The Weight Loss Plateau
Here is a brief video in which I explain the issue of the weight loss plateau and how this proves an important challenge in weight management. (e-mail subscribers will have to visit the blog to view) AMS Edmonton, Alberta
Governments Must Create a Level Playing Field for Companies Trying to Sell Healthier Foods
Government has an important role to play in protecting and improving the health of its citizens. This role also extends to promoting a healthy and wholesome food supply. Anyone, who disagrees, is perhaps best directed to an article by Dana Olstad, Kim Raine and Linda McCargar (University of Alberta), published in Public Health Nutrition, which makes a strong case for government regulations in improving the quality of foods available to children in public facilities. This paper follows on the heels a previous paper, in which these authors documented the appalling state of foods and beverages sold in publicly funded recreational facilities across Alberta. The current paper is of particular interest, because it delves into the ‘whys’ that prevent some facility operators from offering healthier fare to their clients. The researchers conducted in-depth structured interviewers with operators of all six privately operated, for-profit food service companies that provide foods in recreational facilities across Alberta. These included both companies that have and those that haven’t adapted voluntary, government-issued nutrition guidelines (Alberta Nutrition Guidelines for Children and Youth, ANGCY), which “categorize food and beverages according to their nutrient content as ‘choose most often’ (consume daily), ‘choose sometimes’ (≤3 servings/week) and ‘choose least often’ (≤1 serving/week), and recommend that healthier options be available at all times and fresh, convenient, visible and attractively packaged and priced.” The rather unexpected finding of this study was that, “Most managers agreed that government-mandated adherence to the ANGCY was the only feasible means of achieving widespread adoption in recreational facilities, as voluntary adoption was not in their financial interests…. Ideally, managers felt adherence should be mandatory for the entire food service sector, or at minimum for those businesses located within close proximity to recreational facilities.” In addition, “The lack of a single, national nutrition standard was an important barrier to implementation of the ANGCY for franchised operations, which had to simultaneously comply with several different provincial standards.” Overall, this ‘call for mandated regulation (even for Canada-wide standards), is perhaps not all that surprising, given that: “Managers felt very susceptible to competitive pressures and were concerned that the ANGCY targeted a small number of sectors. If they could not sell the items their customers demanded, then patrons would simply purchase unhealthy items elsewhere….The problem was particularly salient for one vending machine company that had implemented the ANGCY in a facility where the concessions had not.” Thus, “Requiring all food service… Read More »
There is No Universal Causal Theory of Obesity…
…except perhaps that there is no universal causal theory of obesity. In a world where everyone is looking for quick-fixes and approaches to dealing with almost any societal problem, quickly degenerate into opinionated activism, I often find it important to remind myself that obesity is not a simple problem where identifying (and eliminating) one cause will “solve” the issue. I was reminded of this by some of the comments to yesterday’s post on emotional eating, which pointed out that too much emphasis on the emotional aspects of overeating simply adds another narrative to “pathologizing” people with excess weight. In other words, not only are obese people gluttonous sloths without will power, they are now also emotionally-wounded wrecks (you can chose, which of these is worse). The fact, however, is that the vast majority of people with excess weight are none of these. There are countless people with excess weight, who eat as much or as little as skinny folks; the problem of inactivity and sedentariness in Canada affects 95% of the population (and not just the 60% who are overweight or obese); throughout history, overweight and obese individuals have expressed incredible feats of determination and will power; and psychiatric wards are full of skinny people with mental illness. Thus, as I have often discussed in previous posts, the ‘root causes’ of obesity are as diverse as not having enough money or time to eat to taking medications for your allergies. Throw in an ounce of genetics (any of the the 1000s of genes involved in appetite, hunger, metabolism), and you have the perfect scenario for continuous and fruitless debates on what is really driving the obesity epidemic. For those of us, who embrace activism, we can chose the target we happen to feel most strongly about and go for it with all our energy and passion. The list of seemingly worthwhile and deserving targets is long: junk food, caloric beverages, TVs, computer screens, lost cooking skills, built environments, cars, automation, over-scheduled kids, poor parenting, sleep deprivation, environmental toxins, allergies, gut bugs, viruses, stress, dieting, fashion ideals, bullies, and probably a few more. Which of these factors individually or in combination are most responsible for making us fat is anyone’s guess – what may have some evidence or support at a population level is often irrelevant when it comes to individuals (your reasons for being overweight are different from mine). So,… Read More »
Emotional Overeating
Over the past few days I have shared some of my thoughts on how a “healthy” diet must not only ensure appropriate nutritional and caloric balance but must also foster emotional balance (reasonably skewed to the positive side). Thinking about this issue, yesterday, I finally got around to picking up the copy of a book on emotional eating that was sent to me several months ago (disclaimer!) by Marcia Sirota, a Toronto-based psychiatrist, who specializes in the treatment of trauma and addictions. The book with the title, “Emotional Overeating: Know the Triggers, Heal Your Mind, and Never Diet Again“, focusses on the many emotional reasons that drive us to diet and overeat. To Sirota, dieting and compulsive overeating are simply two sides of the same coin, both rooted in the need to deal with childhood hurts, losses and unmet needs as well as adult suffering, whether conscious or unconscious. “People think that they don’t have an eating disorder if their weight is normal for their age and body type, but it’s not your size that’s indicative of the problem; it’s the degree to which you think obsessively and behave compulsively with regard to food and your weight. Until you’ve let go of the obsessive thinking and compulsive behaviors associated with disordered eating, you’ll never be happy or free.” “No matter what your size is, if you can’t stop thinking about eating and weight and can’t stop compulsively indulging or restricting, then you’re unhappily locked in the prison of food addiction.” The severity of the problem depends on “…the degree to which you’ve been wounded emotionally and the degree to which food has become the solution to your emotional needs.” But perhaps, I should allow Sirota to speak for herself in these introductory posts on her blog: Emotional Overeating Part 1: The Most Overlooked Reason for Why We Overeat Emotional Overeating Part 2: How to Tell if You’re Doing it Emotional Overeating Part 3: Be Aware of How You Eat While clearly, not everyone with excess weight has a story of childhood or adult trauma or loss, I have no doubt that many (not just those, who experience some degree of emotional eating – and who doesn’t?), will benefit from reflections on the emotional aspects of weight and food obsession. I am still only half way through, so I cannot provide a final opinion on the book and the solution it… Read More »
The Emotional Value of Food
In yesterday’s post, I suggested that the perfect diet could perhaps be described by a triple Venn diagram, where the circles representing nutritional balance, caloric balance, and enjoyment, respectively, fully overlap. As many readers rightly pointed out, “enjoyment” may be too narrow a definition of that third circle. Perhaps we should rather describe this circle as “emotional balance”, recognizing that emotion, although a complex construct, is intimately linked to feeding behaviour. (For the sake of discussion, allow me to include both feelings (e.g. apprehension or fear) and sensations (e.g. hunger and satiety) under the term “emotions”. While experts may argue about just how many basic emotions there may be, there is no doubt that most (if not all) can affect our eating behaviour and/or be affected by it. Thus, foods may invoke both positive (pleasure, happiness, comfort, satisfaction, satiety) and negative (distress, pain, dissmell, disgust, fear, hunger) feelings or emotions. While with an ideal diet, nutritional and caloric balance are hopefully in perfect balance, most people will likely prefer the emotional balance to be tipped to the positive side. This would involve maximising positive feelings or sensations while minimising negative ones. And this is exactly where eating behaviour gets complicated. It is one thing to focus on nutritional and caloric value of foods – these are objective and can be studied in quantitative research. It is a completely different story to sort out the emotional value of foods – these are subjective and can only be approached from a qualitative perspective (our methods to objectively quantify emotions are laughable at best). While our nutritional and caloric needs are dictated by physiology, our emotional needs are dictated by both past and present experiences as well as our general mental disposition. Throw into this mix the complex influence of other factors like cost, convenience, environmental concerns, ethics, religious beliefs, and traditions and you have a perfect storm. Unfortunately (or fortunately, depending on the perspective), short-term emotional factors will easily override long-term nutritional or caloric needs. A food that provides me with enjoyment, comfort, or satiation (even if just for an instant) or relieves my pain, loneliness, boredom, fear, sadness (even for an instant), will tend to be consumed irrespective of its nutritional or caloric value. In other words, emotions trump physiology. This would not be such a big problem if we were a) fully aware of our emotions and b) able to… Read More »
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