Docsplainin' -- it's what I do

Docsplainin'--it's what I do.
After all, I'm a doc, aren't I?



Showing posts with label Health. Show all posts
Showing posts with label Health. Show all posts

Monday, May 6, 2013

International No Diet Day

In honor of International No Diet Day, I thought I'd share my own diet history. 

My mother was a dieter, which is kind of ironic considering that she was so skinny when she was little (the story was, she'd been sick with something) that the family doctor told my grandmother to give her a beer every day to plump her up a little. Even in her teens and early adulthood, the photographs show a slender, athletic build. But that's how the diet industry works -- according to that old sales adage, create a need then fill it. By the 1960s, she was convinced she was fat, and for decades went on every crazy diet that came out, including, once, The Drinking Man's Diet. So dieting, self-hate, and alienation from my own internal signals of hunger and satiety were modeled for me from an early age.

The sixties also, not coincidentally, was the decade in which I hit puberty and Twiggy became an international sensation. I turned 15 the year she began her career. My friends and I were all soon on diets, as our bodies began to fill out in the way nature intended and we wanted them to look like Twiggy's. I remember at 13 skipping lunch to lose weight, when I had very little to lose (I think back then I hovered around 105 lbs) and at some point in there learning to count calories: I had my intake down to 800 calories a day some days. God only knows what kind of damage I did to my growing body during those years, all supported by the messages we were all getting from Seventeen Magazine, television ads, and just about everywhere else in the media, and my own mother. 

That began the weight cycling. I was never fat, hovering around 125 pounds by the time I got out of college, but I was convinced I was. 

By the time I'd got married and started into my first round of graduate school, I'd discovered feminism, along with their take on the objectification of women and diets. For a time, I was free of dieting, learning to eat intuitively, and loving it. But the diet industry is seductive, and by the eighties they'd learned to associate health with weight loss to not only scare us into dieting but convince us that we were actually doing something good for ourselves.

It was in the eighties that I quit drinking. Of course, I lost a little weight right off, and somehow that triggered another round of dieting. I became a little (okay, maybe more than a little) obsessive about it -- there's page after page after page of wasted journal space taken up with little more than calorie counts and daily records of my weight. I lost 30 pounds, which was probably 25 pounds more than I "needed" to. I started passing out and falling, and my friends began to express concern. I was a size 10, struggling to get into an 8, because I had some vague memory of wearing an 8 in middle school and thought that was where I "should" be.

I started graduate school again, and my weight began to creep up as I didn't lift anything heavier than a textbook, I wasn't in charge of the cooking at home any more, and I was under massive stress. By the time I graduated I was, for me, positively huge, weighing in at nearly 185 pounds. And somewhere in there, I got, for the second time, the message that dieting was not the solution, but the problem. When it was relevant to the topic in my psychology classes, I would spin around in front of the class and tell my students, "This is the body you get with dieting." 

But the diet industry is seductive. Somehow, between the fifties and the year 2000, when I was diagnosed "pre-diabetic" ("pre" anything is a whole 'nother problem, more to do with the pharmaceutical industry, and we'll save that rant for another day), the diet mentality had thoroughly infiltrated the medical profession. Doctors were convinced that it was weight gain that led to diabetes, for example, and not the other way 'round, as recent research suggests, and I was placed on a medical diet. Off came the pounds. Back came the obsessive behavior. Until Mr. Wood got sick and had to go out of state for treatment. 

Because here's one of the things about diets. They can call them 'lifestyle changes' all they want, but they're not. Because if they were, they'd be pleasurable and sustainable. But they're not. Instead, they're onerous and unnatural, and when you get busy having a life, there's not time for all that obsessive behavior, and the diet -- because that is what it is -- goes by the wayside. 

Feminists, by the way, would say that is part of the point. The Incredible Shrinking Woman has been used as a metaphor (I wish I could remember by whom, so I could cite her appropriately, but unfortunately I cannot) for what all patriarchal societies, ours not excepted, would like to do to all women -- make us smaller, and smaller, and smaller, and less visible, less powerful, until we disappear entirely. And occupy us with silly things like our hair and our makeup and our pants size so that we don't have time or energy (or money) left over to be intentional actors in the world outside our own skins. 

Anyway, back came some of the weight. Interestingly, however, the diabetes did not come back. Why? Because I actually had, in and around the diet crap, made some actual lifestyle changes. More complex carbs, more fiber, for example. Less stress. Which is what research over the last decade has been showing more and more -- that if you make a lifestyle change having nothing to do with cutting calories or losing weight, a real lifestyle change like more exercise, or more fiber, or less salt, well then. Your health improves. Imagine that! And those are achievable goals, whereas anything more than temporary weight loss is a chimera.

Fortunately, before I could go on my next diet, I discovered Health At Every Size (HAES) and re-discovered intuitive eating. I have not dieted a day in my life for the past two years, and -- surprise! -- my weight is absolutely stable. My labs are fine, too. My blood pressure is fine. My total cholesterol ain't so hot, but that's mainly because my good cholesterol is too low (and my heart attack risk remains rock-bottom for a woman my age, according to the Framingham tables).  My blood glucose is fine. As for my mental health, I have finally divorced food choices from morality, from character. I have no guilt about my eating any more. I don't criticize or dislike my own body but am coming to appreciate what an intricate marvel it is, and to appreciate it for what it can do. No obsessive-compulsive behavior: What I eat or don't eat doesn't rent the best spaces in my head any more. 

The third time, as they say, is the charm. I am experimenting with new foods, eating intuitively and meditatively and enjoying my meals as the sensual experience they are intended to be. And the funny thing is, this business of learning to think with my whole body instead of just my head is expanding into other areas of my life and I'm learning to take care of myself in other ways as well as feeding myself better, learning to enjoy other experiences more. 

This is International No Diet Day. Try it. Just say "no" to food rules today. Say "no" to moral judgments on your eating. Say "no" to character assassination based on your appearance. Just for one day, don't police other women's bodies, either, or tell them what to eat or not eat. Just for today, listen to your body. Eat what you are hungry for. Stop when you're not. 

Try it. You'll like it.
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Monday, April 1, 2013

Fat and your health

This is an odd little piece that doesn't have anything to do with anything other than that these two stories have been on my mind a lot lately.

Some time ago I read an article on ethics that took a dying man to task for not making arrangements for his practice, not telling his colleagues and clients he was sick, continuing to work after he was probably no longer competent to, etc. The writer never addressed what to me was the most poignant part of the whole story, that as he lost more and more weight, becoming thinner and thinner as he dwindled away to nothing, his colleagues congratulated him and told him how wonderful he looked. Only in our culture would drastic weight loss not be an alarm signal that something was drastically wrong. But nobody in his practice, apparently, ever thought to ask him if he were ill. My heart aches when I imagine how each of those well-meaning compliments must have only increased his isolation, and what a lonely death his must have been in the end.

The other story I have for you today is of a woman who had a tumor growing in her belly. It went undiagnosed for a long time because everybody--including her weight loss doctor--assumed it was because she was fat. She'd even complained at the weight loss clinic that no matter how much she dieted, no matter how much weight she lost, her belly wasn't shrinking. It was uncomfortable. It finally got so big that it was about to burst, as I understand it, but it wasn't until she started throwing up green bile that she went to the local Emergency Department. Surgery to remove it nearly cost her her colon, and complications from surgery to repair that almost cost her her life. It did all together cost her 15 months off work, so sick she was unable to walk around her own house. 

Only in our culture could we be so out of touch with our own bodies. 

As I wrote this, Zemanta threw up article after article, photo after photo for me to select from to illustrate my stories or to link to. Every one of them was about diets--most for useless junk like green coffee. Not one article, not one graphic raised concerns about weight loss being a sign of illness. Not one. And yet among wild animals and human cultures of the past, that's universally what it was. A nice, healthy layer of fat has always been a sign of plenty, and of well-being. Bears put on fat before they hibernate. Hummingbirds put on weight before they migrate. Old horsemen used to talk about 'good keepers', that is, horses that could maintain their weight.

But beyond that, I suspect that prior to the last 50 years or so, we've been in better touch with our own bodies. Surely people are born knowing how to eat--half a million years of evolution would have seen to that--but over the last half-century we've let the "experts" and the diet industry tell us what, how, and when we should eat. Signals that should come from within now get ignored in favor of arbitrary directions from without. It's no surprise that few of us know when we're hungry any more, never mind what for, or when we're satisfied. And it would not surprise me if that, in turn, led us to be out of touch with other internal signals, from signals that we are getting tired and need to rest to signals that we might be getting sick. 

If that is so, then might not mindful eating be the start of a path back to a lot more mindfulness, toward getting to know many aspects of our internal experience, and perhaps even a step toward approaching others' experiences free of erroneous assumptions about weight and diet?
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Monday, December 28, 2009

50% success rate for New Year's Resolutions

Albino rat. From: http://dir.niehs.nih.gov/dir...
Despite the Guardian's grim headline (New Year's Resolutions Doomed to Failure, Psychologists Say), what the psychologists in question actually seem to be saying is that if you follow basic behavioral principles developed by psychologists over decades of scientific research, rather than mere impulse or self-help blather, you have a 50-50 chance of achieving your goals this year.
  1. Don't pick something on impulse. Pick something you've been thinking about doing for a while and have had a chance to plan a bit.
  2. Set a series of small, measurable goals instead of one giant one. 
  3. Keep records of your progress.
  4. Enlist support: Go to Alcoholics Anonymous meetings, or tell your family what you're doing, or get an exercise buddy.
  5. Focus on the positive--don't plan to lose weight, plan to add 5-9 servings of fruits and vegetables to your daily diet.

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