was me, too. Still fighting the fight. I wish my mother had accepted my genome as well as you accept your daughter's.
5
This piece was published by the NY Times on the same day as another article, "Our Food is Killing Too Many of Us." That piece lists myriad societal problems, and cites a recent JAMA article, "Association Between Dietary Factors and Mortality From Heart Disease, Stroke, and Type 2 Diabetes
in the United States."
I understand where you're coming from with your idea of intuitive eating, but there are many, many societal factors getting in the way of optimal nutrition and actual implementation of intuitive eating. Emotional eating, and any of the many other reasons why people eat when they're not hungry, must also be factored into the equation.
10
@KEL intuitive eating actually addresses issues like emotional eating (which is often caused by a restrictive dieting history) and helper people to heal from disordered eating.
The real issue that blocks optimal nutrition is poverty and income inequality, something the US suffers from in no short supply. Food insecurity is well known to create overeating. More nutrition education won't fix that. Health at Every Size actually does take into consideration someone's economic status, and promotes doing what you can with what you have.
8
@Dare I agree with your view that income inequality contributes to the obesity problem. But I would contend that poverty doesn't lead to overeating necessarily but it definitely leads to eating low quality high carb food, which causes a deadly cycle of increasing obesity. Of course other causes are the effective marketing of these unhealthy foods by food manufacturers, and stores selling those foods.
3
@KEL
Let me say this clearly, so maybe everyone can grasp it.
Association and causation are NOT the same thing.
2
One comment, just one threw me into a year long battle with anorexia when I was sixteen.
It's not common for boys to suffer thru this but I did. Looking in the mirror I saw a fat person - even thou if somebody had taken my picture with my head covered I would have seen a World War II prison camp person.
It's amazing how much Americans are obsessed with body image and it is NOT healthy. Eat whatever you like - just not too much - and exercise. Ultimately you'll live to be (fill in imaginary age here).
10
@James Thurber I'm sorry but I don't think this is accurate advice. It's the amount of carbs you consume that really matters. You can eat a lot of meat and cheese and consume very few carbs. Exercise is important, but a problem is that a lot of people think you need to do a lot of intense exercise (because fitness businesses market that notion) and I think that's simply not true. Moderate exercise should be sufficient for most people.
1
And live intelligently too. What fat does to the brain seems to be vastly understudied.
2
@James Thurber
My son developed disordered eating in college due to "lightweight crew" weight restrictions. He wisely dropped crew and recovered.
Thanks for pointing out that boys and men are affected by the dangerous diet mentality, too.
7
This talk of "intuitive eating" is all well and good if you have a switch in your brain that turns off when you're "full."
I never had one.
I had a young life full of restriction and fat shaming from my morbidly obese mother (who is 83 and diabetic). I was't even fat as a child. I was rather slim and athletic. I spent my mid-life morbidly obese myself. I got rather ill in my 40s and when I split with the ex, various things caused me to lose 100 lbs. It wasn't a great thing, nor was it healthy, but I did lose it. Now I'm trying to figure out how NOT to put it back on as my health improves.
I was VERY careful to teach MY children. My messages was: "eat everything in moderation. Have sweets and snacks sometimes and mostly good things all the time." Meanwhile, I struggled terribly with my own weight and body image.
ALL THREE of them developed eating disorders, two with full on Anorexia. One of them is diagnosed with a Personality Disorder as well (another had a pre-diagnosis).
The idea that disordered eating comes strictly from "messages from parents," is highly outrageous. It's well known that there's a significant hereditary factor and links to personality disorder. You can tell your child, "eat healthy and in moderation," and your child may *hear* "starve yourself." You are not at fault for what a disordered brain hears, if you try to send healthy messages as you struggle with your own weight.
The same thing goes for obesity. My mother didn't make me fat. I did.
18
@Dejah I think one of the worst things a parent can do is tell their child to finish all the food on their plate. In fact, I would call that an incredibly stupid way to parent because it's teaching a child to overeat...to eat by what their eyes see rather than by what their stomach tells them.
12
@Dejah We ALL can recognize hunger and fullness cues if we unlearn what dieting has taught us. It sounds as though your mother had her own disordered relationship with food which she passed on to you. I appreciate that you did your best to pass more positive messages to your kids, however eating disorders do have a genetic component. With that said environmental factors also play a huge role.
My sister and I were raised by the same woman. Our mother was thin her entire life. My sister grew up in a smaller body and I did not. Our body types couldn't be more different, which resulted in acceptance of my sister, and comments about my food intake and body for me. My sister didn't develop and eating disorder - I did.
Comments about "moderation" may come from a good place, however they create a stigma that there are "good" and "bad" foods which can lead to restriction- which as we all know can lead to bingeing (our body's natural response to restriction). Seemingly innocent comments are the reason many of us are now struggling with eating disorders.
9
@Dan I kind of get your point, but it depends on how much is on the plate. Nothing wrong with finishing a moderate meal, and don’t forget that growing and hopefully active children have entirely different food needs than adults.
1
“You eat the [right] food you lose the weight,” because both the size of the portions and the energy from protein (0-35%), carbohydrates [with fiber] (45-65%), and fat [with good mono and polyunsaturated fat] (20-35%) keep the body balanced and healthy. If my parents were nutritionists, I might have been one of the normal people that have an intuitive sense of food.
Fortunately, I have finally learned the science of nutrition, the art of cooking, and the often-overlooked skills of grocery shopping and meal planning. I lost 60 lbs. this year and no longer require diabetes medication. I also no longer share the same meals with my pleasantly plump wife [I pray she doesn’t read this] or indulge myself with friends.
For me, taking control was aided by some encouragement from my daughter (a Nurse Practitioner) and my ability to design a Microsoft Access database that records every gram of food, computes calories and nutrition for each meal, suggests meals (often high protein), and accurately projects weight loss based on the difference between consumption and burn.
In the near future I predict:
1. all smartphones will have a food app (my Samsung has a beta)
2. nutrition labels will be scannable, data will be more precise, and supermarkets and restaurants will uplink nutrition values of purchases
3. Alexa and Google will make it easy to keep a record: eg. Light English muffin, 84g ham, 63g egg, 17g ketchup
4. Teens will do more grocery shopping
Make America Healthy Again
2
@Eugene Patrick Devany What's a "light" English muffin, and why should someone eat a light English muffin? What's it light on? I presume it's not particularly light on carbs. Ketchup? Watch out...a lot of it contains corn syrup, and even the ones that don't have plenty of added sugar. Not good for any kind of diet.
3
@Dan
Thanks for asking about my breakfast sandwich, Dan. The combined 304 calorie/energy total comes from: protein 28g (37%), carbohydrate 32g (42%) and fat 7.1g (21%). When compared with the USDA recommendations (see above), the nutrient balance is high on protein and average on carbs and fat - exactly the blend that has maximised my weight loss and restored my health.
The "light" english muffin has only 100 calories with 5g of protein, 25g carbs and 1g of fat. The original Thomas's english muffin has 125 calories with just 4g of protein. The light muffin also includes 8g of fiber while the original has only 1g of fiber. The ketchup amounts to just a tablespoon and I use Hellmann's with Honey rather than added corn syrup. The Heinz brand ketchup with no added sugar is a little more expensive in my local market and does not taste as good to me.
No one should have to be a professional bookkeeper to know the nutrition value of what they ate for breakfast. More importantly, it should be easy to know how your next meal or snack should be adjusted if you ate too many grams of fat or carbs, or consumed too many total calories earlier in the day.
An easy to use food and recipe database can make meal planning fun. New combinations of food based on suggested nutrition values can overcome many bad eating habits. No food should be off limits - in the right blend. I have also learned that losing weight does not require starvation. A healthy appetite does the trick.
3
@Eugene Patrick Devany All good except you don't BURN food.
You convert glucose + oxygen into water and CO2 and then you excrete the water.
1
Don't eat this...it's bad...eat that...it's good. Be careful of that food. Eat this...it's a superfood! Make sagacious choices when dining at McDonalds. Carefully compare interminable lists of ingredients when purchasing your frozen frankenfood. Be sensible, goddamnit! Count every calorie!
Or...pay heed to the centuries-old words of Brillat-Savarin:
“Tell me what you eat, and I will tell you what you are."
“To invite people to dine with us is to make ourselves responsible for their well-being for as long as they are under our roofs.”
“the way in which meals are enjoyed is very important to the happiness of life.”
“The fate of a nation depends on the way that they eat.”
7
The best advice I ever got on dieting was to eat everything in moderation.
In the last 6 months I have lost 90 lbs by doing three things. I cut sugar out of my diet, anything with more than 1gm of sugar per serving is off the table. Two, portion control, no meal greater than my fist. And Three exercise. I started walking 2 miles a day and now I have added and hour of strength training.
There is not a single prepackaged item in my refrigerator. I cook everything from scratch. Sure it takes time but then, I save time by not going to my doctor or lying in some hospital bed.
For the last 30 years I had many excuses not to do these changes. And it was not easy. I was a hungry and cranky but in the end it has paid off. I have lost 16 inches off my waist and 4 inches of my collar. I am no longer hungry and feel better.
Dieting sucks, eating everything in moderation with minor changes is great.
14
@A A It worked for you because you didn't diet, you changed your diet. That distinction is critical.
6
The best comment on a preposterous article! Thank you. At 85, I can report that both my parents ate with the same care, teaching me. They died at 89 and 92.
2
@A A - Not to be a Debbie Downer, but you have only been doing this for 6 months. You are still in the honeymoon phase of weight loss. I hope you keep it up, but many people cannot.
7
Intuitive eating would make so much sense if most of the foods available to us were fresh, whole, and local. Instead, we live in a fraught eating landscape, where high calorie, high sugar, high carb, low nutrition foods are cheap, abundant, and- even among foodies- often celebrated. As a mother of two young daughters, I try to focus on listening to their tummies, I applaud them for telling me their tummy is full, and often talk about "everyday" foods vs "not everyday" foods. I don't wish to demonize any food choice, but I feel the need to teach them that choices are important when deciding what and when to eat.
82
@KMH, congrats to you! I raised my teenage daughters with the same philosophy. At 19, one is in recovery from a severe eating disorder. Be careful when making blanket statements about your food and childrearing philosophies. What works for one may be another’s worst nightmare.
2
At 73, I am not a wreck, but thanks to my genes and a bout with polio in childhood which capped my physical ability throughout life, I now am dealing with type 2 diabetes. I have adapted with some medications and a revamped interest in the exercise I can do--500 miles on my new bicycle in the last 4 months and swimming at the 'Y'--and I lean toward a plant-based diet.
Over 40 years as a practicing family doctor also influenced me. We practitioners emphasized weight over wellness because with the pressure of time of short visits, it was a concrete marker of what we thought of as health, one of the "vital signs". This is and remains a "numerical tyranny".
Sometimes I could break from this constraint. I found it very useful to ask a question of all patients in an examination: "It what way are you a special person?" This told everyone I thought them special and could yield a greater understanding of how best I might approach their relationship between their concerns and their health.
Archimedes said, "Give me a fulcrum and a long enough lever arm and I could move the earth". As Ms. Harrison surely believes, an absolute weight number cannot be that fulcrum for health.
7
I think the biggest mistake doctors make in this realm is not understanding metabolic syndrome. They tend to parrot years of misinformation about calories in high fat foods instead of giving the advice that carbs are the culprit.
5
@Dan Italians eat lots of carbohydrates, in addition to plenty of other nutritious food, and have a lower incidence of obesity that we do.
3
Thank you for this series of articles.
Despite various conditions and medications, emergent allergies, and the normal aging process, I am reasonably healthy and if anything, many days I have trouble figuring out what it is that my body wants me to eat. I would like to be more fit and exercise more, but that's an issue of strength (for gardening), not weight. If anything, being more fit would add a bit of weight through muscle.
I was brought up to eat intuitively, in the 70's, by a hypoglycemic mother and my grandmother. Growing up everyone thought it was just weird, but I didn't "diet" and we always had candy, cookies, etc. in the house; Dad had a sweet tooth. I fully credit my foremothers for a good relationship with food and understanding how my body works. I'm sure the research will continue to show that there is no ONE TRUE WAY to manage weight, aside from eating everything or nothing.
3
@Barbara Lee
We always had sweets in the house too. A box of cookies or a gallon of ice cream would last forever, but they were there for when you wanted something sweet. It took me a long time to understand the people who would tell me they'd eat a whole box of chocolates in one sitting.
I have to take issue with the use, in both articles, of the term: people in bodies. It is used so much these days that it makes me wonder if the concept of people in machines is right around the corner. If so, we can finally settle the debate of whether the mind is separate from the body. I know where I stand on the question as I gaze into the abyss.
7
The problem in our contemporary diet is that it lacks fiber. Essentially we are eating highly concentrated food instead of a more natural diet. I think some of the fault was with the early nutritionists who specified a 4 ounce chop,a four ounce potatoes, a six ounce vegetable and a highly refined desert. Our ancestors didn't eat that way. They would have a luxurious stew, a large dish of vegetables flavored with meat. potatoes and bed ad libitum, and lots of apples. Not much sugar, sugar was expensive.
2
@Analyst
They also worked much harder than we do today. Machines have reduced our daily exercise to next to nothing. We don't rake, we "blow" the leaves. We don't shovel, we snow blow or plow with a tractor. We don't push a lawn mower around we drive a toy car, aka a lawnmower. The machines free up more time but they are detrimental to our bodies.
2
The doctor lost me at this," As for how to help a child with diabetes and fatty liver disease: Those conditions can be treated without ever prescribing weight loss..." The answer cannot be to throw some pharmaceuticals at it.
7
@Traci
Well said.
3
@HRD- The primary target is not weight loss, it's focusing on the behaviors that influence health, and for some people, also can result in weight loss. Weight loss is not a behavior, walking the dog every evening is a behavior. Drinking more water instead of more soda is a behavior. Getting 9-10 hours of sleep instead of 4-5 is a behavior. And, all of these behaviors have a positive impact on blood sugar management and other health indicators. When the prescription is "You need to lose X amount of weight" the focus becomes solely on the weight loss as the indicator of success. For many, losing weight is difficult, and for most, maintaining weight loss is beyond difficult. So, there is a perception of "doing something wrong" or "not having enough willpower" and all the behaviors (walking the dog, drinking water, getting more sleep) get shoved aside in a "what's the use, it doesn't work" mindset. So begins the weight cycling (loss-gain-loss-gain) and worsening health (diabetes, fatty liver). And, the lack of weight loss and subsequent weight gain gets blamed. And, what complicates this even further for children are the attempts to lose weight at a time in their lives when they are supposed to be growing and gaining weight....more bone, more muscle, more body organs, and yes, even more body fat.
61
Obesity of adults and children is an epidemic in the US, with grave near- and long-term consequences.
If parents do not take an active role in shaping what their children eat, who will? The purveyors and advertisers of fast food and other unhealthy comestibles? I don’t think so.
9
@Mon Ray did you not read the article? Dieting, weight cycling, and weight stigma are the problem at hand. 95% of dieters gain more weight long term. Weight stigma causes long term weight gain and disease. The language you're using is literally making this problem worse. Do yourself a favor and read this article again.
12
@Jessica Eating whatever one wants (or has been led by marketing to want) is a recipe for disaster.
Obesity is harmful for children and adults.
1
@Mon Ray You’re right, Jessica is wrong, and I did read the article.
Only one comment above mentioned a key factor in all this, the excuses we tell ourselves so that we don’t have to do something we don’t want to do.
2
The "way we were born eating" is with breast milk, formula, or other presumably healthy foods. Intuitive eating, i.e., eating what your body craves beyond early childhood where free will is available, in a kitchen or fast food restaurant or 7-Eleven full of high carb junk processed food, is decidedly a terrible way to eat. Why do you think there's so much more obesity nowadays? Look around at all the junk food that calls out to us everywhere we go: heaping portions of unhealthy high carb foods (bread, pasta, rice, pastries, sodas, chips, etc.). are engineered to stimulate our cravings and as a side effect cause destructive metabolic syndrome. Telling people that it's OK to eat however you want and be however overweight you want is HORRIBLE health advice that does nothing to stop or reverse the ravages of diabetes, heart disease, joint problems, low self-esteem, etc. Nobody wants to be overweight, and pudgy is not the new slender. Much more informed and useful advice would be to dump WW and calorie counting and instead focus on carbs and metabolic syndrome.
41
Following our "intuition" about eating is what got us into this mess.Endorsing something so unscientific is exacerbating the problem. My intuition says,"if it feels right,how wrong could it be?" People need to learn how to count servings,and how big there portions should be. My intuition tells me to eat like it's Thanksgiving every day--eating beyond the feing of satiety. So I need to keep it in check. It's not intuitive;it takes a lot of work.
39
@Randeep Chauhan
That's not what is meant by "intuition."
Mindfulness (or if you don't like that word and have been fooled by a lot of ignorant hype about it - "attention") can be practiced to a point that one's intuition is sufficient to be able to eat almost the precise amount of calories the body needs, within about 3 or 4%.
Research studies have been quite well replicated showing this to be the case.
The craving for Thanksgiving excess is the result of failing to attend carefully to the difference between what is pleasurable and what is good for one.
I hope you'll forgive me for pointing you to one of the greatest texts in what I assume to be the great civilization of which you are fortunate to be the heir.
Nearly 3000 years ago, the Katha Upanishad spoke eloquently of the need to discern the difference between "preya" (what is pleasant, that is, what our emotional cravings drive us to do) and "shreya" (what is beneficial, promoting harmony within and without).
In the Indian tradition, it is considered one of the highest achievements of humanity to develop such discernment.
It's kind of like the difference between Trump and Obama.
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@Randeep Chauhan
If you detect satiety then your eating intuition is working just fine. The fact that you keep going means it's your judgment that's impaired.
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@don salmon
Reading my name and deciding I'm a part of a "great civilization" or Indian tradition is very patronizing,presumptuous and judgmental I do not think you meant it that way--but please don't assume. I understand your premise;but the majority of Americans are overweight. So something isn't working.
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“That’s not always because people can’t stick to the diet; in many cases people regain lost weight even while continuing to adhere to the same diet that initially produced the weight loss. “
Citation please.
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@AJ
There are many valid articles on the information that you seek, available online by searching why diets don’t work. Skeptics who have not struggled with weight may find it enlightening what others are dealing with. A Washington Post article among others, explains for those who thinks it is simply a matter of willpower or calories in/calories out.
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People who lose weight quickly seem to cause their bodies to turn more food into fat when try return to a normal dietary, not overeating. To avoid this one must control how fast one loses weight and how long to return to normal to allow the body to not react as if it has just been starved. When people regain weight lost the new weight is higher than the weight was previously, and this is a common pattern for those losing large amounts of weight and who become oversight again. Most people after they lose a lot of weight do not change how they had eaten before dieting but resume it.
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@Artur. Most of those articles focus on the reasons people are unable to stick to a diet. The Wapo article focuses on things like feeling hungrier and being more tempted. None cite a scientific study that shows those that stick to a diet still regain the weight. That’s what I was looking for a citation to.
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If people focus upon dietary, they will focus upon what they are eating, and that will tend to make eating more than just taking in nourishment. And it's true that generally, people who go on crash diets, end up weighing more that before.
Instinctive tastes for foods that produce stored fat is why people end up eating too much of them. Educating people so that they don't is part of training them to not become obese. Maybe don't try to avoid eating them but keep the amount low and don't overeat. But saying nothing and just letting them eat, well, that will not work any better than forbidding any of it.
But dismissing the role of obesity in health is just misleading. People who lose weight greatly improve their measures of high risk conditions.
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