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.

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.  

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.

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.

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?

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.

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