Sunday, March 13, 2011

Conspicuous Consumption

A few months ago I mentioned how some people are utilizing Facebook and Twitter to track their diets and lose weight. On the flip side, more recently I've encountered the phenomenon of in-your-face eating, a public gorging of sorts, and I'm wondering what the motivation is for such behavior.

My interest was piqued after reading an article in the New York Times about actresses' "documented instances of public eating." It is more common than not, that high profile interviews with female celebrities are conducted in restaurants where the waif thin starlette will indulge in an unnecessarily decadent meal, documented in print as she discusses her latest film, television show or theater project if to say that she is a "normal" person too. Public displays of eating, particularly of comfort food and fast food, has become a type of countercultural way for people to prove that they aren't obsessing about their weight like everyone else is. And in some circles it's become downright obnoxious, with Facebook photos of gluttonous meals that instill envy (intentionally or not) in friends who watch what they eat or struggle with their weight. Last week a friend of mine was particularly peeved at the implication of a friend's gratuitous photo of a meal that could only be called pornographic (see CSPI's food porn column for more on this). She was offended by the Facebook post because to her it screamed,"I'm so lucky the rules don't apply to me."

Thinking back to my sociological theory days, Veblen's term "conspicuous consumption" was meant to point to the ways wealth is often displayed to demonstrate social status. Similarly I think that in a post trans-fat world the conspicuous consumption of excessive saturated fats, refined carbohydrates and sugars can sometimes be used to convey a level of luxury, a transcendence of health concerns, a liberated and carefree approach. Maybe that's what is so infuriating to some. But then I wonder, oh why take everything so seriously? Whatever happened to the phrase "eat, drink and be merry, for tomorrow we die"? What are your thoughts?

Thursday, March 10, 2011

Does Size Matter?

It seems that my post about hCG struck a nerve with some people and I'm glad to see it generating some discussion. One bottom line issue that it presents is: how important is it to be thin? Can a person be overweight and healthy? Linda Bacon's Health At Every Size (HAES) movement argues that an overwhelming body of research is now pointing to the fact that while increased weight is correlated with health conditions like diabetes and heart disease, it may not necessarily cause it. What may be causing more problems are the stress-inducing measures people go to in order to lose weight. The yo-yo dieting, overexercising, disordered eating that can lead to self-hatred, depression and a sense of failure, may be more detrimental in the long run. HAES is fighting a long uphill battle to promote body acceptance and healthy living, independent of size. For many of us, this can be difficult to chew on.

A few weeks ago I attended a discussion of HAES with dietitians who use it in practice. They described the potential for helping patients completely change their sense of self and their relationships to their bodies. But how do you equip them against the barrage of media and images that counter this notion that you can achieve not only health and (I feel compelled to add) beauty at every size? They looked at me and each said: "It's very hard." How hard? After watching "America the Beautiful," a documentary about Americans' obsession with beauty I realized it was much hard than I'd even believed. One shocking statistic: Within three minutes of looking at fashion magazines, 70% of women report feeling guilty, ashamed and depressed. Click here for more shocking stats.

The connection between size and beauty cannot be overstated. While Dove worked hard to create a "real women" campaign, it still focused on physical beauty and size. They may admit to doctoring images in magazines, but they are still presenting images of ideals that do not conform to reality. In my relationship with my own body I noticed a few significant turning points. One was when I canceled my cable service and stopped watching television regularly and the other was when I worked at a community center teaching swimming lessons. Every day in the locker room and swimming pool I saw that bodies come in all ages, shapes, sizes and colors. You learn that strength and endurance in the water are not necessarily correlated with how good a person may look in their bathing suit. The magic of the water is its forgiveness. It is one place where fat enables you to float, to relax, let go and just be.

As the winter draws to a close (at least on the calendar, if not in temperature), I notice my own body a bit softer and curvier than six months ago. My pants are more snug after a winter filled with school work, less time to be active and more warming comfort foods. And it's tempting to hate myself and my body, to hide at the gym until I look the way I want to and feel as strong as I like to. But I recognize my own pattern, my annual response to seasonal change, the constantly shifting priorities and demands on my time, and I'm working hard to quell the critical voice in my head. And I try to go swimming when I can. I find the water refreshing and therapeutic because forgives and that's a lesson I could use for myself. At the end of the day, be it size, health or beauty, we can all learn to go a bit easier on ourselves. Holding ourselves up to impossible standards will only decrease our happiness and increase stress, depression and anxiety. Research shows that is the best way to improve our quality of life is to learn self-compassion.

So in the end, does size matter? Only if you let it.

Wednesday, March 9, 2011

The hCG Diet

Or: How Making Money on Weight Loss Undermines the Medical Profession

A few months ago while at the Hazon Food Conference, I was approached by at least two people who wanted to know my opinion on the hCG diet. At the time I'd never heard about it, though I was familiar with hCG, or human chorionic gonadotropin, a hormone that surges in pregnant women, released into their urine - the very one, in fact, used to indicate pregnancy on the at-home test kits. My curiosity was piqued, and suddenly I started noticing hCG was everywhere. In my spam emails, on talk shows. One Google search for hCG diet yields over 5 million hits in 0.09 seconds.

Just a few days into my winter quarter classes, I learned about a group project in my Nutritional Supplementation class that would focus on a variety of supplements. I signed up for weight loss supplements and focused on hCG, among others. That provided me with the motivation to investigate this diet further. At the same time, my sister, taking a personal training course had to present on a fad diet too - her instructor assigned her hCG. We shared our findings and were shocked at what we discovered.

The hCG diet was born out of the work of Dr. ATW Simeons in the 1950s. The hormone, which is used (and approved) for treatment of infertility and hypogonadism, was found to help obese women lose weight when administered in conjunction with a 500 kcal/day diet. Ever since then the diet has had followers, despite repeated studies throughout the 1970s and 1990s that showed it held no validity whatsoever. Dr. Simeons believed that hCG injections helped reduce hunger and stimulated release of fat stores while the calorie restriction accelerated weight loss. Studies do not confirm his claims, but many medical professionals continue to use hCG, charging patients thousands of dollars to undergo treatment. HCG is also available online as homeopathic drops and creams, but the "gold-standard" requires a prescription and care from a licensed professional. Despite the FDA and JAMA's warnings about use of hCG for weight loss, just yesterday the New York Times printed an article about doctors using the hCG diet:

“From an anecdotal point of view,” Dr. Bissoon said, “physicians all around the country have seen people losing a tremendous amount of weight with this stuff, and you cannot afford to ignore that.”
Actually, you can. Anecdotal weight loss supplements via injection of sex hormones is not okay in a medical profession that relies on evidence-based research. It's true that patients have been losing weight, as anyone on a 5oo kcal/day diet would. This segment about success with the hCG diet on The Mike and Juliet Show is particularly amusing:

One site commented that the diet validated anorexia, by endorsing such low calorie dieting for significant periods of time. In fact, one woman interviewed for the article was a former anorexic who liked using hCG because she could lose weight and control her hunger without obsessing over food like she used to. But beyond that, I think Dr. Bissoon betrays something greater. When he says "You cannot afford to ignore that" he really means that he cannot afford to ignore that. As doctors struggle to find more ways to make money (see recent piece on psychiatrists' shift toward drug therapy), the hCG diet provides an easy way to make a few thousand dollars at a time. One cycle can cost patients between $1,000-1,500 a pop, and patients may return for up to four rounds.

What amazes me is how people - especially medical professionals - do not seem to be concerned with potential side effects, long term implications of taking pregnancy hormones and living on low calorie diets. I have not found any convincing reports from within the medical profession (allopathic or naturopathic), other than statements that it helps people lose weight. And that is perhaps the saddest reality of the diet. As we increasingly stigmatize obesity for being correlated with so many chronic diseases, we fail to address root causes and instead search for quick-fixes. After researching weight loss and ergogenic supplements this quarter I've learned that there are billions of dollars to be made, few products that show any efficacy and countless cases of false claims and contamination. In the quest to make more money, social and medical responsibility seem to have been tossed aside. The irony is that the recent resurgence of hCG is attributed to Kevin Trudeau's The Natural Weight Loss Cure "They" Don't Want You to Know About, who alleges that the FDA and pharmaceutical industry are conspiring to keep it a secret. Instead, his book supports professionals swindling people out of millions of dollars rather than helping them lose weight responsibly and sustainably.

The issues around obesity, size, public health, body image and eating disorders has become increasingly complicated. The more I delve into this field, the more I find that the real need lies in media literacy, education, critical thinking and self-awareness. Over the next few weeks I plan to focus more on these topics, that have been on my mind for a while and I invite your input to steer that conversation.