Sunday, November 8, 2015

A Letter to My Son: What I Hope You Learn About Men's Health

Movember is upon us!  Men everywhere will be growing their mustaches to help raise money and bring awareness to men's health issues that, at times, fly under the radar.  Since my wife forbids me from growing a mustache and a happy wife leads to a happy life, I figured I'd write a post instead of growing any more facial hair.  So here is a letter to my 8-year old son, sharing my "health" tips that I hope he can incorporate into his life. After all, what better way to promote "men's health" than by preparing our sons for what lies ahead of them.

Dear Son,

You've just turned 8 this month but there is still a whole life that lies ahead of you.  Since the day you were born, I've seen so much of myself in you.  They say you are like an Aaron 2.0.  It seems we have so many similarities, physically and emotionally.  The same things bring a smile to our faces.  Our laughs, our senses of humor seem to be cut from the same vaudevillian cloth.  On the other side of that coin, when we are upset, frustrated or angry, we do the same thing. We close up, shut the world out and crawl within our emotions.

Because we are so similar, I want to write to you so that I can share some of my experiences about my life in the hopes that you will read it, and when you are ready, use this information to learn from what I've learned.  If you are really version 2.0, I hope that the latest version is just a little bit better than the original. So in no particular order, here are some things I hope you'll learn sooner than I did in the hopes you have the healthiest life possible.

  • I hope you appreciate all the amazing things your body can do.  It helps you run, play and compete.  But it also is amazing to see how every muscle of your body moves each time you laugh.  Your body will change over time but I hope that you always cherish each and every thing your body will help you do in life.  
  • I wish I could say your Mother and I gave you the genetic code to have a body like Bruce Lee or Dwane Johnson, but that is probably just is not in your future.  You'll probably look more like Seth Rogan than The Rock but that doesn't mean you should be envious.  You have all the tools you need to do anything physical you put your mind to.  I promise you, your body is capable of doing much more than you ever can imagine. Trust your body and don't be afraid to challenge it.
  • Food is nourishing and fun.  You can eat for many different reasons in life and I hope that you will learn to use food for fuel and not as a way to punish yourself or to feed your emotions.  
  • Your emotions are powerful but not something you need to be afraid of.  It can be hard to open up and tell others how you are feeling but when you finally get the courage to do it, know that others will be waiting and willing to help you.  
  • Being alone and keeping your emotions to yourself will only create a cycle of isolation. Being vulnerable will be the most courageous thing you will ever do.
  • Respect all bodies.  As you get older, the default behavior of many of your friends will be to ridicule or tease any body or person that is different.  When it happens, be brave and stand up to shaming and teasing.  Remember what Brené Brown says, “Vulnerability sounds like truth and feels like courage. Truth and courage aren't always comfortable, but they're never weakness.” 
  • Moving your body feels good and will help you feel better about yourself.
  • Breath in and breath out.  I hope that you will learn how mindfulness can help you connect to your body and your emotions.  It will help you learn to be comfortable in the moment and honor each and every thought and feeling.
  • Honor your partner with love and respect.  Love is the greatest thing you can ever give someone, so when you find that right person, don't hold back.  Share every part of yourself with them and fight every day to sustain a strong union between the two of you.
  • Have faith.  Whether it is the religion we are raising you with or something else that resonates with you, find peace in learning that there are things in this life that are larger than ourselves.  
  • There is no one way to be masculine.  These days, there is a common refrain to "man up" to the issues and occasions.  People will tell you how to be a "real man," but remember,  you are already a man.  Follow your heart, do what feels right and don't feel like you have to live up to some ideal image of what a man should be.
  • Be a feminist.  Understand that because of your gender, your race and where you grow up, you have been given opportunities that many women who are in similar situations might not have. Stand up for all women.  Fight for equality in the work place, equal access to health care and equal access to education and careers.  
  • Don't forget to be a mensch.  Be kind to others and don't take advantage of those who might not have what you've had access to as you are growing up.
  • Find a good doctor that you trust.  Don't be afraid or intimidated of their white coat.  It's ok to ask them questions, challenge their recommendations and have conversations with them.

I know that you might read this and dismiss it, but one day, you'll be confronted with each of these things in real life and when the time comes, remember this letter.  I hope it helps you and I hope you find your path towards a long and healthy life.


p.s. If you ever need help writing a letter like this to your son, it would be an honor for me to sit beside you to help if you ever need it. 

Wednesday, October 7, 2015

Problems with #WeighThis Campaign from Lean Cuisine

One of my friends sent me this video recently.  It is a part of Lean Cuisine's #WeighThis campaign which launched earlier this year.  Watch the video and let's discuss it!

As I watched the video I enjoyed seeing how there was a shift in focus from the number on the scale to other more important things in life. The participants in the video (all women by the way) were asked to weigh the most important things in their lives.  The types of things that they wanted to weigh varied to wedding rings, diplomas, Dean's List honors, back packs and siblings.  It was a nice message to send, especially by such a notable brand as Lean Cuisine.  It shows that the mainstream notion of "weight loss" might be changing.

But after a few minutes of thinking, I became much less complimentary of the video.  It actually got me pretty riled up and here's why: it's a perfect illustration of the mixed messages we get about weighing ourselves yet still try to lose weight.  Is it an improvement compared to past campaigns? Yes but let's be honest, Lean Cuisine is selling and designing food for people who want to eat smaller portions with the ultimate goal: to lose weight!  Lean Cuisine is co-opting the non-diet message in the hopes of selling a few extra million frozen dinners.

This co-opting of messages is a common theme these days.  "Eat mindfully and tune in to your hunger and fullness! IF you do these things, you'll surely lose weight." Now I'm obviously paraphrasing a little but it's basically what the messages comes down to.  Despite a change at the surface, when we look closer at what lies underneath, we are still a society that is focused on changing the number on the scale.  Although we might be changing the words we use, we are still focused on changing our body.

C'mon, think about it.  Lean Cuisine is telling you not to focus on what you weigh, to think more about what you have accomplished in your life, and it's not the number on the scale.  Great message and I agree 100% percent. But this is coming from a company whose name is LEAN friggin Cuisine!  Every box of frozen-food says it right there, in front of our face: "LEAN!" The package does not say, Every Body is Beautiful and Deserves Delicious, Frozen  Cuisine.  No, it says LEAN Cuisine.  You might say, well it's just the original name of the company and maybe they are talking about the food being lean.  To that I say, everything is in the name.  Sure maybe they are referring to lean food but the underlying message is also having a lean body! Brand names are important.  Think about Skinny Cow.  What is that product name saying about us?

So, let's give up on the name thing and then focus on the food.  Sure, Lean Cuisine makes some great options.  Their food philosophy has changed recently and they are meeting the need of the consumer by offering different choices like high protein, gluten-free and organic meals.  They've removed almost all mention of "low calorie" from their website but if you look at the nutrition information you'll see nearly all dishes (except for a few) are less than 300 calories per meal.  Why would someone intentionally eat a 300 calorie meal unless it was to lose weight?  If I eat one Lean Cuisine meal, 3 times a day, that would be around 900 calories a day an not nearly enough to satisfy any normal level of hunger.  Restriction like this is what leads to binge-related eating.  What if I just have them for lunch or dinner (which is totally reasonable)?  Again, I would argue that 300 calories might not be enough energy to sustain someone from mid-day to bedtime which can lead to this scenario.  Eat lunch --> it satisfies my hunger for an hour or maybe two --> hunger levels increase --> I don't have permission to eat because I just ate 1-2 hours ago so I wait until the next meal --> hunger levels increase --> I overeat my snack or dinner because hunger levels became so strong.  In my experience, the low calorie frozen meals just don't sustain hunger levels long enough for most people.

I'm left with another in a series of gray area answers to real-life issues. (Appreciating the gray areas is foundational for intuitive eating.)  Sure, Lean Cuisine should be applauded for a change in their philosophy but in my opinion, this change is only on the surface.  In reality, their core business is to help people lose weight and if I'm true to my Intuitive Eating and Health at Every Size® philosophy, then the two can not live together in harmony.  When the underlying goal is to lose weight, it will ultimately sabotage any Intuitive Eating and HAES® beliefs. I leave you with this graphic which I adapted from the Intuitive Eating book that shows the cycle that is created when we put our desire to lose weight at the forefront of our concern.  Nice try, Lean Cuisine, but I'm not buying it and nor should you!

Thursday, September 24, 2015

Honey, Are the Kids Making Their Own Lunches?

Photo Credit: Aaron Flores, RD
One of the things that I'm most proud of is how my wife and I have instilled Intuitive Eating and Health at Every Size® philosophies in our kids.  I often tell people it's my greatest accomplishment as a dad and as a dietitian.  To see how their positive relationship with food and their bodies is developing is truly a blessing.

Even though I see little things that reinforce their food and body trust each day, occasionally there are things I see that truly amaze me and make me so proud.  One of those moments happened last week as both of my kids asked my wife if they could make their own lunches for school.

Let me give you some back story before we go any further; we go to a Jewish day school which means we need to bring a Kosher-dairy lunch.  No meat of any kind.  Eggs and tuna are ok but no turkey, roast beef, hot dogs or chicken.   We are also a nut-free school so, we can't send peanut butter either.  This means we are just a tad limited as to what we can pack in their lunches.  Now, for the most part,  most things we pack are a success but we do sometimes find that our kids get into a bit of a rut after so many years of dealing with these limitations.  It's actually the chore that my wife and I enjoy least because we feel we've run out of creative lunch options so, when our kids said, "We want to make our own lunch," we more than gladly agreed.

Because of how we have our house set up with regards to food, if a child wants to be responsible for making it, they can choose what is in the meal.  That means my wife, who usually makes the lunches, did not tell the kids WHAT to pack, she was just the sous chef.  She provided them with the ingredients they wanted and supervised them as they used a knife.  That's it.  I'm sure you probably want to know what the kids packed themselves for lunch, right?  I mean c'mon, what would you pack if you had no limitations in place(except those already described above)?  Well, that's not the point of the post and to be honest, it doesn't matter one little bit!  For me that's not "where the magic happened."

The magic is that without pressure from my wife and I, my kids are interested in food.  They want to be a part of meals.  They choose to be involved in meal preparation because they enjoy it.  In our house, food is fun.  It's not punishment, a way to reward good behavior or achievement.  It's not something that is held over them like a carrot on a stick (i.e.: "just eat five more bites of protein and then you're done").

A healthy relationship with food is not just about tuning in to what our bodies tell us about the food we've eaten. It is also about being a part of the process of how food is made, where it comes from and how it impacts our environment.

My kids understand their role in our house when it comes to food. They trust that we will provide them with all different kinds of food.  They trust that we will sit as a family every night for dinner.  They trust their body to stop eating whenever they are done.  They trust that food will not be taken or hidden from them for any reason.  As parents, we trust that our kids will not abuse this privilege with food.  We trust that they will eat what is served and they will not ask for separate meals.  We trust that they will stop eating when they are full, no matter how little or much is still left on their plate.

I believe this family trust is where our kids' positive relationship with food and their bodies comes from and I'm so grateful that my wife and I have found something that has worked for all us.

Our kids continue to make their own lunch.  They are enjoying it and my wife and I are proud to watch their creativity with each new day.  I'm sure one day, the novelty will wear off and they'll give up this chore but that will be ok.  Until that day comes, though, my wife and I will gladly take a step back and marvel at the simple pleasure of watching our kids explore their food environment.

Monday, September 14, 2015

Learning to Fly!

This week, I'm celebrating Rosh Hashanah, the Jewish New Year.  This time of year is a time to reflect on the year that passed and the year to come.  It seems that I've been doing more reflection over this past 45 days than any other time of year.  Reading Brené Brown's book, "Rising Strong" was a large part of that but also, I'm in the process of starting my own business.  Combined, all of these things have forced me to look inward more than usual and I wanted to share some of those thoughts with you.

Although my last post didn't get the kind of traffic it usually does, I think it was one of my most important articles that I've ever written.  Even though it might not have resonated with many, it did with me!  So selfishly, maybe I just wrote that post for me, to inspire myself to "get outside my comfort zone" and "make some magic."

After all, starting a new business is all about taking a leap, trying something new and seeing if it will be successful.  Something new is the hard part.  Part of what I need to do in order to make this business take off is to really understand what it means to learn to fly.  Like a little bird, whose mother has left the nest, now it's up to me.  I have the tools, I know how to be a good dietitian and help people improve their health, but now I need to make sure everyone else knows it too!

But here I am in the nest, looking down 150 feet at the ground below and the nerves are there.  Just like the little bird, I know that I'm going to eventually get the hang of it, but those few seconds of free fall are what scare me.  Free falling downward, the ground racing up to meet me in a fatal crash, but all I have to do is trust my instincts.  Stick out my wings, let the rushing air flow over and beneath them to create the necessary lift to move me from perpendicular to parallel.

I'm still in the nest right now.  Well, maybe I'm not 100% in the nest...perhaps I have both feet out, dangling over the edge. I'm sitting on the edge, my instincts are there but I don't yet trust them. I know that they'll work if I just test them out.

So here goes, I'm pushing off. I'm going to be courageous and be vulnerable.  I will try new things and I understand that I will fall and stumble along the way.  But I'm willing to risk the fall because I know that I can rise stronger!

I'm going to try to fly and I don't know how long the free fall will last until I run out of time, but I'm confident that even if I hit the ground, I will be able to get back up and try it again.  My instincts will kick in and I will soar, but the hardest part is right now.

I don't know what this new year will bring but I'm confident in a few things:
1) I have the best support system around me.
2) Although I tend to be scared of new things, I know that I will have to try new things each day to be successful.
3) I will work hard every day to accomplish my goals.

To those who celebrate, shana tova and may we all be healthy, safe, and have the courage to be the best possible versions of ourselves.

Tuesday, September 1, 2015

Where the Magic Happens

Believe it or not, the first time I saw this image on the left was on an episode of Girls on HBO. It’s a great show and, for sure, one of my not-so-guilty pleasures. I can't recall the exact scenario for how it came up but I remember the main character, played by Lena Dunham, sitting in some sort of job interview and seeing a poster with "Where the magic happens" in big circle with a much smaller circle off to the side which was labeled, "Your comfort zone."  I recall from that episode how Dunham's character just sat there and stared at the poster on the wall, contemplating the meaning.  

I've been in that exact same position as Dunham's character, staring at this picture, for what seems like an eternity, reflecting on my own life.  "Why can’t I be where where the magic happens?" "Why am I stuck in my own comfort zone and what will it take for me to get out?"  These were two thoughts that came up most often. The words might vary but the theme was the same: "What was keeping me from stepping outside my comfort zone?"  My comfort zone was my job, my comfort zone was staying hidden, behind the curtain and afraid to step out and get noticed in my professional work. The potential magic was taking a leap to do something brave, daring and to risk failure.  The predominant vision that kept recurring was leaving my full-time job to start a private practice.  The comfort of a regular paycheck was preventing any career magic from happening.  But finally, just recently, I was brave enough to be vulnerable and make a leap outside my comfort zone to where I am now--I'm stepping out from behind the curtain, hoping to be noticed and trying to make some magic happen.

The funny thing is that, until recently, I never turned this idea of "where the magic happens" around to focus on something other than me.  Now I'm applying this notion of stepping outside your comfort zone to Intuitive Eating.  I've begun to think about the people (some clients, some friends, some just acquaintances) that I know who are struggling with or working on incorporating Intuitive Eating (IE) into their lives.  Some are struggling to get rid of their diet mentality.  Some are fighting even to start to use IE in their life.  Some are dealing with letting go of their food rules while still fearing loss of control.  No matter what the issues are, leaving one’s comfort zone is a huge challenge and I for one know full well what it’s like.

The comfort zone is where we feel safe.  It’s the familiar environment were we know what to expect.  It’s the safety of a “home base” that we never stray too far from for fear we might not find our way back.  Wanting to be comfortable is normal. But here’s the thing: sometimes we mistake safety and comfort for something positive when it can actually be negative, holding us back from that amazing magic.

The common things I hear from people who struggle with IE are:
  • “If give into my cravings, I won’t stop eating.”  
  • “I am not happy with my body unless it is a certain size and I won’t try anything that might cause me to gain weight.” 
  • “IE sounds great, but I don’t think I can do that. I need to be on a diet. I need structure” 
  • “I don’t think I’ll ever feel safe or comfortable around dessert.
If you look more closely at all of these statements, you’ll see fear.  Fear of the unknown, fear of giving up control, fear of our bodies and fear of trying.

Your diet, your food rules, your cleanse, your body loathing are not your comfort zone.  You might think you are safe and supported with your structure, your meal plan or your diet, but that is a false sense of security.  Those constructs are just keeping you from landing where the magic happens.  

It’s a scary leap to truly be ready for something new.  It takes courage to put your foot down and say, "enough is enough."  "I’m done living in fear of food and my body."  "I’m done with feeling horrible about every food choice and every curve of my body." It’s time to take that leap outside your comfort zone.  

Maybe some of these simple tips will help you get started:
  1. Read Intuitive Eating - It is the basis for how I work and it will change how you think about food!
  2. Be curious - Think hard about what might really be at the center of your resistance to change.  Learning to objectively examine your thoughts is a skill that is essential for becoming an Intuitive Eater.
  3. Learn to check in - Check in with hunger levels throughout the day. Check in with what cravings you might be having and honor them.  Check in with how satisfied you are at the end of a meal and adjust what you eat the next time to ensure satisfaction.  
  4. Listen - Listen to the inner voice you use to talk to yourself about your body and about food. Is it nurturing or negative?  Just learning to be more nurturing to yourself is an important first step.
  5. Permission - Give yourself permission to ask for help. There are many people out there who are willing to help, myself included. Give one of us a call to find a partner in your journey towards the place where that magic happens when it comes to food and your body.
Take the first step toward making some magic.

Wednesday, August 26, 2015

Not Your Ordinary Back to School Post

Across the country kids are putting their flip flops and bathing suits back into their closets.  The days are slowly getting shorter and it's starting to get a little cooler.  Kids are buying new backpacks and mentally preparing to get back into the routine of getting up early and as they start another year of school.  Parents are getting ready too.  They are setting up after-school activities and planning lunch menus.  If you go to social media or news sites, you are sure to find beautiful pictures of the "healthy" school lunches you should be packing.  There are plenty of back-to-school lunch articles, but this isn't one of them...

In some states, school administrators are getting ready to weigh your child to monitor obesity rates and some of those states are going to send you a letter telling you that your child is overweight.

These BMI letters, as they've been called, are a fairly new practice and only 9 states are sending these letters  home to parents if their child is heavier than "normal".  There was recently a study that reviewed one state's data to see if letters like this were working and--surprise surprise--they aren't. The study, done in Arkansas, found that there was no benefit to the letters (no significant weight change or improved eating habits) but they also found that there was no increase in adverse affects (disordered eating or diet pill consumption) either. So basically, these letters did not have an effect either way. Or did they?  More on that later.

So this begs the question: why do this at all? Why are some states going to the trouble?  Why are we, and more importantly schools, so concerned with our children being above "normal" weight? The answer: all of this is being done in the name of fighting this so-called "War on Obesity."  It's a war to stop the spread of fat across the land and, in many cases, our nation's kids are caught on the front lines.

If we are at "war," then we must be fighting an enemy and in this case we decided we're fighting "obesity." What if YOU are heavy/fat/above normal weight or obese (choose which word fits best for you), then YOU, (and your body) are the enemy and our country is enlisting resources in fighting you and your body.  You, or more importantly, your children are being targeted.  Whether someone is saying it to them or not, children who are heavy know what their parents, their friends, their teachers and society is saying about them. They are saying, "Your body is not ok and we are ashamed of it." You think they don't hear you whisper about them.   Do you really think they don't notice when you make them a "healthier" plate than their brothers and sisters?  Even though we're not trying to intentionally make them feel bad, the fact is, simply the act of labeling them could pose a risk for future weight gain.

Now back to the unseen effect these school letters might really be having. There is research article upon research article that describe the negative affects of weight stigma on our children and how these weight loss programs (although well intentioned) are creating some real long-term issues for children.  Consider this from the Eating Disorders Coalition:
A December 2012 report of the C.S. Mott Children's Hospital National Poll on Children's Health examined the association between school-based childhood obesity prevention programs and an increase in eating disorders among children and adolescents. The Poll found that 30% of parents with children aged 6-14 years reported one or more behaviors in their children that could be associated with the development of an eating disorder. These behaviors included inappropriate dieting, excessive worry about fat in foods, being preoccupied with food content or labels, and refusing family meals.

So, what are we supposed to do when it comes to providing a healthy environment for our children when it comes to food, weight and exercise?  Here's what I recommend:

1) If your school district does send letters home or weighs your child for statistical purposes, you can opt out of these programs and choose not to participate.

2) Become aware of your own biases when it comes to weight.  Examine closely how you really feel about having a heavy child and the habits you may have fallen into without even realizing.  Some might be slightly embarrassed, some might overemphasize weight loss, but either way, I hope you will understand that no matter what size your child is, they can be healthy and what they want most from you is love and acceptance.

3) Don't ever put your child on a diet.  Never try to restrict what food they eat or hide food in the house.  Read Ellyn Satter's book to learn about raising a competent eater.

4) Along those same lines, I do not recommend enrolling your child in extra exercise classes or hiring a trainer.  If they are younger, encourage them to play more outside. Do more active things as a family, like going for walks after dinner, going for a bike ride to the store instead of driving.  If your child is older, teach your child the joy of movement; that moving their body is a great way to socialize with friends, build self-confidence and enjoy the outdoors. Movement should not be punitive and seen solely as a way burn calories or lose weight.

5) Change how you talk about your own body.  Don't use shaming words about yourself.  Try to model body positive actions and your child will follow your lead.

I hope these tips help you.  Remember, the goal is to raise a child that is proud of their body, knows how to eat for fuel rather than for emotional reasons and most importantly to never, ever, ever want to go on a diet in their life.

I hope you all enjoy your school year!

Monday, August 17, 2015

Open letter to the young ladies who fat-shamed me this weekend.

Dear Young Ladies,

It's been hot here in LA over the past weekend.  Really hot!  I mean, 100+ degrees hot and the only respite from the heat is to find any collection of water, put your body in it and stay there as long as you can.  That's exactly what my family and I did when we went out to my mother-in-law's community pool in Westlake Village.

Of course, we aren't the only geniuses to consider going to the pool that day so it was crowded.  We got in the pool and my son and I started playing catch in the water.  As we played, I noticed you three young women diving down under water, staring at me below the surface, then coming up for air, giggling and pointing at me.

I don't know exactly what you were saying to each other in the pool this weekend, but I could tell that you were watching my stomach "jiggle" underwater as I threw the ball with my son. You continued to stare and make funny comments to each other even after I noticed you.  I looked you right in the eyes and you made virtually no effort hide what was going on; you just continued to stare and make fun of me. I wish I had a witty comment, or some way to confront you on this but this was literally the first time something like this has happened to me.  I should have said something to you. I should have let you know that I saw what you were doing and that it made me feel very uncomfortable. I should have done 99 different things but instead I froze. I just tried to ignore you and continue to play with my son who was, thankfully, 100% oblivious to the whole thing.

I don't know why, but I was surprised that this was happening to me and I was surprised at how I handled it.  You would never know this but for a long time, I would wear a shirt when I went swimming. I told myself and others, it was because I was worried about getting sunburned, but the truth was I was ashamed to show my stomach in public.  As I've become more involved in the Health at Every Size® (HAES) and body positive movement, I finally realized that I have nothing to be ashamed of.  Quite the opposite, I should be proud of my body and if I'm going to encourage others to be as well, I better walk the walk and not just talk the talk.  They day before this incident, while swimming at another pool, my daughter asked, "Daddy, why don't you swim with your shirt on anymore?"  I told her the truth: that I used to wear my shirt because I was embarrassed of my body and now, I'm proud of what I look like and I'll only wear it if I'm out in the sun too much to avoid a sunburn.  She had no comment at all and just accepted it saying, "OK."

To the people close to me, my body shape is not an issue and, in the end, that is what really matters. After struggling so many years with showing my body at the beach or the pool, to have this experience really flustered me. Girls, I want you to know I won't be putting my shirt back on because of you. You can laugh and giggle all you want, but I won't be hiding myself any longer. I'll learn to deal with the comments and looks. I will learn to be more comfortable.  Hopefully, you will learn not to make fun of something that is different from what you might normally see.  Hopefully, you'll be nicer to others in the future who have a similar shape as me.  Hopefully, you won't tease your classmates who are in larger size bodies. Hopefully, this was a one time thing for all of us, but we all know it won't be.

Summer is not over and who knows when it will cool down, so there's a good chance we'll meet again either this summer or the next.  I'll still have my shirt off and I have chosen what I'd say to you or to anyone else who starts to  stare and giggle.  It goes something like this: "Hi there.  I'm Aaron.  I hope you are enjoying the pool today.  I sure am. Want to play catch with my son and me?"

See you at the pool.