Tag Archives: diet

Doctors Consult on Fat Profits from Medical Weight Loss Programs

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New profits from an old formula

A recent article in the New York Times got my blood boiling this morning.  The article cites a few medical professionals (and others) talking about how to fatten profits from offering weight loss products, potions, procedures and magic pills.  In particular Dr. Kaplan (touted as a “leader in the medical weight loss industry) talks about his Long Island Weight Loss Institute and the various products and services he offers people to help them lose weight.

In fact, Kaplan is so well known as an expert in the industry that he has started a consulting business to help other doctors.  Is he helping other doctors figure out what are the best evidence-based options for helping their clients actually lose weight.  Well no.  He’s helping doctors figure out how to increase their bottom line by teaching primary care doctors how to bill insurers for obesity treatments.

This is a very big business, at least in part, due to a provision in the federal health care law requiring insurers to pay for nutrition and obesity screening.  Marketdata Enterprises Research Director John La Rosa has studied the weight loss industry for more than 20 years.  In an interview cited in the Times, La Rosa estimates that medical weight loss programs currently bring in $1 Billion annually–a number he expects to grow 5 percent annually at least through 2019.  La Rosa calls the Federal health care provision a “game changer” and mentioned a seminar he recently sponsored advising entrepreneurs to take advantage of the insurance coverage by opening their own weight loss clinics.

While the profits appear to be new, the procedures being sold don’t seem to be new at all.  In fact many of the procedures, potions, chants, and magic pills offered have not been proven to be effective or have even been discredited as widely ineffective.  Kaplan’s own office offers very low calorie diets, meal replacements, B12 shots and vitamin supplements.  None of these techniques have been demonstrated effective for anything but very short term weight loss which typically begins to reverse very shortly after the treatment period (which can be as short as six weeks).  What’s more, many of these programs offer little medical supervision.  The patients are often actually seen by nurse practitioners or physician’s assistants with little specialized training in the fields of nutrition or bariatric care.  One company, Medi-Weightloss (with over 76 locations throughout the country) advertised for a medical director at its Connecticut facility stating that the hours are “not very demanding” stating that files could be reviewed remotely and “there are no set hours or emergency calls”.

Now don’t get me wrong.  I think most doctors work very hard in a system that is not very hospitable to good medicine.  And I am an entrepreneur.  I believe in the power of invention and good business practices.  But when you are holding seminars to teach guys in white coats the best way to get insurance companies to reimburse the same snake oil they have been trying to sell us for centuries, I get a bit miffed.  I think people are entitled to research-based medicine.  And by research-based, I mean medicine that is proven to be effective, not just turn an ever increasing profit.

In this country, not everyone has access to even basic, decent medical care.  Medicine is very expensive here.  And we are often taught that the reason that medical care is so expensive here is that the fatties are driving  up the costs.  So the idea that doctors are learning to fatten their profits at the expense of their fat patients has got me more than a little upset.  Lets give every BODY access to bias-free, evidence-based, reasonable healthcare.  And let’s put the fat-shaming, profit mongering medical weight loss industry on restriction.  That would seem to be the healthy thing to do for our bodies and for our economy.

Love,

Jeanette DePatie (AKA The Fat Chick)

P.S. Want me to come and speak about evidence-based medicine and wellness to your group?  Go here.  Or just email me at jeanette at thefatchick dot com for more info.

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New Study Suggests Fat Correlated With Lower Risk For Dementia

FatBrain

Nearly 60 percent of the brain is composed of fatty acids.

Previously we heard that obesity increased your risk of dementia.  Now a new study contradicts these former findings and suggests that increased body size is correlated with a decreased risk for dementia.  I say correlated with, because no causal link has yet been found.  And we don’t want to go the way of those finger pointers who say that being fat “causes” sickness by saying being fat “prevents” sickness.  We simply don’t know that much yet.

However, this new study does seem to indicate that there is a strong correlation between low body weight and dementia in middle aged people.  The study reviewed statistics for nearly 2 Million people from the United Kingdom Clinical Practice Research Datalink (CPRD).  The CPRD data included people over 40 who had their BMI measured between 1992 and 2007.  (The median age for those measured was 55.)

The study found that compared to those of a “healthy weight” (heavy airquotes here) those who were underweight (BMI less than 20) had a 34% higher risk for dementia.  As people got fatter, their risk for dementia decreased–with the fattest people (BMI over 40) experiencing a 29 percent lower risk of dementia than those with “healthy weight”.

Cue the inevitable articles about the “obesity paradox”.  This is the title given to the fact that fat people are at lower risk for certain conditions than skinny people, despite the medical establishment’s insistence that this shouldn’t be the case.  This is the label given to the fact that overall, “overweight” people live longer than “healthy weight” people.  It really makes me wonder when they are finally going to do away with the “healthy weight” label, since in many cases, other weights are healthier than the healthy weight level.  And it also makes me wonder when they are going to stop calling something a paradox, when it clearly isn’t one.  Some weight ranges come with higher risks in some areas and lower risks in other areas.  And maybe we will come to realize that there isn’t one healthy weight, but rather a range of risks that slide around in various places on the BMI chart.

As reported by the BBC (LINK WARNING, HEADLESS FATTY PHOTOS GALORE) Alzheimer’s Society’s Dr Doug Brown said: “People should make positive lifestyle choices to keep their brains healthy by taking regular exercise, not smoking and following a healthy balanced diet.”  This seems sound HAES oriented advice to me.  Naturally, despite the fact that this study is much larger and more detailed than previous studies that claimed that obesity increased the risk for dementia, there’s a lot of head scratching and backpedaling going on.  The article is careful to point out that there is no clear causal link yet evident (hence the opening of this blog post).  If you have the sanity points to spare, you can click on that BBC link earlier in this paragraph to read things like, “Sure you’ll be less likely to get dementia if you live long enough.”  and “This is no excuse to sit on the couch and eat an extra piece of cake.”  Because somehow, no matter what the evidence shows, some medical professionals just have to get their jab in at the fatties.

I am just hopelessly naive enough to imagine a day when the “healthy weight” category is called something else.  I imagine that over time we will find more and more evidence that being fat has risks, being skinny has risks and being midsized has risks.  After all, being alive has risks, for people of all sizes.  Maybe we can finally focus on living the best, most productive, most joyful and healthiest life in the bodies we have right now.

Food for thought.

Love,

Jeanette DePatie (AKA The Fat Chick)

Docs Admit Diet and Exercise Don’t Equal Weight Loss, Then Jump to Wrong Conclusion

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An article hit my feed from LA Times today and it seemed to offer some refreshing news.  It seems 4 doctors, weight-loss specialists set out to say what so many of us have been saying for so long now.  They admit that for the vast majority of obese children and adults in this country, telling them to eat less and move more is a prescription for failure.

They acknowledge that once a fat body begins to lose weight, a whole lot of processes, hormonal and otherwise kick in.  Hormones increase hunger signals.  Metabolisms slow down.  The body struggles to maintain the weight.

Furthermore, the 4 weight loss experts admit that a body that has lost weight are biologically quite different from bodies that have never been fat.  One states:

“Few individuals ever truly recover from obesity,” the authors wrote. Those that do, they add, “still have ‘obesity in remission,’ and are biologically very different from individuals of the same age, sex and body weight who never had obesity.” They are constantly at war with their bodies’ efforts to return to their highest sustained weight.

So far, so good.  Many of us have been pointing out the studies that show these results for years.  So after this, those docs recommend a behavior-based approach where we focus on exercising and eating well for their own sakes (as both have been demonstrated to improve health regardless of whether or not they are accompanied by weight loss), right?  Right?

Well, as it turns out, no not so much.  The docs are suggesting that we simply increase awareness of other tools for weight loss (pills, potions, surgeries and devices) and turn to them sooner.  They suggest we increase fear mongering in the overweight to help keep them from becoming obese.  They suggest a greater focus on weight maintenance for those who have lost weight in order to help them keep it off.  (They somehow neglect to tell us how this is going to work or how it will help.)

The funny thing is, that the doctors see the stigma.  They see how telling patients to just eat less and move more is cruel, since it for the most part doesn’t work.  They see how stigmatizing fat patients and simply labeling them as non-compliant isn’t the answer.

But they simply substitute in another bad answer.  And this bad answer is likely to drag along much more devastating side effects than the original bad answer.  At least suggesting people move their bodies more and eat more nutrient-dense foods is likely to improve health, regardless of whether or not it leads to the holy grail of weight loss.  While pills and potions and surgeries and devices are slightly less ineffective than diet and exercise alone for weight loss, these methods can also carry significant dangers like increased heart rate, higher blood pressure, heart defects, permanent disfigurement, malnutrition, depression, suicide and death from other causes.  And there is not much evidence that in the long run, the few people who do sustain weight loss from the pills and potions and surgeries and devices end up any healthier than the people who stayed fat.

Meanwhile, there is ample evidence that eating well and exercising have a positive impact on health regardless of whether they are accompanied by weight loss.

So why on earth are we not just focusing on healthy behaviors here?  Why do we insist on focusing on weight loss at all?  Well these docs do label themselves as weight loss specialists and that may have a lot to do with it.  And as a society, we do love to blame fat people for stuff.  So I guess they took a few steps out into the light and then fell into a deep, dark hole.

Oh well.

I for one am going to continue my focus on living the best life I can in the gloriously wondrous body I have now.  So if you’ll excuse me, I’mma gonna get on with it.

Love,

Jeanette DePatie (AKA The Fat Chick)

P.S. Want me to talk about evidence-based medicine and wellness at your school or organization?  Learn more HERE.

“Guilt-Free Holiday Partying”

ProducersGuildParty

Hubby and I get started on some guilt-free holiday revelry at the Producer’s Guild Holiday Party.

Over the past few weeks, the media has been requesting experts to comment on recipes and plans for “guilt-free” holiday dining.  I have a lot of suggestions, but somehow, they haven’t been picked up.  They tell me that the items I am pitching are not what the media outlets are looking for.  The media is looking for recipes for low fat appetizers and low-calorie cookies.  They are looking for plans about how to get through the party without eating “too much”.  And they are looking for advice about what should eat to look hot in the LBD (Little Black Dress) you bought for the New Year’s Eve party.

Well here on my very own blog, let me offer you some thoughts.

Here’s how to make any holiday recipe, guilt free:

1.  Stir up, cook, bake or make your favorite recipe.

2.  Eat some of it.

3.  Enjoy it.

4.  Decide not to feel guilty about it.

I know it seems overly simplistic.  In a world where we are taught to binge on Saturday and Sunday and restrict and regret on Monday, this is some heavy-duty out of the box thinking.  But seriously folks,  can we just decide to give ourselves the holiday gift of not feeling guilty every time we put a morsel of food in our mouths?  Just because the media tells us that we have to feel awful every time we eat, doesn’t mean we have to actually do it.

And here’s a strategy for eating any holiday party:

1.  Tell yourself you are there to have fun.

2.  Tell yourself that you are taking a holiday from restriction and regrets.

3.  Tell yourself that any treat you see is allowed at any time, not just at a party and not just during the holidays.

4.  Eat what you want.

5.  Enjoy what you eat.

6.  Stop when you want.

7.  Eat whatever it is that you want!

Let’s simply take the time to enjoy holiday treats while they are here.  And since we know we can enjoy those treats on Monday (or any day of the week) if we want to, maybe we can put aside the need for the crazy weekend binge.

And finally,

How to Look Great in Your New Year’s Eve Little Black Dress

1.  Find an awesome dress.

2.  Put it on.

3.  Strut your stuff.

See?  That was easy!  No need for diets or foundation garments that squeeze you until your hair is taller or strategies for slimming.  Just put on a dress and ROCK. THAT. THING.

I hope my holiday strategies are helpful to you.  Even though you won’t be seeing them in your favorite newsstand magazine.

Love,

Jeanette DePatie (AKA The Fat Chick)

P.S. Want me to talk to YOUR group about guilt-free living?  Click HERE.

P.S.S.  Want to get on my mailing list and get free stuff?  Click HERE.

Stuff That Weighs More than Me: Columbian Mammoth

PGMU406248059410Spent a wonderful afternoon at the Page Museum next to the La Brea Tar Pits.  It was super fun and we were spoiled for choice in terms of stuff that weighs more than me.  The saber toothed cat (not tiger) pictured above fit the bill quite nicely.  As did many other critters like the sloths.  But for sheer hugeness, I have selected as today’s stuff that weighs more than me, the Columbian Mammoth.

ColumbianMammothThis bad boy (Mammuthus columbi) was pretty darn big.  He lived in North America during the late Pleistocene Era.  Ready for the stats?  Copy that!

Height:  12 to 13 ft.

Tusks: Up to 14 ft. long

Diet: Herbivore, so like salad.  700 pounds per day of salad.

Weight: 7 to 9 metric tons

Conclusion

Love, Jeanette DePatie (AKA The Fat Chick)

Is Godzilla Yo-Yo Dieting?

Japanese fans are up in arms about the new Americanized Godzilla’s hefty size–citing poor diet as cause for the unwelcome change.

The trailers for the newest Godzilla film have hit American shores and has spawned some significant controversy.  It appears that Godzilla has come “under fire” not for his acting (which has been notably wooden in the past) but for his BMI.  No we are not talking about the Bad Monster Index–where Godzilla holds the undisputed title of King of the Monsters.  We are talking about the Body Mass Index.  Many are currently arguing that Godzilla is just sporting too much weight on his 350-foot high frame.  Using the current BMI, Godzilla could weigh about 750,000 pounds before he hit the dreaded “Obese” category.  Godzilla has not been forthcoming about his weight, but many Japanese fans have calculated that the hapless lizard may have stomped out of the “ideal weight” category.

“He’s so fat I laughed,” was one particularly cutting remark found on Japanese forum 2chan.  Others have referred to him as “metabozilla”, “marshmallow Godzilla” and even “pudgy and cute”.  Some have speculated that Godzilla’s size is due in part to his American diet and sedentary lifestyle.  “That’s what happens when all you do is eat Snickers bars,” said one commenter.

Much of this has led to speculation about Godzilla’s diet.  He has never been shown on screen eating (although he has ingested a nuclear reactor and seemed to absorb energy from that).  He has been seen in comic books eating raw seafood.  Most people guess that he lives largely on radiation and sushi.

It seems pretty likely that Godzilla has to eat quite a bit to sustain is 350 foot high body.  An African elephant weighs in at about 7,000 pounds and needs to eat about 500 lbs. of plant matter per day to sustain itself.  Using that same ratio, Godzilla would need to eat about 50,000 pounds of plant per day.  Now the King of Monsters might be able to absorb some of his energy via nuclear radiation.  And naturally protein sources like fish are more dense in calories than say, trees.  But I ask you, do we really want a creature that needs to eat 10,000 pounds or more of food per day to turn to a protein diet?    So far as we know, Godzilla does not eat people, yet.  But I don’t know if I want to encourage him.

But Godzilla hasn’t always been svelte.  A quick look at his film debut publicity photos in 1954 show a relatively “fluffy” monster with more of a pear-shaped figure.

There is no question that Godzilla has gotten bigger over the years.  Traditionally, the giant lizard has grown larger in proportion to the buildings he stomps around.  The Godzilla of 1954 was a mere 50 meters tall.  The newest Godzilla is over 100 meters tall and noticeably beefier:

But if you look carefully at the creature’s shape, you might notice something very interesting and somewhat familiar.  It’s even clearer if you look at this picture here:

Clearly the great monster’s shape has cycled too.  He appeared to have shed some pounds in the the MusoGogi period (1964) beefed up considerably in the BioGogi period (1989-91) gone through some sort of radical weight loss program in the Shodaijira period (1998) and bulked back up for his current appearances.  Seem familiar to you?  Seemed that way to me too.  In fact, I think Godzilla is experiencing the most common outcome of trying to stay slim.  I think the King of Monsters is weight cycling–probably from yo-yo dieting.

Now there is no way to know for sure.  As my good friend Ragen Chastain says, the only thing you can know about a fat  person (or monster) by looking at them is your own prejudices about fat people (or giant lizards).  But if our good friend Godzilla is experiencing weight cycling, he would certainly be experiencing the same thing that most people who try to lose weight experience.  Most people are able to keep some weight off for a while, but the vast majority of folks (90 percent or more) regain the weight they’ve lost and often a little more.

So this leads us to the question of what should be done about Tokyo’s most famous building-stomper.  I think if we are seriously going to spill digital ink regarding the size of a fictitious reptile who bangs buses together for fun, we should use this as a truly teachable moment.  Let’s talk about what really works in making creatures of all shapes and sizes happier and healthier.  I think the first thing we should do, is to stop trying to shame the poor creature.  There is ample evidence after all, that shame doesn’t help anybody lose weight.  I’m sure the producers at The Biggest Loser are planning epic monster battles between Godzilla and their “Monster Trainers” as we speak.  And even though the King of Monsters’ agent is probably taking calls right now from diet companies seeking his endorsement for the new “Monster Weight Loss Formula”, we should probably discourage him from falling into his old habits of dieting and weight cycling.

I recommend the same thing for Godzilla that I recommend for everybody else.  He should eat a varied diet including foods that he loves (but not including people).  He should engage in joyful and pleasurable physical activities (not too close to major cities).  In fact, I think he should try my DVD.  He should sleep well.   And he should manage his stress (again, hopefully not too close to major metropolitan areas).   At 60 years old, Godzilla is showing no signs of slowing.  If he follows these simple recommendations, he’s likely to stay happy and healthy for many years to come.  Which is good.  Because I freakin’ LOVE this guy.

Love,

Jeanette DePatie (AKA The Fat Chick)

CEO: Every BODY Can Exercise.com

 

The Unwritten Sports Stat: Female Athletes Must Be Gorgeous

A friend forwarded me a link to an interesting article in the Guardian about how female athletes fear that how they look may outrank how well they perform in terms of their careers as sportswomen.    The article chronicles the results of a major study commissioned by BT Sport.  The study was commissioned after the 2012 Olympics partly in response to Olympic Gold Medalist Rebecca Adlington’s very public admissions about body insecurity after the games.  The study included over 100 elite female British athletes.

To those of us who study body image questions, it’s probably not that surprising that 89 percent of the athletes polled felt that they could relate to insecurity about body image.  67 percent felt that the public and the media valued their personal physical appearance over their athletic prowess, and over 70 percent said that it affected their diet and training regimes.  Let’s take a moment to ponder here.  We are talking about professional athletes who make their living from the capabilities of their bodies who are making training decisions based at least in part on how they will look in their singlet.  It makes you wonder if their performance might have been even better if they could allow their training and nutrition to be focused exclusively on what pushes their bodies to their best performance.

I have written before about the fact that I love the Olympics with a big old passion.  I have also expressed before, my deep disappointment over how we could spend time skewering the very best Olympic gymnast for the quality of her hairdo, or why we need to make Olympic uniforms look like outfits for cheerleaders.  (Another group of highly trained athletes that are hypersexualized to the point of ridiculousness.)  And don’t even get me started on Olympics advertising that looks like softcore porn.

And we’re not just talking about Olympians here.  Anyone from tennis stars to golfers are expected to look runway perfect these days.  Maybe that’s why I’m so excited about our Fit Fatty Virtual Events this year.  It allows you to complete all kinds of fabulous physical activities wearing what you want, wherever you want and on your terms.  We have had several incredibly inspired entrants who have completed significant tasks wearing pajamas.  We have had entrants complete events and perform community service simultaneously.  We have met Santa Claus on a 5K and performed epic, family-style, living room dance parties with kids of all ages.

Because Ragen and I are crazy enough to believe that physical activities should be about moving your body and having fun.

Love, Jeanette (AKA The Fat Chick)