I recently read a blog that was getting a lot of attention – not very positive – in the blogsphere. The blog posted at MailOnline.com, was written by a woman who for the last 30 years, “diets every day of her life.” She describes hosting a dinner party and being gifted a delectable and large box of chocolates. It ended up in the garbage, covered in coffee waste that I assume was meant to ensure that it did not, hours later, get retrieved in a moment of “I want a treat” weakness. The 42 year old writer goes on to state that any “self-respecting woman would want to be thin,” and thin requires that you spend every day on a diet. Before you let that last comment raise your ire, you need to know that quote is apparently directly from the lips of Joan Collins, the actress.
The writer gloats that she made it through the most recent Easter with nary a chocolate passing her lips. She makes no effort to conceal her disgust of those around her who see the holiday as a “free pass to gorge on chocolate.” You do sense some of her teen angst and misery, apparently still with her, as she describes being an overweight teen and “quite dumpy.” Samantha paints in great detail losing weight as an adolescent and the wonderful feeling of being slim and in control; of trying austere diets in her 20s to keep the weight off; of loving Los Angeles because it is the “city on a permanent diet.” She even rented a house with no kitchen (never heard of that before) to keep all eating experiences outside the home and well-controlled. Samantha only dated men who liked her thin, because it kept her self-limiting eating habit under control, and she married a fellow who met this criteria, because the pressure to keep him happy via her slim waistline, fuels her dieting (albeit with an occasional slip). She channels the French and their dietary concepts, and acknowledges that the world condemned Kate Moss for suggesting that “nothing tastes as good as thin.” For Samantha Brick, “nothing in life signals failure better than fat.”
Where to begin?
If We Call Obesity a Disease
If we indeed classify obesity as a disease, then like all other diseases, the patient needs to follow the prescription that ensures that (a) he thwarts the disease and its multiple negative health implications and (b) he keeps the disease from recurring and (c) he preserves a decent quality of life as he accomplishes the first two goals. Samantha is correct that the answer to obesity is diet. For some it may also include surgery, medication, and therapy (and maybe Samantha needs the therapy). But if you are diagnosed as obese, you will likely have to find an eating program that includes some strict parameters, and that basic approach to eating will have to continue for the rest of your life. Glaringly missing in her blog is any remote mention of exercise – a terrible omission. Exercise can help you to maintain energy balance and provide a host of other health benefits. Most experts do consider the food part of the equation as the main core of the prescription. So Samantha’s incredible vigilance – minus the unhealthy food approaches she utilizes in between, and her judgmental tone and unkind words and comments – is the current reality of obesity treatment. You can hate that truth – but it is just that, the harsh truth.
If We Are To Treat Obesity
Empathy has a role in this disease, but so does honesty. Quite frankly, this disease is especially daunting because unlike other addictive vices, we need food in our environment and we can’t always control tempting moments or food scenarios. It can also be excruciating to try and alleviate stress, anxiety or other negative feelings and sometimes positive celebratory moments, without the high fat, high salt, high sugar food that most of us have come to love….and overeat. Someone who struggles with extreme weight issues has to find a way to do so. Then there’s the problem with perception. A recent study suggested that doctors are not taking the time to address weight (and lack of exercise) when they see patients. Then another study suggested that patients don’t want to be confronted by their doctor with regards to treating obesity unless they, the patient, bring up the topic. Still another study suggested that obese doctors, who try to discuss weight issues with their patients, are perceived as hypocrites. Finally, another study suggests that a significant number of parents identify pediatricians as “butting into their business,” if they try to address a child’s weight in any sort of meaningful way.
I have had patients who need to literally keep their cupboards empty for fear of a binge. I know of one woman whose husband locks the refrigerator at night, because she will wake up in the middle of the night and try to eat. You can call it crazy – I call it – their personal solution to fighting back against entrenched habits that won’t resolve easily. I can also tell you about clients who never miss their daily exercise, even on vacation, and whose family members or friends are not supportive but rather, critical. I can tell you about long term successful dieters who have kept weight off for ten plus years and are very rigid in how they eat, while suffering the judgment of others who think they are “a drag.” I can also tell you about friendships broken because when one loses weight, others feel they are being judged, even if they’re not. I can also point to some spouses who initially supportive of the other spouse’s weight loss, then find themselves disliking the new attention their slimmer spouse receives, and decide to sabotage with constant food gifts and unkind words.
Is being fat a failure? No more so than someone who struggles with blood sugar control, or maintaining a healthy blood pressure or cholesterol levels, because of diet and lifestyle decisions they choose to make or not make. Treatment requires an ongoing and proactive commitment and it will typically have many challenges along the way. Not everyone is successful, despite their efforts, but then the disease and its impact persists, sometimes with very awful consequences. Sometimes a more moderate goal is achieved, and that's to be commended but also acknowledged as disease modification, not full remission. That's reality. So before we castigate Samantha for her harsh words and questionable approach to her own weight issues – let’s at least be willing to discuss some of the truths that seem to be hiding among her very revealing blog comments.
Amy Hendel is a health professional, journalist and host of Food Rescue, Simple Smoothies and What’s for Lunch? Author of Fat Families, Thin Families and The 4 Habits of Healthy Families, she tweets health headlines daily @HealthGal1103. Catch her guest appearances on Marie! on Hallmark and other local and national news and talk shows.
Published On: May 05, 2013