Thursday, January 6, 2011

Village Faces Nightmare on ELMM-Street?

Last night I had a chance to catch up with the first episode of Village on a Diet, a new CBC “reality show” that documents the efforts of the inhabitants of Taylor, a small village in British Columbia, to lose 1 ton in 10 weeks.

Frankly, I found the 45 minutes painful to watch. Not because of the magnitude of the obesity problem in this little town or because of the evidently appalling lifestyles of its inhabitants, but rather, because the approach to tackling obesity (as far as I can tell from watching one episode) appears to be entirely based on the overly simplistic formula of “eat-less-move-more” (ELMM), which we know simply does not work for the majority of people with excess weight.

While the boot-camp drill-sergeant approach to chastising and chasing the unfortunate participants across fields and up hill slopes or cleaning out “junk food” from pantries and refrigerators may provide cheap voyeuristic entertainment, I have little hope that any of this will result in lasting success as far as long-term weight management is concerned.

Rather than launching into a point-by-point criticism of this episode of Village on a Diet, I would like to simply refer my readers to yesterday’s scathing review by my colleague Yoni Freedhoff on his blog Weighty Matters.

As one of the commenters on Freedhoff’s post so rightly points out:

Honestly, it seems like this show would actually contribute to the obesogenic environment by perpetuating the idea that exercise = pain, weight loss = deprivation, and motivation = yelling. If I was on the fence about becoming more active, imagery of a couple of buff folks yelling at me to work ’til I vomit would dissuade me right quick.

Perhaps the show will get better – I guess we’ll see.

Nevertheless, I’d certainly love to hear what my readers have to say about this show so far.

If you’ve missed the episode, Canadian readers can view it here.

AMS
Edmonton, Alberta

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Village Faces Nightmare on ELMM-Street?, 7.0 out of 10 based on 7 ratings

27 Responses to “Village Faces Nightmare on ELMM-Street?”

  1. sudhir sajwan says:

    GREAT DR. SAHEB.

  2. Ali Zentner says:

    As the physician on the show I am disappointed with your comments. FINALLY a show that hopes to inspire patients to seek treatment and to encourage small changes in the proper direction. FINALLY a show that hopes to at least provide some solutions. This show is NOT perfect. But I think it at least shines a popular light on a disease that very few of us are currently even treating. Hopefully the show will raise the bar in terms of empathy and kindness for this patient population that you so often talk about in your blogs….You and I know all too well how prevalent this disease is. Unfortunately the treatment options for Obesity are limited at best. I realize we should all aim for the best care for our patients. However, I realize that this was still a television series. Sometimes what is “good tv” is not always perfectly accurate science. I hope you’ll continue to watch the show and keep an open mind and look forward to your final evaluation once you see all 11 episodes and perhaps the inspirational impact the series may have on all of our patients.

  3. Hilary MacKenzie says:

    I left a lengthy comment on Weighty Matters, but the bottom line is that I don’t see how this show can motivate anyone. I was so turned off that I didn’t watch to the end. I’d rather Jamie Oliver’s approach – educate, encourage, & pass it on to your neighbours!

  4. Arya M. Sharma, MD says:

    Ali,

    I have no doubt about the good intentions and the importance of highlighting the nature of this problem. But I think you sum up the issue I have with this show nicely in your statement that, “what is “good tv” is not always perfectly accurate science” – that exactly is the problem.

    When I see pictures of severely obese people being pushed to their physical and emotional limits to do things that have little to do with addressing the ROOT CAUSES of their problem, I cannot but fear for the effect that this will have on viewers.

    You and I know that obesity is a complicated medical condition and that the root causes of obesity (childhood trauma, depression, emotional eating, sleep deprivation, stress, addiction, ADHD, etc., etc., etc.) are not solved by going on a diet.

    Rather than jumping into boot-camp style “kick your butt” interventions, I would have wished that the first episode in this series actually took time to look at the WHY rather than the WHAT behind the obesity problem in Taylor. The images I saw only reinforce the stereotype of fat people being lazy self-indulgent slobs who simply need a good “kick in the butt” to become better people.

    You and I know that each one of the severely obese individuals on the show have personal reasons for being in the situation that they are in – you and I both know that no matter how motivated individuals may appear on the show or how much weight they manage to lose in 10 weeks, few will keep the weight off and few will be able to maintain these efforts.

    I do hope that the coming episodes focus more on the WHY of this problem:

    Why is there no grocery store in Taylor?

    Why do people not have time or the skills to cook healthy food at home?

    Why do people feel exhausted and depressed?

    Why do people suffer from poor-self esteem and body image issues?

    Why do people turn to these unhealthy foods for comfort?

    Why is the only solution for weight-based bullying “homeschooling”?

    Why did the couple stop dancing?

    If obesity is a medical condition, why don’t we leave obesity treatment where it belongs – in the hands of trained and experienced health professionals, who understand the science and know the evidence (when did the designation “personal trainer” become a regulated health profession?).

    I do hope that you and your licensed medical colleagues (the RD and the psychologist) do receive more “air time” on subsequent episodes and that in the end viewers do get a better understanding of why obesity is such a difficult condition to treat.

    I realise that you may have had very little influence on the final product – a TV show.

    I will certainly watch other episodes and will hope for the best.

    Perhaps the show will at least help spark off a discussion on why the approach to addressing obesity depicted in the show is so wrong – that, in the end, may well be a success.

    AMS

  5. Joyce says:

    I am in the process of losing weight on a medically supervised diet. I was horrified by this TV show. Morbidly obese people will not succeed long term while being bullied and make to feal fearful and ashamed. Maybe the good from this show is to focus on the issue of obesity.

  6. Twitter Trackbacks for Village Faces Horror on ELMM-Street? | Dr. Sharma's Obesity Notes [drsharma.ca] on Topsy.com says:

    [...] Village Faces Horror on ELMM-Street? | Dr. Sharma’s Obesity Notes drsharma.ca/obesity-village-faces-horror-on-elmm-street.html – view page – cached Last night I had a chance to catch up with the first episode of Village on a Diet, a new CBC reality show that documents the efforts of the inhabitants of [...]

  7. Adrianna O'Regan says:

    I watched the show and honestly, my main question in my head was for you, Dr. Ali Zentner. You mentioned that as a formally obese person, you lost 180lbs. Well how did you lose it? Was it just diet and exercise or did you take a more medical supervised approach and have baratric surgery? I think sharing your story with the people of Taylor, BC will help them. BUT in the same respect, if people don’t want to get help for their weight “issues”, it doesn’t matter how many people talk to them. They have to make that decision themselves.

    As a super morbidly obese 25 year old I had to make that decision for myself. I got a doctor’s referral and was accepted into the Weight Wise Clinic at the Alex Hospital in Edmonton. When I entered the clinic in March of 2009 I was 360lbs and had a BMI of 76. YES. 76. I am also extremely short at 4’9 so the BMI scale does not work in my favor at all. After losing 19.4kgs or 42.68lbs while following the guidelines of the clinic, I had the RNY Gastric Bypass surgery on July 13, 2010 performed by Dr. Daniel Birch. I still follow the guidelines of the clinic and am now at a weight of 244lbs or 110.7kgs. My BMI is still considered extremely high at 54 but I am well on my way.

    I know that I never would of lost 116lbs without:
    1) Following the “rules” of the clinic
    2) Having the support of the staff of the clinic
    3) Having my surgery (RNY)
    4) Support of others that are in the same situation as me
    5) Making the decision myself that I needed to do something

    I think the tv show is a good idea, but I agree with Dr. Sharma that I hope they start focusing on the root and the different issues and work to resolve them. I know that telling me to eat less and move more was great advice…but HOW to do that I needed help with. The average gym is not equiped with dealing with a severly obese person. For me, I couldn’t ride the exercise bikes. Not because it was hard but because I couldn’t fit in the seat with my stomach. And starting on the elliptical…I couldn’t do more than 10 minutes on the easiest level without feeling like I was going to pass out.

    BUT again, no matter how many people talked to me about my weight, I had to make the decision myself.

  8. Tanya Beattie says:

    I will repeat what I said on the Weighty Matters site…. And add a sincere thank you to Dr Sharma for discussing this further and your response to Dr Zentner is spot on… although I disagree that the RD needs more air time, I was shocked by her disrespectful and demeaning treatment of the people in that community who welcomed her into their homes looking for help and support! There is no reason for anyone to be treating this community the way they are being treated, the words unethical, unprofessional and unfeeling come to mind! I think this show should be pulled off the air immediately!

    As soon as I saw the advertising for this show I was sad. I watched a good part of the episode and my initial reaction was confirmed. It is a highly unfortunate attempt to “do something good”. I see this series as harmful not only to the individuals who are being exploited directly, but also to the population who is viewing it in the hopes of being helped. This show and the latest CBC campaign, Live Right Now, is an unfortunate attempt to “motivate” the public to “do the right thing”. Well, both are doomed to failure from the start. Why you ask? Because neither of these campaigns actually do anything to change the environment that has been built around us or the life situations we each have to manage to the best of our abilities. We expect the population to change their behaviour in an environment that does not support these changes. The list of conditions I am referring to is long but includes food promotion, food availability and affordability, even the “nutritious” food we think we are eating isn’t as nutritious as it was 50 years ago, time, income, mental health, stress, physical environment (it isn’t only about food intake), work environment, school environment, housing, etc. I could go on, but hopefully you get the picture. As long as these programs, campaigns, resources, etc only focus on changing the behaviour of individuals, we have no hope of improving the health of the population and sadly will only perpetuate the problem! Please, let’s stop blaming individuals for merely trying to live and do their best with what they have. Let’s all focus on creating an environment that actually supports and improves health! We wouldn’t blame fish for dying in a polluted river, would we?

  9. Mark Young says:

    Dr Sharma,

    I have to admit that I’ve never watched the show (aside from watching a couple snippets of the episode online) due to the very fact that this is exactly what I anticipated it to be. I figured it would shape up to be a large scale version of The Biggest Loser which appears to be very much the case.

    However, with the relative imbalance between health practitioners who understand obesity (and the realization that private sector weight loss programs will probably never disappear) do you not feel that there is a place for weight management in an educated person who is not a “health professional”?

    Could people not be educated regarding the uselessness of the ELMM model and taught more effective practices to use with their clients? I know I have certainly changed my practice tremendously as a result of reading your blog and that of Dr. Freedhoff as well.

  10. Nicole Glenn says:

    I agree with you Arya. I could barely watch the episode for many of the reasons you stated. The story of the young boy who was being homeschooled due to bullying and the proposed solution of losing weight was particularly disturbing to me.

    I also agree with Hillary and I much preferred Jamie Oliver’s approach in his American school lunches show. Although far from perfect, there was a strong element of advocacy and government responsibility and less finger pointing at individuals.

    Thank you to Ali and Arya for the interesting conversation. I hope this continues.

  11. Jane says:

    I think that the CBC must be desperate for ratings to create a program like this. What is wrong with this doctor? The only way to achieve successful weight loss is through EDUCATION. If these people do not know what kind of food they should be eating, the portions, the calories required, the amount of exercise they need to be doing, how can they ever be successful? Introduce them to a website like sparkpeople.com. It’s a no brainer. I think that the exercise that those people were required to do was bordering on dangerous. You should never start into serious exercise until you have worked up to it at your own rate. Shame on you CBC.

  12. Tracy says:

    I think the show should be watch from the beginning to the end before it is judged. This show has helped people through counselling, exercise and education. Just watch the show to the end, then make your judgements. It has done a really good job for the people who needed the help with weight loss :)

  13. Edith says:

    I watched the first episode of Village on a Diet from beginning to end, and in my opinion, it was a gimmick show that has potential to lead to nothing more than a gimmick series. Someone please correct me if the following math is wrong. According to Taylor’s website, its population is 1,384 residents. According to the show, Taylorites want to lose a ton (2000 lb) of fat. If we apply the Canadian statistic of two thirds of the population as being overweight, that equates to 860 people who carry too much body fat in Taylor. Therefore, the town’s goal of an overall weight loss of one ton works out to be less than 2.5 lb per overweight person! This seems like a small goal to me, given that they have 10 weeks to reach it. I have to hope that after all the media exposure and professional help (not to mention the time and energy of Drs Sharma and Freedhoff spent in blogging about this show), these ill people will lose more than 2.5 lb apiece — albeit I congratulate them if that is, in fact, all they can accomplish. Any weight reduction is better than none or additional gaining. My significant and underlying question, however, is this: Regardless of how much fat the “stars” actually burn off, will they be able to keep it off based on their starting behaviour? And if they don’t/can’t/won’t, will the money that Canadian taxpayers have paid through their indirect support of the CBC have been put to good use in the production of Village on a Diet? Something in me says no to both questions, but I really hope I’m proved wrong!

  14. Michelle Wilson says:

    It’s unfortunate that so many people focus on the negative of this show, when there is so much positive to be found. What I love about the show is that it focuses on reaching a goal as a community, and by supporting each other. There is no voting off the island. There is no gimmick weight loss tactics. There are no over-the-top challenges that do not relate to real life. The show offers to educate, inspire, and motivate people to make changes. And the prize at the end is the knowledge and motivation to live a healthier and longer life with the people you love. Wow, what a horrible idea.

  15. bananacat says:

    FINALLY a show that hopes to inspire patients to seek treatment and to encourage small changes in the proper direction.

    Clearly your definition of “small” is very different than mine. For example, exercising excessively in a boot-camp style does not fit my definition of a small change.

  16. Alexie says:

    Where are the shows where camera crews go round to food corporations and stand over them while they start making and marketing healthy foods?

    This idea of individual responsibility – e.g. that fat people are lacking in will power – drives me crazy. I live in a small German town where eating unwisely is literally difficult, unless you want to go out to restaurants every night (which would be expensive). The economics are all tilted towards eating at home from fresh ingredients. There is junk food, but you have to get out to the edge of town to get it, which is the same place the big supermarket is. It’s easier to go to the farmer’s market in town, and to the butcher and the baker around the corner. And if you DO buy something, it has to be what it says it is – a sausage is 80% meat, not a casing full of additives and gristle.

    Contrast that with my Christmas holiday to London. Try eating healthily in a modern Anglophone economy – you need a bloody science degree to understand what you’re getting, plus a high degree of vigilance. There is trickery around every corner. I almost bought a sandwich labelled ‘smoked ham and honey mustard’ which sounded lovely, until I turned over the packet to discover it was mechanically recovered meat plumped up with saline, doused in chemicals created to mimic smoke flavour. The bread had so much sugar it was more like cake, and the whole thing was more than 500 calories.

    Why aren’t companies accountable for lying like this?

  17. NewMe says:

    I too blogged about the first episode of “Village on a Diet” and, like almost every other commenter, I was appalled and saddened by what I saw.

    I feel no need to repeat what I said, much of which was quite similar to what you can read here and at Dr. Freedhoff’s site. I would however like to add two further comments to the debate.

    First, to Dr. Zentner: how can you state that “Sometimes what is “good tv” is not always perfectly accurate science.” without feeling intense discomfort at what we saw on the show? If overweight is such a pressing issue (and even that is questionable–I would posit that HAES [health at every size] is a much more laudable and attainable goal), how can you attach your name and reputation to a widely broadcast programme that only adds to the myths and misconceptions of weight management?

    My second comment deals with the commercials that were broadcast numerous times during the course of the program, specifically the commercial for weight loss surgery. WLS is, at best, the solution of last resort. With the non-negligeable possibility of serious side-effects and even death, WLS should not be touted as a weight-loss solution for the masses. Yes, CBC needs advertising revenues and WLS is a legal, recognized medical procedure, but seeing it so widely advertised definitely rubs me the wrong way.

    All of this being said, I fully intend to watch the whole series and to continue blogging about it, despite its inauspicious first episode.

  18. zarzamora says:

    Another spin on public humiliation of obese people for entertainment. It does not educate, inspire or motivate the people who desperately need help, it serves to entertain those who are not obese at the expense of those who are. It presupposes that obese people are lazy, indolent, uneducated idiots. If you come to these issues with the belief that obesity is the ‘fault’ of the person suffering , then this show, all about changing a person’s ‘bad’ behavior, will confirm all your prejudices.

  19. Mitzi says:

    As the tall, skinny daughter of a short, round mom, I cannot stand to watch these programs. We commiserate weekly about the sick body-image problems of our culture. She is accused of laziness and gluttony because she is obese (people are actually surprised by how little she eats), while I am accused of anorexia because I am thin at 40 (and I put away astonishing amounts of food- you can do that with plant-based, whole-food eating). “Cain’t win fer losin’”, in our vernacular.
    Obesity is a complex problem, and the show would do well to use some of the production-cost money to open a small healthy grocery store providing free (easy-healthy, working all the time and on a budget) cooking lessons, along with crock pots, rice cookers, and salad bowl sets, instead of boot-camping everyone. Not judging, just saying-” This food will save your teeth and quite possibly your life. Your grandmother ate like this on the farm. You can, too.” Provide people with doable health measures (I have learned this from Mom), and the support for the long, slow haul back to health at whatever size they can manage, and most will improve. Try the unrealistic and you just yo-yo down and higher up.

  20. Taylor Resident says:

    Well I have to tell you I live in Taylor, I was not a part of the show but I did see some of it being taped etc, and talked to people that were involved. The closest grocery store well it is 12 minutes away, not far at all. We are 15km from Fort St John, I was very disappointed at how they made the town and the people who live here look. Not everyone here is depressed, obese etc. of course they dwell on this because this is what the show is about. We have an ice skating/hockey rink, curling rink , swimming pool, golf course as well as numerous playgrounds and ball diamonds. Yes you can buy other food here besides junk and more junk. Would we love to see a little grocery store? Most definately. After seeing and being a part of some of the first parts of the show being taped (some of it staged to the T) we decided to not have alot to do with it. Lets just say it is like any other reality TV show, its entertainment made for TV. I hope it helped the people that were involved, cause really that is all that matters. But please don’t think the way that it portrayed our little town is right, because it so is not, there are constantly people on the walking trail that they said is never used, it is well utilized. There are alot of active people here and non active, just like anywhere else. I guess what I am trying to say, is don’t believe everything you see on TV, even if it is a documentary

  21. margaret yufera-leitch says:

    Since when did the CBC take it upon themsellves to fund Victorian Frakshow style ‘documentaries’?! How embarrassing for the Canadian Broadcasting Community…

  22. Beth@WeightMaven says:

    As I’m in the US, I can’t watch this show. But from the description, I can only assume that it’s similar to a very popular show here, The Biggest Loser. I watch that regularly with very mixed feelings. The personal stories of the participants are always heartbreaking, and despite the horror that are the exercise-bulemia inducing, chronic cardio workouts on the show, I do tend to find it inspiring to see them approach their goal weight (however short-lived that might be).

    Alas, not sure if you’ll see them, but here in the states, the networks are all racing to put similar shows on. MTV has “I Used To Be Fat” where kids lose ~90 lbs in 90 days in a similar bootcamp fashion. And next week, A&E is debuting “Heavy” which features 22 morbidly obese folks “documenting their incredible transformations during a six month treatment program” … whose trailer features a trainer saying “we’re going to push them to their limits.”

    What these three shows in the US show is that yes, you can lose weight if you have a buff fitness trainer yelling at you. And that if you have the time to devote to being yelled at 24×7, then you too can lose 90 lbs in 90 days … or more!

    I’ve no doubt that this makes for great TV. But I rather doubt it makes for good public health!

  23. Brenda says:

    When was TV real? I was also very offended by this show.Please people overweight people are a very sensitive crowd.We feel very deeply and need to be treated kindly not like morons that have no feelings and just need motivation. Lets stop the shaming!! It reminds me of the days when the alcoholic was hospitalized and forced to detox alone and with no understanding only crulety and shame and let go to cope on his own.This is our last prejudice in society!!!

  24. Walter says:

    This TV reality show is even awful as a reality show. It does not inspire me. Ali Zentner should focus his attention on having the food “industry” stop injecting strange chemicals including salt into food that upset our metabolism. Also the Heart and Stroke people should stop awarding those types of processed foods with their health check. Also Ali Zentner has no clue what it is to be obese and how to overcome compulsive overeating. That TV show is a pathetic copy of many other American style diet/exercise reality shows. Sure, watch some person weighing more then 500 pounds ( sorry i don’t know what that is kilograms ) loose all that fat with the help of high priced trainers, doctors and dietitians while controlling their food intake. Join WeightWatchers for a sensible change of eating life style and save your self an hour of useless TV watching this reality show.

  25. Former Taylor resident says:

    I have lived most of my life in the proximity of Taylor and 20 years in Taylor itself. While I totally support all efforts to be healthy, active and eat properly, I feel that this show is leaving people with misconceptions of Taylor and many of the people there. This seems to me to be a “staged for TV” series. I would like to clear up a few misconceptions. First of all not everyone is obese, depressed or unhealthy in Taylor. The village has many facilitys for fitness which are being well used. I personally doubt that health issues there are much different from any other place in Canada. Secondly, it is not a long distance to a grocery store. It takes maybe 15 minutes to drive to Fort St John (on good highways) where there are at least 4 major food stores. Years ago there were 2 small grocery stores in Taylor but because the bulk of peoples shopping was in Fort St John, they closed. Next, the pizza place is not the only eating establishment there and truethfully not everyone lives on pizza and junk food. On the third episode it was made out to sound as if there had never been a garden planted in Taylor. For many years Taylor was the market garden capital of northern BC. The soil and growing conditions there make gardening ideal and many of its residents grow beautiful gardens. While I lived there I grew corn, cucumbers, tomatoes etc and even cantalope in my garden. I felt like this episode was an insult to Taylor as it made it look like no one there even knew what a garden was. I find the general tone of this program condesending and almost insulting to Taylor and northern residents. I wish success to those who took part in it but I really feel CBC did a poor job in presenting this.

  26. Annon says:

    Hey Walter, First of all, Dr Ali is a WOMAN. Second, SHE used to be 330 lbs and knows EXACTLY what it’s like to struggle with obesity. Have you even watched the show?? Gives you tips on eating right and living a healthy lifestyle, not just a diet. Stop making excuses for yourself. FYI Weight Watchers only has a 1% success rate ;) Way to spread the good news my man.

  27. Taylor Resident says:

    After watching the first three episoded I almost think they need to do a truthful episode on what Taylor is really like. We are not all the way they are portraying the whole community. We don’t all live on the pizza that is being shown or all the junk in the local corner store. There are many many active healthy people living here. CBC might need to make an apology for they way they have portrayed our little community. Thanks for your help with the people who needed/wanted it but no thanks to all your untruthfullnes

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