Thursday, November 7, 2013

No Weigh

This post originally appeared on Wholify, Restoring Your Wellbeing website which is operated by Michaela Ballmann, MS, RD, CLT

I get a lot of questions being a dietitian. One that comes up pretty often is how often I weigh myself. It's such a great question and my answer has changed over time. When I was in highschool I saw a nutritionist to help me lose weight. I remember weighing myself in her office each week. I'd come in, hand her my food journals and head off into her bathroom to step on the scale. In the interest of full disclosure, I lied to her every time I reported my weight. I figured, tell her what she wants to hear so every time I said I lost 1lb each visit. (I lied on my food journals too but maybe that's another post). Why did I lie? I guess because I wanted to tell her what she wanted to hear and I was fearful of her reaction if I didn't lose weight that week.

After I stopped seeing the nutritionist, I don't think I weighed myself until many years later. Of course I'd get weighed at annual physicals but it was not something I did at home. Not coincidentally, it was during this time of my life that I really started to gain weight.

Once I made the decision to lose weight (and it happened one morning in April 1999), I still hadn't weighed myself in quite some time. I had no idea of what my actual weight was but I would guess it was over 300+. I didn't weigh myself that morning but instead I waited about 2-3 months until I noticed a difference in how I looked and felt. I remember that day as if it was yesterday and my weight was 285 lbs. From that day on for about the next 10-11 years, I weighed myself every morning. At first it was to monitor my progress and later on it became my tool to "stay on track."

Over those 10-11 years, the scale became the best indicator to what kind of day I was going to have. If it went up, it was going to be a bad day. I felt less secure, less confident, less worthy and therefore I ate less. If the scale stayed the same or went down, it was going to be a great day. I'd be more confident, more secure, and therefore have freedom to eat more. There were even times I would weigh myself more than once per day. I'd see how the weight changed after a workout, after a bowel movement or after a big dinner. Sounds crazy, right? It was crazy but I am 100% confident that I was not the only person to do this.

After I read Intuitive Eating, I realized how the behavior of weighing myself was part of my "diet mentality" and it all started with my desire to be "thin." I knew that to make peace with food, I had to reject that behavior and ditch the scale. It's scary to stop doing something that you've done every day for over a decade. My security blanket was going away but once I started not to weigh myself, I noticed that my attitude towards myself and towards food changed. I noticed that I had a little more freedom with food if I didn't have the scale as my tool to determine what and how I should eat each day. I was able to tune into my body’s signals more and more which was reassuring.

I went about 2-3 weeks without weighing myself at first and then I wondered if I was gaining weight as an intuitive eater so I decided to step on the scale. I have no idea what the number said but I know that my mind went back to it's old "less vs more" thinking. What can I say, old habits die hard. It was after that event that I really realized how much power the scale had over my behaviors and that the scale deserved to not be part of my life.

It's been about 2 years since I've stopped weighing myself and I've never felt more confident about my body. Has my weight changed since I stopped weighing myself? I don't think so. My clothes still fit and I don't notice a difference in any pictures, so I guess I'd have to say it's pretty stable. Do I still have issues? You bet! Those might never go away but that is another post.

So that's my personal story about the scale, but what does that mean for you? If you are anything like me, you might be obsessed with the scale just like I was. And you might be thinking, "There's no way I could stop weighing myself." Some of us are not ready to ditch the scale and in some cases, regular weigh-ins might be completely necessary (like for those in treatment for eating disorders) but for most, the scale is only a measure of one thing...your weight at that exact moment in time. It doesn't measure self-worth, it doesn't measure your overall health and it should never tell you how much you should eat in a day.

Saying goodbye to the scale is not 100% necessary to become an intuitive eater but it is a very strong symbol for our emphasis on body weight. It is a symbol for why we diet, why we create food rules and why we stop listening to our body. I've already removed this symbol from my mind but it’s still in my house, why I have no idea. Today, I've chosen to say good-bye forever. Are you ready to say goodbye to the scale?
Goodbye and good riddance!
  

Sunday, October 13, 2013

Unconditional Permission

As I start a private practice I've been getting more questions about Intuitive Eating and what it really means.  I've had these conversations with both dietitians and lay people and no matter who it is, one of the things that always seems to come up is idea of giving yourself permission to eat what you crave.

Before I get there though, let me take a step back and give you some insight into Intuitive Eating. It's based on 10 Principles that when all working together help you learn to "eat when hungry and stop when full." Obviously that is much easier said than done, especially if you've had a long history of chronic dieting, but it can be done and the 10 Principles give you a framework to get there. The principles start from 1 and go to 10 and on some level, you start at 1 and go through them one at time.

The third principle of Intuitive Eating is "Make Peace With Food."  Here is where the idea of permission comes in to play.  For many of us we restrict foods that we really crave.  Why would we do this?  For many reasons, obviously, but in most cases it has to do with the idea that these foods are unhealthy, they will cause us to gain weight and should be avoided at all costs...especially if we want to be healthy.  The foods we avoid could be many or few depending on the person, but some examples that I've seen with my clients are things like ice-cream, chocolate, croissants, donuts, and candy.  I'm sure you have your own thing that you might add to this list but either way, if you're becoming an Intuitive Eater, at some point, you are going to have to trust the process and give yourself permission to eat...anything you crave.

This unconditional permission is a core fundamental to Intuitive Eating.  If you don't give yourself permission to eat what you crave, you won't be able to really make peace with food.  But again, some of us have been dieting so long that having permission to eat is a challenge. The fear is that if I start eating that food, I'll never stop. If I never stop, I'll gain weight and if I gain weight, my health will suffer.  

In my conversations about permission people have trouble getting past the concept that some food is so inherently bad for your health that there is no way that they can allow themselves to eat it.  I'm not going to argue that some foods (and food-like substances) are not healthy and probably should not be consumed in great abundance, but if these are the foods you crave, you should eat them!  Why, you ask?  Because if deny your craving eventually you'll give in and eat more of that food when you do eat it.  And after you are done, you're going to feel guilty for doing it.  

What's the goal of giving yourself permission and why am I making such a big deal about it?  Because if you know you can have anything you want, at any time, you can really listen to your body.  You might realize that eating foods that you've been craving make you feel horrible.  For example, if you sat down at ate three donuts, physically how would you feel?  Would feel sluggish, tired or lethargic?  But you can't get to this unless you embrace the idea of having unconditional permission to eat. And once you have unconditional permission to eat anything you like, you make different food choices.  Instead of fighting the rules you might have, you begin to listen to your body and learn what "eat when hungry and stop when full" really means.

Giving yourself permission is scary.  It's like taking away the safety net and the fear of falling is real. That is why for some of you, it might be nice to have a partner in the journey and that's what I'm here for.  Adopting the third principle of Making Peace with Food takes time and I'm here to help.  Make an appointment today and let me help you through the process of becoming an Intuitive Eater.


Wednesday, September 25, 2013

Yes I Am an Overweight Dietitian

This is Weight Stigma Awareness week which is being organized by the Binge Eating Disorder Association.  This online conference has provided both healthcare providers and the general public with a wealth of information about what is weight stigma and how it affects us.  Going into this week I was planning on writing about weight stigma from a general sense but after I saw the tweet below, I thought a personal post might be more appropriate so, here goes.

If you're an overweight dietitian, how am I supposed to listen to you telling me how to eat ? -- Via Twitter on 9/25/13.

I've discussed it before but I will say it again, I'm an obese dietitian.  Comments like the one above are not new to me.  I've heard it before either directly to my face or from second-hand conversations.  The comments come in many different ways, "Why should I listen to you?"  "Well it doesn't look like you eat that way." "Why don't you practice what you preach?" It doesn't matter how you say it or the context you say it in...all of these comments are shaming.  It fits into the old mindset that if your BMI is anything above normal, then you must not be healthy; that having a tummy is a sign of laziness, filth and sloth.

The funny thing is, being a healthcare provider, I don't only get it from my clients, I get it from colleagues.  "I've noticed you've gained some weight?"  "I"m going to tell on you for eating that." "Should you really be teaching that class?"  Even if I don't hear the comments, I see how they look at me.  I hear what they say and I read what they write.

But I'm here today, during Weight Stigma Awareness week, to stand up and say enough!  Enough of you judging my body.  My weight, my body, my habits are MINE and NOT YOURS.  The topic of my weight is off limits.  I did not ask for your archaic, backwards, close-minded comments.  My body is MINE.   Mind your own business and keep your comments to yourself.  I have never judged you for coming in my office/class and gaining weight.  I don't care if you are 320 or 120 pounds.  I respect your body, now please respect mine.

For me weight stigma hits home more often than most will realize.  Maybe you have to be "fat" to know what it's like but fat shaming happens more than I care to admit.  When I was 300+ pounds, people stared at me.  They rolled their eyes as I sat next to them on a plane.  They stared as I ate my Jack 'N the Box Double Cheeseburger. They laughed as I took off my shirt at the beach. It was as if the stares, eye rolls and teasing was going to somehow help me. Well, guess what?  It didn't.  Like any normal person, the shaming led to self-imposed isolation.  Isolation led to more eating because I really didn't want to be alone. And my weight rose higher and higher.  It's a horribly helpless feeling and you don't know what it's like until you've been there.

As I lost weight, people looked at me differently.  On some level I loved how their eyes and attitudes changed towards me.  I loved that now I was accepted by society because my belly was gone. But even though they saw someone new, the old person was still there (and on some level, still is today).  All that shaming that happened still affected my self-esteem.

So when someone asks, "If you are an overweight dietitian, how am I supposed to listen to you telling me how to eat?" my answer is simple.  You should listen, because I know what the hell I'm talking about.  Not just because I have a degree, completed an internship and passed a registration exam but because, despite what you think by looking at my stomach, I am a fantastic educator/motivator/coach/nutrition expert.  If all of you see is my stomach, you're going to miss out, not just what I have to say but what others who are just like me have to say as well.  My clients listen to me because I've been where they are.  You should listen to me because my full stomach is not a sign that I don't know what I'm talking about, it's a sign that I know exactly what I'm talking about when it comes to making peace with food.  I've fought the war against food and my weight.  The only casualty though was me.  Instead of fighting, I've made peace with food, my body, my weight and my critics.

I wish that I had a six pack, broad shoulders and rippling muscles but I don't.  I've come to accept my body for what it is.  Hopefully this post helps bring weight stigma to the forefront of our conversation. It's an issue that we need to discuss and that we need to be aware of.

And finally to thank the individual who posted their honest comment on Twitter thank you!  Thank you for your tweet that inspired me to write this down.  It has been cathartic to share my thoughts and without your tweet, they might have never made it out.

UPDATE: (9/26/13 8:45am)
I've been asked by the person who posted the original tweet to delete her name from this post.  After much consideration I've agreed to do that.  The reason I did: shaming someone, for any reason, is wrong.  I hope you respect my decision.

Thursday, September 12, 2013

Clear Eyes, Full Hearts (and Stomach)...Still Can't Lose

At sundown on Friday night, Jews around the world will begin to celebrate Yom Kippur, the holiest day of the year.  It's a day to atone for the sins we have committed but also to reflect on our lives and commit to doing better next year.  One of the ways we do this is through day-long prayer but also by fasting for 25 hours.  (Why 25? Because anyone could do 24, the extra hour makes it hardcore!)

I've written about this holiday before.  I encourage you to read my whole post that I wrote two years ago here.  In short, what I decided after Yom Kippur of 2011 was that I was not going to fast on this day of days.  Why?  In short because while I was fasting, I was focused on my growing hunger and as that uneasiness grew, I was less able to focus on the day and instead I just focused on my belly.  As a continually learning Intuitive Eater, I feel that staying connected with my body and honoring my hunger is helpful for me, especially on Yom Kippur.  Since I wrote my original post, some have commented to me that fasting and the discomfort is part of the meaning of the day.  They said that this ritual is something that reminds us that if we can give this up for just one day (+1 hour...remember, we are hardcore) then we can do the hard work to make our lives more meaningful and be better humans, Jews, fathers, wives, sons, daughters and so on.

But as this second Yom Kippur comes up, I remain certain that for me, eating is my path to mindful reflection.  Honoring my hunger allows me to honor my body and soul and commit to the work of living a full life.

The funny thing about not fasting is that by the end of the day, when the "break the fast" meal approaches, you aren't overly hungry and don't end up binging on all the food that's available after the sun sets.  The "break the fast" meal symbolizes why fasting is not for me.  Most people I know who are fasting start counting down the hours until their fast ends.  They are waiting for that proverbial finish line to appear so they can run past it, right for the dinner table.  It's like they said, "I made it, now get some food in me NOW."  It seems to me that all the reflection is lost because now they binge to remove the feeling of hunger.  We spend 25+ hours suffering, atoning, and praying and how do we start a new year?  With a binge.  Well, no thanks.

I choose to continue my own ritual to eat on Yom Kippur.  I know it's not what some Jews agree with but that does not make me any less than them.  My spirituality is my own and I choose to engage in my Judaism as it best serves me.

How will you spend this Yom Kippur?  Do you fast or not?  Let me know what you think.

2015 UPDATE:
Just a few days ago, my son asked me why I don't fast on Yom Kippur. As my kids get older questions like these make me analyze my actions on a whole new level. I explained why I choose to eat during this holiday and I wanted to emphasize that I still make the day holy!  So with that in mind, I figured that I'd share  this page  that was written for Jews in recovery or working toward recovery from eating disorders.  It highlights how to mark the day without fasting and I find it very useful for me.  It allows me to make sure that what ever sustenance I do take it, that it's purposeful and with intention.  

Thursday, September 5, 2013

What Did My Rabbi Just Say?

Today's post is short but sweet!

"It's not what you look like, it's what you do that is important"  That is what our Rabbi said today during this morning's Rosh Hashanah service.  The context had nothing to do with Health at Every Size (HAES) or body image.  He said these words because it was 100 degrees outside and the AC was broken in the auditorium we were sitting in.  We were all uncomfortable and to help us relax and enjoy the service, he encouraged all the men to take off their ties and jackets and to roll up our sleeves to help us be a little more comfortable in the unbearable heat.  "It's not what you look like, it's what you do that is important," he said to us.

Immediately, those words meant something else to me than the religious context we were in.  I looked over to my kids and repeated to them, "It's not what you look like, it's what you do that is important," hoping those meaningful words would sink in.  I know that they didn't (because of the heat, because they are only 5 and because they didn't really want to be in services) but the seed was planted!

Now that I am home, just a few minutes removed from that service, those words continue to resonate with me.  No matter what your body looks like; round or thin, big or small, "it's not what you look like it is what you do that is important!"  I know those words mean a great deal to me and I find that message above all others today, this day of new beginnings and reflection, most inspirational.



Monday, August 26, 2013

These Are Not the Clients You're Looking For

I'm getting closer and closer to starting my own private practice.  I've registered my practice name as a DBA (Doing Business As), I've got insurance coverage for my practicd and I'm zeroing in on an office space.  I will only start seeing clients on a part-time basis because I still need to keep my full-time job but things are moving quickly.

As I'm starting this new journey, some acquaintances have referred some friends or family that they'd like me to see.  One such referral was for someone who was looking to lose weight because they were interested in joining a branch of the U.S. Armed Forces.  In case you did not know, each branch of the service has their own weight requirements and everyone who enlists must be below the maximum allowable weight or they are not allowed in.

From what I could gather, my client's date to enroll was getting close and needed to jumpstart their weight loss plan and they were looking to me for guidance. I thought long and hard about whether I should take this client.  Just like I tell my clients to do when they embark on making changes, I weighed the pros and cons of taking the client.  After some time I made a decision not to take this client on.  In the end my decision came down to this:

  1. As a believer in Intuitive Eating, I don't subscribe to meal-plans for weight loss.  They are useful in some situations but when it comes to really embracing Intuitive Eating, a meal plan gets in the way of listening to and honoring your body's cravings.  
  2. By helping this client lose weight with a calorie budget and meal plan, would I be starting them on a cycle of dieting?  So let's say they meet their goal with me...they enlist in the military and then sometime after basic training or somewhere down the road they start to gain weight.  Once this weight gain occurs will they fall back on that familiar meal plan and continue to ignore their own intuitive signals?
  3. The fact that it ssemed to be an urgent need to lose weight concerned me. This is not the kind of work that I'd like to do since the focus on just the number on the scale ignores so many other factors that determine our overall health.n I'd rather focus my efforts on health and not just a number. 
  4. Although I can not change the military, this notion that anyone outside of their silly weight requirements can not perform as a soldier is absurd. It spits in the face of the whole Healthy at Every Size® movement which I so firmly believe in.  
I really struggled with this decision.  As I'm starting to make a name for myself in the private practice world, I was essentially throwing away money by rejecting this client.  Could I have helped them meet their goal?  You bet I could have.  I'm sure I could have helped them learn how to count calories and plan some meals that would help shed the pounds but at the end of the day, I don't think that's why I'm starting a private practice.  If I took this client, I was starting down a slippery slope and eventually I'd be seeing clients who came to me only for quick-fix weight loss plans.

So my question is this: Do you think I made the right decision?  Should I stick to my beliefs or should I not turn away any possible client as I get my practice started?  I'd love to hear your thoughts.  Also, be sure to stay tuned to hear more exciting news about my private practice.


Saturday, August 3, 2013

Happy Is The New Healthy

Recently I saw this interesting article on Huffington Post.  It was an infographic (displayed on the left) that showed which states were the happiest.  The study done by the University of Vermont analyzed Tweets from across the country looking for negative language.  Using that data and calculations they tried to see which states were the most negative and positive thereby assuming which regions were happier than others.   The states with the ligther colors were "happier" than those that were darker.  

When I saw that map, the first thing I thought about was a similar map we've all seen so many times from the Center for Disease Control (CDC) which shows obesity rates across the country (see map below). 

These maps make me think about the old chicken vs. the egg argument.  Which came first, the weight gain or the negative attitude?  Thinking about it, I thought of course the happiness is first then weight follows.  My wife saw this and thought of course the weight gain came first and then the decline in happiness follows.  We each saw it totally differently.  

My theory is this: happiness leads to healthy behaviors.  I'm not discussing obesity rates, I'm talking about behaviors.  The states that are happiest--California, Colorado, Arizona Nevada, Minnesota, etc--also seem to have lower obesity rates.  Ok, so I don't love BMI as a tool to determine health but for the sake of this argument it is an interesting basic correlation.  

It reminds me of another theory about health as it relates to behaviors and that is Blue Zones, These are communities around the world where people have longer life spans than the general populations.  The notion is by looking at these communities we can try to see the key to not just living longer but also living better.  The Blue Zone site recommends the Power 9®: the behaviors these Blue Zones have in common that lead to longevity.  If you take a look at them you'll notice that many are about belonging, connection with people, friendships and overall happiness.  

My theory is simple.  Live happier, live longer.  I don't care what your weight is but if you are happier, you are going to have healthier behaviors that will help you have a better quality of life.  

Think about it, when you are depressed, sad, lonely, bored or angry, how many of us go to food to help us feel better?  Perhaps if we worked on being happier instead of being thinner we'd eat a lot better. We'd move our bodies more.  We'd live longer and live better.

So what do you think?  Is your health determined by your happiness?

Wednesday, July 17, 2013

Boy Scouts Discriminate Against Obese Children

Photo courtesey of USScouts.org
There are times when I feel like I'm living in a make believe world.  I hear some stories in the news and I think this must be from The Onion; the story is so absurd that it must be fake.  Today was exactly one of those days because I saw a story that the Boy Scouts of America (BSA) was not going to allow Boy Scouts whose BMI was greater than 40 to attend their annual Jamboree.  In addition to that, children with a BMI between 32 and 39 had to submit medical information beforehand to be cleared to attend.   Part of the reason for this harsh rule was explained in the Time.com article:
The quadrennial pow-wow’s activities range from mountain biking and rock climbing to scuba diving and a water obstacle course — all strenuous exercises that require physical fitness, Dan McCarthy, director of the BSA’s Summit Group, told the Associated Press. Because there are no vehicles on site, the participants are required to walk everywhere, often on hilly or mountainous terrain.
In all honesty I'm almost at a loss for words for how shocked and appalled I am at this news.  I'm sure we've all heard news that the Boy Scouts are known for their previous discrimination of homosexuals, preventing openly gay scout leaders from joining their organization.  They recently changed that policy but they've decided to change their focus now to "fat kids." The spokesperson for the BSA tried to justify this new policy by saying that Scouts were made aware of the weight rule a year in advance and that troops developed health-related programs to help Scouts lose weight.  Health-related programs are great but we don't need any focus on weight.

BMI is not the only indicator for health and some would argue that it's not even a very good tool to use in the first place.  So why are the Scouts allowed to do this?  Well in short, discriminating against heavy people is probably the last form of discrimination that is socially acceptable and it's even more prevalent than we may think.  One common example is when companies have higher health care premiums for the obese employees.

So let's play this BSA scenario out a little.  Let's say Scout X has a BMI of 42 at the start of last year and he starts to try to lose weight.  He loses some weight by joining the Troops healthy living program and as the deadline approaches, Scout X's BMI is now 40.2.  With the deadline just days away, what does the boy do?  Does he try to sweat out those last pounds by working out extra hard, does he think about restricting his food intake for just a few days.  Maybe he goes to an extreme and takes a diet pill that he saw advertised on TV?  Are these behaviors healthy?  Are these the skills that we want our children to develop in the Scouts?  I don't want my son to ever have to resort to this behavior.  I fear that this might lead to an unhealthy relationship with food, a bad body image and a lifetime of dieting.

I'm sure that the Scouts that are not going to this year's Jamboree because of their weight are disappointed but I'm also guessing that they feel incredibly ashamed.  How will this shame lead to improved healthy behaviors?  Will someone who is ashamed feel more inclined to go for a walk and choose healthy foods?  Or will that person isolate themselves, maybe feel depressed, maybe begin to eat more?  Where is the support system for these kids?  As the rest of their troop returns, how will these Scouts be treated?

The saddest part of this story to me is the fact that I've not heard a lot of public outrage over it.  Take this Fox News online poll that was started as the story broke.  With a total of 9000+ votes recorded 35% agreed that they Boy Scouts are allowed to ban obese kids from attending the Jamboree and 48% thought it was discrimination.  18% were undecided.  Seriously, 35% agree?! Wait 18% are undecided?!  You must be kidding me.

Hopefully this policy will soon change and we will stop fat-shaming our children, our friends, our family, our co-workers. Hopefully we will begin changing our attitudes toward obesity and focus more on healthy behaviors and not the number on the scale or what our BMI is.  Hopefully, we will change our attitudes about fat the same way we are changing our attitudes towards minorities.

Sunday, July 14, 2013

Zipzicles!!!

If you've been following my blog recently you might have read my post on Otter Pops.  If you haven't read it, click here.  After I wrote that article, my wife found a product on Pinterest called Zipzicles. Basically they are slender, reusable BPA-free zip top plastic bags so you can make your own homemade Otter Pops.  You can imagine how happy I was that my wife found these products.  God bless the internet, right?  This weekend, the stars aligned: it was 90+ degrees, we had no plans all day, we had the right ingredients in the house so it seemed like a perfect day to give the Zipzicles a test run.

Our ingredients
The company provides you with a couple of sample recipes on the back of the package so we tried one of their suggestions: strawberries and lemonade.  The recipe provided was as follows:
1 cup strawberries
3  + 1/2 cups lemonade
Puree 1 cup strawberries and 1/2 cup lemonade in a blender.  Once mixed, add 3 cups lemonade and pour into Zipzicle.
Pouring the mixture in the bags
Simple enough to do, right!  Once our mixture was ready we broke out a little funnel and filled the bags one at a time.  The recipe is supposed to make enough to fill all 12 bags that come in the package but we only had enough to fill 9.  After filling the bags, we put them in the freezer and 6 hours later they were ready to enjoy.


Once we were ready to try our finished product, I was anxious to see what my kids thought.  They were very excited to try them and they loved the flavor we made.  While we sat there and enjoyed our Zipzicles in the afternoon shade, we thought of new flavors to try so it looks like we'll be doing this again which is great!

What color is my tongue?
When we were all done with our Zipzicles, Reuben asked "What color is my tongue?"  Of course since there was no food dye in our treat, his tongue did not change color. He was a little sad about this, but mommy and daddy were quite happy!  We explained to him why his tongue had not changed color and he seemed to understand but still wasn't quite happy since he really likes that effect!  That's ok.  He'll survive.

Overall, I would say our Zipzicle experiment was quite successful.  We'd definitely make them again when the opportunity presents itself.  We might even try some "adult" variations with tequila for some dinner parties.  What recipe ideas do you have?  Let me know and maybe we'll give them a shot.

Disclaimer -- I did not receive any compensation from Zipzicles to write this post.  It is not an advertisement in any way and my opinions/thoughts/comments are my own.
Shira's Zipzicle
Reuben's  Zipzicle

Wednesday, June 26, 2013

My Intuitive Eaters

I often get asked about how I apply Intuitive Eating to my kids so I thought I would give you an example from tonight's meal.

I really didn't feel like cooking tonight so I knew I was going to make something simple. As my wife and I try to do on a consistent basis, we asked our kids what sounded best out of three different options. Once my kids decided, I helped them prepare their own plates. We had turkey sandwiches with carrots, hummus, and fruit.  They were in charge of making their sandwiches with as much or little turkey, cheese, mayo and/or mustard. I stood by just to help unscrew a container or handle a sharp knife.  They also put as much or as little of the other foods on their plate depending on their own hunger.

When they started to sit down to eat I made sure not to comment on what or how much they ate.  When they were finished they said their usual, "I'm done" and they took their plates to the sink.  Of course they wanted dessert and we usually offer something sweet to our kids. As with the main meal, we offered choices and tonight my son choose Bunnies, and my daughter wanted a Popsicle.  The interesting thing we do with dessert is we let our kids choose how much they want.  As you can see from the picture below, my son got a small bowl, opened the Bunnies himself and served his own portion.  In case you can't see it, he took about 15-20 Bunnies. 


We have worked had to build trust with our kids and their food choices.  I think that our kids trust it too. They know that we will offer foods they like and a variety of play foods. We trust that they will eat until they are full and that they will not abuse the play foods that we provide.  

How have you succeeded or struggled with feeding your kids?  I'd love to hear your experiences.

Thursday, May 30, 2013

Enough With the Otter Pops Already

My wife and I share a lot of responsibility with our twins.  We both work and we've been fortunate enough to have different work schedules so one of the ways we divide up some of the work is that my wife drops the kids off at their preschool and I pick them up.  Most of the time I'm there by 4pm and the vast majority of the time my kids have already had a snack.

Before I go too much further, let me say that our preschool has provided my kids with a very loving, nurturing environment.  They've met great friends, they've had great experiences and developed an early love of Judaism.  But one thing that our school needs to work on is the food they feed my kids.  

We provide lunches for them but the school often gives them snacks.  Since I pick them up I hear mostly about the afternoon snack. If you've ever met my daughter you'll understand why some people call her the "court reporter." She remembers everything and will report back to you anything you want to know about the day's events.  It's not common but there are some days that I pick them up and they have bright blue faces!  The "court reporter" yells, "Daddy, we had popsicles today!" They are smiling, excited to see me and they show me how blue their lips and tongues are.  Of course they're blue, that's what happens when you eat Otter Pops.

I know that some Otter Pops are now made with 100% juice and that they only have 40 calories per pop.  I know that some of you are saying what I've heard before, "Just lighten up." Well to be honest, I will not lighten up when it comes to feeding my kids, thank you very much.  When my kids feces is bright green the next day because of the food coloring in their popsicle, I will not lighten up.

There are plenty of alternatives to the neon glow of an Otter Pop.  Why not make some juice pops with the kids?  My colleague, Sumner Brooks, MPH, RD recommended frozen mango chunks.  I'm sure a handful of grapes or some watermelon would be equally refreshing as a popsicle.

I'm doing my best to raise my kids as intuitive eaters and I believe in the principles I've learned from Ellyn Satter.  My kids have eating habits that I'm proud of and I do not deny them any shortage of play foods inside and outside of our house but in the end the issue is this: when I see bright blue faces when I pick my kids up from school, a part of me feels like the hard work I'm putting in is being unintentionally undermined.  Dr. Yoni Freedhoff said it very well in this article he wrote, "Why is Everyone Always Giving My Kids Junkfood?"
Somewhere along the line, we've normalized the constant provision of junk food to children. It seems no matter how small the ship or short the journey, sugar pretty much christens each and every voyage on which our children set sail. 
There's simply no occasion too small to not warrant a junk food accompaniment. But for me, the strangest part of all is the outcry that occurs if and when I point it out. My experiences have taught me that junk food as part of children's' activities has become so normalized that my questioning this sugary status quo genuinely offends people's sensitivities and sometimes even generates frank anger.
I'm hoping that the status quo will change soon and that my kids will not be supplied endless amounts of sugar and food coloring in the coming years but that might not happen.  I hope that we stop relying on the highly processed food as our go-to snacks for our kids.  I hope that when it comes to treats, we make it from scratch instead of getting it from a box.

What do you think?  Do any other parents struggle with what their kids are fed when they are not with them?

Thursday, May 16, 2013

What's Wrong with Fat?

Photo Courtesy of Oxford University Press
I was fortunate enough today to attend a lecture with Abigail Saguy, PhD discussing her new book, "What's Wrong with Fat?"  It was a very interesting discussion and I'm excited to read the book to learn more about what she has to say about "fatness" and our society.

The major point of her discussion today was to help us question whether our society's emphasis on the "Obesity Epidemic" is really helping or are we stigmatizing those individuals who are overweight or obese.  By the way, Dr. Saguy used the word fat so I'll use that here instead of the former terms.

Her talk was very interesting and I'm not going list each point but the the highlight was learning about how we "frame" the obesity or fat issue has an effect on how we address it.  Most of my fellow employees in healthcare see fatness as a medical issue.  Something that can be cured or fixed with the right treatment.  Some of my fellow RDs see it as a public health issue where numbers are reaching epidemic proportions.  But lastly, there are some who would see fatness as a social justice issue, where fat is just a diversity issue and we must learn to accept people no matter what their size without bias or stereotypes.

She also discussed how no matter what perspective we use, there is research that would suggest that weight alone is not a good predictor of mortality.  One study she highlighted was Flegal KM, et al., 293[15]: 1861-7, 20 April 2005 in which the authors found this notion of an "obesity paradox" where people with BMIs between 26 and 29 (overweight) actually had a decreased risk of death compared to those in the normal weight category.

As we concluded she closed by questioning why our perception of fat changed over that last 100 years.  It used to be that being fat was a desirable trait but that is no longer the case.  But today, being fat is quite negative.  When you see someone who is fat, what do you think?  "They're lazy and weak. They're slobs and how could they do this to themselves?"  One interesting point that Dr. Saguy made was by explaining that a disproportionate number of minorities and lower income people are fat compared to other groups.  Fatness aside, these groups are also ones that are often discriminated against for other reasons so are we just adding another by making obesity such an issue?

As a dietitian, this topic is extremely important in the work that I do.  Many of my colleagues and other health-care providers will not agree with me, but I agree with Dr. Saguy and I feel that if we can take weight out of the equation we can focus on the behaviors that really matter.  Why should we force our clients to lose weight when 1) most will likely gain weight and 2) losing weight might not improve their health unless they change their behaviors?

As a individual, this topic hits home with me.  I am fat!  I have a belly but that does not limit me in my health.  I can run, I can play sports, I can bike and I am healthy.  I know that some of my clients and some of my fellow employees look at me and say to themselves, "Why is this guy teaching a class on losing weight! He should take some of his own advice."   Well to those folks I say this: my weight is just one part of me. From what I learned today and what I continue to learn, it does not mean I have five years less to live than you.

So what do you think, does Dr. Saguy make you change the way you think about how we frame the question of obesity/fatness?

Thursday, April 18, 2013

CPK, Stop Marketing Soda to Kids

As a dietitian and a parent, I'm very sensitive to how foods are marketed to kids.  This week I took my daughter with me to meet some family friends for dinner at California Pizza Kitchen.  Of couse when we sat down, my kids got their own Kids Menu complete with pages to color, crosswords, and word searches.

I'm not going to go into their kids menu but let's just say it is pretty standard and could use some improvement but that's another post.

After my daughter was done coloring she wanted some help with the word search.  Since she's not even reading yet, I was doing most of the work and as I tried to help her find words, I noticed what one of the word search words was, "Pepsi!" See the picture below.


Well, needless to say I was a little upset about why on earth Pepsi would need to be included in the word search.  Maybe it's just what CPK thinks makes up a healthy kids meal.  Pizza, pasta, sundae, brownie and Pepsi.  Why that's just all the good stuff a growing body needs.  Sugar, fat and salt. Yum!

So I took to Twitter and posted the tweet below. 
I didn't expect a response at all but the good news is that tonight, CPK sent me the following tweet:
I'm always amazed by the power of social media.  I'm not naive enough to think that just because of my tweet that CPK is changing it's word search, but the point is, when you notice something that goes against what you believe in, make your voice heard.

How have you noticed junk foods marketed to kids?

Sunday, April 14, 2013

Mission Accomplished!

Well, I can say that I am a marathoner!  I can't believe it but I completed my goal and finished the LA Marathon last month.

I've been waiting to write this post about my run because honestly, it has taken me a while to process what I've done.

Let's start with the basics.  My time was 6:32 minutes.  My goal was to be under 6 hours but that didn't happen.  I ended up waking the last 9 miles because I was feeling pretty nauseous.  Leave it to a dietitian to screw up race-day nutrition!  Regardless of my time, I never felt down, or upset or angry.  I finished and above all things, I kept moving forward. I even put a reminder on my hands to keep me focused on the goal, "Forward is a pace."


The day was filled with emotions.  I was scared and nervous as my wife drove me to the starting line. I could barely eat my pre-race meal because of my nerves.  When I got to the starting line I calmed down and I was so happy to have some friends from work there who I was going to run with.  My father also came to send me off as well.  We were supposed to run together but an injury during training sidelined him for the big day.

As the race started and I waited for my turn to cross the starting line, my first tears of the day began to form.  I was really going to do this.  With all the training and anticipation, I couldn't believe the moment was finally here and in that moment I realized why I was doing this.

Ready for the start.
I was challenging myself because even though I am a totally different person, there is still a part of me that thinks of myself the young man that weighed 300+ pounds that could not walk up a flight of stairs and who shied away from any exercise. That person does not exist anymore, but the memory of that former life is like I'm am still living it.  So crossing the start line I raised my hands up in joy because the courage was to start, and not in the finish.  I started this journey to prove to myself (again) that I am strong. That I am an athlete.  That I am a runner and that I can do anything I put my mind to.

Greeting my kids
During the race there were other moments of joy filled tears.  Tears came twice as I saw the video message that my wife and kids made as it played on the big screen at mile 8 and 21.  There were more tears as I met  my kids at mile 23.  It was a moment I will never forget and I honestly can't think which was more meaningful, the kiss and hugs I got from my kids or finally crossing the finish line. Of course there were even more tears as I finally crossed the finish line and was reunited with my wife!  What I didn't expect, though, were the tears that came in the days after as I began to reflect on what I had done.  Not one tear was from pain, sadness or anguish, but rather joy, pride and awe.

Hugging my wife at the finish line
I ran the marathon alone but I couldn't have done it without so much support from friends and family.  I have to, of course, thank my wife for being my biggest cheerleader and supporter.  Seeing my friends and family along the course was so great so thanks to everyone who came out to cheer me along.  Thanks also should be given to my father who helped me train.  Running with him early weekend mornings was an amazing experience!  I should also thank my un-official coach Juli for helping me plan training runs and listening to me while I worried about each new milestone.  And lastly, I have to thank my friend Dana who was my first running partner.  She was such a great help to me.  Every time I had a bad run or had any self-doubt, she helped me refocus and encouraged me to stay positive. The best thing she did was jumping in at mile 19 and walking the last part of that marathon with me.  Having her alongside me helped me move forward each step.  Thank you to you all!

Overall I have to say my marathon experience was nothing but positive.  Remember, up until just a couple of years ago, I've never been a runner.  So this milestone was huge for me.  If I can go from the couch to 26.2 miles in just a couple of years, so can you.  I'm already thinking of what my next race will be.  Maybe a half marathon, maybe a 10k or maybe another marathon.  Are you inspired by my story?  Want to join me?

I got my medal!
The mass of runners climbing Hill St.



All smiles at mile 24!
Dana greets me at mile 19



Monday, March 11, 2013

Ready for 26.2!?

My apologies for not updating this blog more frequently but life has been busy.

I've written about my fitness bucket list that I created to help motivate myself and others to be more active and so far its been working.  I am getting ready to cross the first thing off my list.  Watch out world, because I will be running the LA Marathon this Sunday, March 17th.

There are so many emotions as I get ready for this Sunday.  I'm excited because the long road of training is finally over.  I'm anxious about my performance.  I'm scared of not being able to finish.  I am proud of how far I have come to date.

My goal is to finish the marathon.  I won't lie, I wish I was faster but I'm not. I wish I could run without walk breaks but I can't.   I wish I could finish in under 5 hours but I won't.  But I have to keep telling myself that it is about progress not perfection.  Three years ago I would have never dreamed of doing a marathon and each long training run has been a new personal record for distance. I look forward to setting a new personal record this Sunday!

My running partner shared a great quote with me today that captures it all, "The miracle isn't that I finished. The miracle is that I had the courage to start." -John Bingham, spokesperson for the slow running movement.

What will you have the courage to start?