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Category Archives: Weight Loss
The Mental Health Effects of Weight Stigma & Why We Have To Stop Pushing Diet and Exercise As a “Solution”
I have been working lately with Roni Davis in helping patients understand the concept of “Healthy Weight” and how weight loss. Roni has been through the cycle of regular person, regular person who became concerned with weight gain, regular person who went through diet weight loss and weight gain, regular person who struggled with their mental stability due to dieting, figure athlete, personal trainer, and then to a regular person who talks people down from how they feel about their weight to how they should feel about their weight. Roni’s experience reflects not only what people feel after years of struggling with maintaining or losing weight, but also shows the results of a growing food environment that sets up the general population for failure from the time they wake up until they go to bed – even if they don’t leave the house. We also need to be aware of comments that are derived from privileged individuals who supply advice based on personal feelings of overweight individuals. While I’m a big fan of “not one eating pattern can claim to be the single plan for everyone”, her words of comfort are based on one woman’s experience from a high altitude level that helps to ground everyone.
Last week apparently Bill Maher went on a rant about fat shaming. His argument? We need more of it.
James Corden replied with this:
“If making fun of fat ppl made them lose weight, there would be no fat kids in schools, and I’d have a six pack by now.”
“I’ve been off & on diets since as long as I can remember & this is how it’s going.”
It was brilliant. But even he’s still missing the point a little and so I wanted to really dive into the topic.
That is, fat shaming, weight stigma, and weight loss because like Bill Maher I was someone who also used to fear the fat acceptance movement – but as they say, when we know better, we do better.
So, what will follow is decades of personal experience, as well as, almost a decade of professional experience.
You see, like tens of millions of other people, I also bought the lie. You know the one I mean, the one that says if I was only thinner, if only I was smaller, if only the scale displayed a lower number, if only I could stick to “diet and exercise” then I’d be worth something – then I’d be happy and healthy and life would be perfect. The lie that says only people who are lazy and no self-control gain weight – the lie that says if only I’d get off my ass and diet and exercise – then I’d be skinny and worthy of love, belonging, goodness, and respect.
THEN, I’d be happy – I’d be worth something.
But it almost killed me.
And it’s all lies. Right down to the “diet and exercise solution” we’ve been sold – and I say that as a former award-winning personal trainer/nutrition & wellness coach.
Have you noticed this?
You’re sitting around chatting with friends, the subject of weight, or your bodies comes up and everyone is expected to add something derogatory about their body.
“I’m so fat. I’m so gross. This shirt makes me look like a whale.”
“Yeah, me too… I can’t take it anymore and am starting that keto thing on Monday – so gotta enjoy myself this weekend cuz I’m not gonna be allowed to eat this anymore after that”
And if in that discussion you piped up and said, ‘I actually feel OK about the way I look,’everyone there is going to judge you, scrunch up their noses and think “well doesn’t she just think she’s special”…and they probably wouldn’t call you to hang out anymore.
That’s how pervasive and expected body hate has become.
We’re supposedto be ashamed of our bodies.
It’s become not only more acceptable to insult your body than it is to praise it, it’s expected.. it’s even become how we bond… in this weight stigma fueled, collective dysfunction of disordered eating that is serial dieting and body hate.
And it is so toxic.
My mother has always told me about this one time I was with my grandmother in K-mart when I was 2 – sitting in the shopping cart, I pointed across the aisle and asked loudly… Grammy, why is that lady so fat?!
I was 2. I wasn’t born knowing what fat meant but by the time I was 2 years old, I had already been taught to judge it, to question it and not want to be it.
I was taught that “letting myself go” by gaining weight was a fate worse than death.
So, in my mid-teens, when I put 2 or 3lbs, I was horrified and desperate to take it off.
That first attempt at weight loss, would have ended in a very different way had I known then what I know now.
But those were the Atkins days.
His low-carb miracle cure said carbs were the problem and my weight loss dreams would be answered if I just quit those. But the more I tried to eliminate carbs, the more I thought about and craved them.. and the more weight I’d gain.
Each time I tried and failed, I was ashamed and felt like a miserable failure. I spent decades scared of my own growing body!
Since “we are what we eat“, I felt like I was bad because I couldn’t stop myself from eating bad stuff. Thoughts like, “you’re a failure, you’re so stupid, weak, pathetic, disgusting!” ran through my head a million times a day.
His low carb diet rules destroyed my relationship with food, started a 2 decades long battle with my weight and my already low self-worth ended up even lower. By the time I was in my early 30’s I was borderline morbidly obese and haaaated myself and my body.
In 2007, “clean eating” entered my life and within 4 days of trying to follow “clean eating” rules, I had my first binge. The following day, my first compensatory behaviors emerged – I starved myself and exercised for about 3 hours to “make up for it”. Overnight, by doing what I was supposedly “supposed to do” to “solve my weight problem”, my mental health was trashed, just like that.
Within 8 months I was sitting in a therapists office, hearing the word bulimic come out of his mouth while bawling my eyes out & begging him to tell me why I couldn’t control myself with food.
We’re taught that perfect bodies are the only bodies worthy of love and goodness and the rest… well, the rest must be shamed and blamed into conforming.
We’re taught that gaining weight makes us bad and losing weight makes us good.
That’s a message we all promote loud and clear every single time someone loses weight and we celebrate them like they just won a Nobel. (but what happens & how do they feel when they regain it – like 95-98% of people who lose weight always do?)
So we punish ourselves with decades of dieting, severe calorie restriction, binge eating (the result of feelings of shame and dietary restriction), over (or under) exercising, and a horribly abusive inner dialogue – without even realizing those things and that world, all just making it worse.
Personally, at my heaviest, I was borderline morbidly obese for my height – and while I WAS dieting and trying to “stick to” exercise – I just kept getting heavier.
Like many people, I started dieting at a healthy weight and “dieted” my way to obesity.
And then, also like many people, dieted my way to an eating disorder. Sure, eventually I did manage to lose the weight and become a “success” story. But that’s ridiculous rare (only about 2-5% who lose weight ever actually manage to keep it off).
We have GOT to change our definition of success around this whole weight conversation.
Weight gain is not failure and weight loss is not success. Especially when so few actually keep it off and so many end up with eating disorders that almost kill us.
The sickest thing of all is that in our culture, that’s okay – because it’s better than still being fat, right?
I carried shame with me every where I went like a 100lb weight wrapped around my neck. I felt like I was the only one who hated myself and couldn’t control myself with food, or “stick to” anything.
I thought I was the only who treated my body like a garbage dumpster, the only one punishing myself in that desperate attempt to make my body conform into something considered acceptable.
I thought I was the only one using food to so desperate try to fill a hole that I couldn’t quite identify.
I thought I was the only one who spent decades in the disordered eating world of serial dieting, and getting up every morning vowing that “today I’m going to be good!”only to hate myself for caving and eating a cookie or something by mid-day.
I thought I was the only one who stood in the mirror using words like disgusting, fat slob, gross, and worse when I’d see my reflection.
But I wasn’t.
There are millions.
Trust me when I tell you this – people who struggle with their weight ARE TRYING TO DIET AND EXERCISE THE “PROBLEM” AWAY.
It isn’t working. We have to stop telling everyone that’s what they need.(I wrote an ebook that talks more about why it’s not working. If you want a completely free copy, email me: firstname.lastname@example.org)
75-97% of women report having unhealthy thoughts, feelings or behaviours towards their bodies at least once a day.
That is a whopping majority of women who already believe there is something wrong with their bodies. They don’t need you, or Bill Maher or their doctor, or ANYONE else reinforcing it.
How, as a society, did we ever come to believe that the answer to physical or mental health is walking around living with shame, unhealthy thoughts, feelings or behaviours and hating ourselves for not being good enough because of our body size?
And we just keep passing it on to each new generation.
80% of 10 year old girls report having been on a diet and more than half of girls as young as six report wanting to be thinner.
The scariest part of that is that studies also show the younger a girl is when she starts her first diet, the more likely she is to engage in extreme weight control behaviors (get an eating disorder), gain even more weight, struggle with her weight her whole life, and even abuse alcohol by the time she’s in her 30’s.
The average woman makes 3-4 (unsuccessful) weight loss attempts every single year for her entire adult life.
Of the rare few people who actually lose weight when they go on a diet, as many as 98% regain it all and 2/3’s of them will weigh 11lbs more than when they started within 5 years.
Here’s the thing and I want to make sure this point is made loud and clear:
WE HAVE BEEN TRYING TO DIET AND EXERCISE THE PROBLEM AWAY.
It ISN’T WORKING. It’s making people gain even more weight over time.
We have ALL grown up in this diet obsessed culture that taught us 1) weight loss equals success and looking amazing, 2) all weight gain is equally bad… very bad… and needs to be “fixed” 3) it’s the result of being too lazy to “fix” it, unmotivated, weak-willed, having no self-control and 4) you fix it with shame, blame, willpower and band-aids that actually make things worse
It’s all lies and it’s NOT working.
Diet & exercise advice is NOT working.
Blame and shame is NOT working.
Tens of millions of people are dieting every single year and have been for generations – weight watchers has been around since the 50’s. Atkins since the 80’s or 90’s.
The weight loss industry has been doing nothing but growing and along with it, so has the population.
That’s not a coincidence.
It’s NOT working.
Diet culture is built upon the back of weight stigma and promotes fat-shaming, fear, and distrust in ourselves. It feeds on our insecurities and fuels the story that we are only worthy of love, acceptance and goodness if a scale displays the “right” number or we eat the “right” things and that happiness is only found on the other side of the next diet promising miracles.
And it’s all making our population MORE unhealthy.
This isn’t just a mental health issue, but a social justice one as well – weight stigma & fat shaming remains one of the last socially acceptable forms of discrimination in our society and diet culture has made it not only accepted but even normal and expected.
As James Corden said, it’s bullying but worse, it’s socially acceptable bullying that’s hidden under the guise of “just caring about people’s health”.
But it’s not acceptable, it’s not helpful, it’s most definitely deeply damaging our physical and mental health – and it’s making weight gain worse.
Traditional wisdom is based on a misguided fear that if people feel too good about their bodies and themselves, they will not be motivated to engage in healthy behaviors.
But what we now know is that the opposite is actually true.
There are strong, negative associations between internalized weight shame and poor mental that include 2.5 times higher levels of depression and anxiety. As well as, lower self-esteem, disordered eating, eating disorders, increased binge eating, and just overall worse mental health-related qualities of life.
1 in 4 people who diet to lose weight, end up with an eating disorder – a number that’s doubled in the last 20 years. And eating disorders have the highest mortality rate of all mental illnesses.
Further, higher levels of weight bias internalization are actually strongly linked with worse physical health as it creates lower motivation for healthy behaviors, worse adherence to healthy eating attempts, worse weight maintenance, and more.
We are simply more prone to self-sabotaging, self-punishing, and unhealthy behaviors that actually promote more weight gain when we experience the bullying that is, fat-shaming.
The bottom line is… there are severe mental health consequences of fat-shaming and weight stigma and they become cascading effects on mental and physical heath as well.
Just imagine for a second if we stopped all the blaming, shaming & judging.
If we all just collectively stopped obsessing over body size or what our bodies looked like and started actually just focusing on how we feel in our bodies? If we focused on how our choices were making our bodies feel and on WHY we made choices that make it feel like crap?
I don’t want one more woman to destroy her mental health in that ridiculous war with her body and her scale. I don’t want one more little girl’s life to be destroyed by an eating disorder because someone taught her she had to be skinny to be worth anything and that food rules and restrictions were the key to health, happiness and self-worth.
If the diet and exercise solution worked the planet would be skinny and happy by now.
It’s not working because it completely ignores the brain – the WHY behind the hundreds of auto-pilot choices we make every day.
Behavior and habit modification doesn’t happen with blame and shame and it doesn’t happen by trying to force willpower and motivation for “sticking to” a bunch of strict food rules that accompany diets or trying to force ourselves to stick an exercise program in the hope that maybe someday a few weeks or months from now, if we’re just good enough and follow it, it’ll make us skinny.
Habit and behavior modification happen at the brain level – because our brains control everything.
They’re controlling the things we tell ourselves about ourselves, they control everything we think, everything we feel and every choice we make – and much of the time unconsciously so we don’t even realize they’re doing it.
THEY are the greatest determiners of the quality of our lives and our health – and they are where these beliefs live in us.
The reality is, we can have a society that continues judging, shaming, blaming and ineffectively band-aiding symptoms while feeding a multi-billion dollar industry at our own expense but is that really what we want?
I sure don’t.
We have to love, respect and value allbodies… unconditionally because choices made from love, respect and acceptance are 100 times healthier than choices made from shame and hate.
Imagine the difference that would make… if we lived in a culture that didn’t even think about weight.
A culture that just focused making choices from a place of love, self-compassion and acceptance.
If we had a culture that promoted healing our wounds instead of creating bigger ones.
If we had a culture that promoted befriending ourselves and our bodies, no matter what size they are.
If we had a culture that uplifted everyone within our orbit, rather than tearing them down.
That’s what we need.
The truth is, if you truly care about people’s health, you’ll start becoming part of the solution rather than continuing to remain a huge part of the problem that is fat-shaming.
If you’ve been struggling with food, dieting, your weight, and the shame that accompanies those things, help is available. Visit http://www.ronidavis.com/stonesfor more.
There are many reasons that people struggle with their weight and food for their entire lives – their thoughts are right up there among the biggest.
I have seen this scenario play out a million times in people everywhere — hell, I lived it.
Our thoughts are creating our results.
You look in the mirror in disgust. That prompts the thought, ‘I’m disgusting’. That thought creates a corresponding feeling of inadequacy (or even hatred) for not having “willpower” or for being so “lazy” or for not being able to “stay on track”.What kind of choices do we make for things we hate? NOT good ones. NOT choices that are in our best interest. So, those feelings create negative actions towards the objection (in this case the thing we see: our body). We slam it with insults, berate it, punish it with either more restriction or go in the other direction and binge on stuff that makes us feel like crap – and we give up on it (and ourselves) until the next time we get motivated to try again when the same old cycle just keeps repeating itself.
Or we see the scale go up a pound and think, “I’m such a screw up, I’ll never lose this weight.” That thought makes us feel terrible and makes us either try to restrict further (which almost always ends in overeating) or giving up and eating everything the rest of the day.
The result we’re getting on the outside with our bodies is merely the result of the actions we’re taking because of the thoughts and feeling going on IN us. Our body didn’t decide to starve itself because the scale went up 2lbs and our body didn’t decide to punish itself by chasing a half gallon of ice cream with a bag of potato chips and two glasses of wine because we had a crappy day and are feeling bad about ourselves.
And our hearts are so tired from fighting the same war it’s just looking for ways to numb itself.
That’s why we keep getting the same result. There’s not a single diet on the entire planet that can fix any of that. They just make it worse.
Notice the contrast in this second graphic below…
If we work on switching the thoughts, we can switch how everything turns out.
Positive thoughts create positive feelings. And how do you treat something you have positive feelings about? You treat it with kindness, and care.
Actions based on kindness and care create, you guessed it… some pretty awesomely positive results. ?
Ending the war with food and our bodies, actually trusting ourselves, being mindful and present in our bodies, listening to them and honoring their needs changes literally everything.
And it starts with taming your inner critic, changing your brain and your thoughts—not another diet.
Your brain controls everything so change that and absolutely everything changes.
Can you relate to any of the thoughts I discussed and want help changing them? Check out the two new mindfulness based cognitive behavioral courses available and see which one fits you best.
Roni Davis for Stone’s Pharmasave, Baddeck, NS
What I used to think:There’s so much wrong information out there, most people just don’t know what they’re supposed to be eating and when. I have found the clean eating answer that everyone needs!
What I now know:Knowing what we’re “supposed to” be eating is soo NOT the problem. There are literally billions of pieces of nutrition and healthy eating content in the world and hundreds of thousands of people sharing their recipes and magic secrets about what they believe is the healthiest way to eat (and have you noticed, they all contradict each other?) – but most people still just aren’t doing it with much consistency.
Lack of information is not the problem.
How many times have you “started over” vowing to “be good this time” only to end up “screwing up again” and keep saying to yourself, “Why am I so stupid? Why do I keep doing this? Why do I keep screwing up?”
You have all the information you need. Even if someone has literally told you exactly what to eat, how much and when to eat it …but you’re not doing it. Why?
What is the problem? What’s driving the consistent self-sabotaging behaviors?
Disconnection from the wisdom of our own bodies, habits that have been hard-wired into our brains and the relationship with have with ourselves and food.
Those are the reasons behind why we eat the things we eat, the way we eat. Those are the things driving our choices. You can start a new miracle diet with different food rules every single day from now until the end of time but if you just don’t care enough about yourself to change, or if you’re using food to punish yourself or to numb emotions or to try to control everything around you, nothing is ever going to change about the way you eat because you’re not changing the WHY, you’re not changing the subconscious driving forces behind your choices.
One more time to let that sink in: KNOWING what we’re “supposed to” be eating isn’t the problem – the subconscious driving forces behind our choices is the problem.
That’s the key we keep missing.
Changing hard-wired habits and the relationship we have with ourselves and food, is the key to changing the way we eat.
Dig into your own whys with Mindful Movement or Cognitive Eating, two new programs available through Stone’s.
The first of January inevitably brings on a list of common resolutions among your patients as well as yourself as a professional. Most of these are directed towards what we perceive as something that will lead to a healthier, if not happier life. With any luck it results in both.
A while back I wrote an article that explained how a popular weight loss program (Ideal Protein) worked. I still believe it to be the best we have available to safely lose weight, both in scientific background and in personal clinical results. It stands as our most popular blog to this day. Many key points however are often lost on the patient we help to lose weight and both the patient and the clinician MUST regularly remind themselves of these points. Failing to do so steers us and the patient gradually away from reality, and more towards a route that can often result in disappointment.
I have found these so vital to the understanding of the concept of weight that I have pinned them on the wall of my consultation room. In a time when our patients are bombarded daily with the best ways to lose weight and how to eat healthy and “clean”, I’m a big fan on grounding them with a few simple concepts:
- Weight is not a measure of health
- Suffering yourself down to a goal weight that you will suffer to remain at results in no quality of life
- Your weight is not as directly under your control as some will have you believe
- There are unhealthy thin people and healthy overweight people
- Extremist forms of eating that are difficult to maintain will result in a waste of your time and money
- If your excess weight is determined by your doctor to be detrimental to your health and quality of life, then an overall change in your lifestyle is required
- Typical exercise that 99% of us do, does not result in lost weight (It will help with blood glucose, lung capacity, joint mobility, cholesterol, mood, cardiovascular health, and make it more difficult to gain weight however)
- It is estimated that 80% of those that lose weight will gain it back
- Eating food is not only cultural, but it should also be enjoyable. Eating in moderation and doing your best to avoid added sugars and any trans fat is recommended.
- The weight you are at is not as simple as calories in vs calories out
- There are many ways to lose weight that are effective and safe. If you decide to lose weight, pick one that is sustainable for you and ask your healthcare professional for advice.
Graham MacKenzie Ph.C.
In 2015 I took four months to film a healthy grocery shopping tour with the help of a local filmmaker where I went through all areas of the grocery store to help people make healthy choices for themselves and their family. https://www.youtube.com/watch?v=cgEbpNL9PSg&t=1s
In the 40 minutes of video, the opening scene stresses the importance of cooking your own meals at home and knowing what to buy in order to do that.
This year I had the pleasure of attending a Diabetes Canada meeting in Sydney, N.S. It was a great morning of networking and meeting colleagues from all over Cape Breton. I asked one of the attendees at that meeting, Ann Marion Willis, a Registered Dietician who works with Atlantic Superstore if she was able to help out with an idea I had to do a cooking class for a small group. Out of that conversation I requested a location at the home economics room at Baddeck Academy with four stations to do a cooking class. They were gracious enough to allow us to use their facilities.
The plan is to have a parent or two bring their children in (from grade primary to grade 12) and show them how easy it is to make a meal that is healthy for them. Ann Marion has healthy recipes with nutrition information for all, a starter smoothie, a meal and dessert. She also demonstrated the preparation of the food. Space is tight but hopefully demand will drive further classes.
Studies that try to tie food intake with outcomes are notoriously plagued by problems that measure food consumption with questionnaires based on personal recall of consumption. Nevertheless there are studies that show the effect of how your food is prepared and what affect it has on your health. A 2007 study of 84 undergraduate students in Greece found that diet becomes less optimal when the student leaves home to live away, including eating out. Specifically, fresh fruits and vegetables and oily fish consumption dropped once they moved away from home.
The time taken to cook and cleanup after a meal has decreased by 50% in the last 40 years. While this number on its own isn’t very significant in determining anything, but it does reflect the availability of commercially prepared food, which is both quicker to prepare and cheaper because of its mass production. It stands to reason that both of these factors can lead to increased food consumption. In fact, countries that spend more time in food preparation correlate with a lower obesity rate. Again, there is no causality claimed here though.
In another study in the Journal of the American Dietetic Association (2006) that utilized food intake questionnaires in just under 1000 young adults, it was discovered that young adults that prepared food less claimed time restraints as a major determining factor. However in those that did report frequent food preparation did claim that they ate out much less often and were more likely to meet dietary objectives for healthy eating.
Learning to cook meals at home not just for yourself but your loved ones is one of the single most important things you can do to live a healthy life, when combined with physical activity. Teaching yourself and your children to prepare healthy meals at home controls much of what you consume and much of your overall health.
The month of March ushered in news of a new report entitled “Obesity in Canada”. Submitted by the Senate, this report was a 21 recommendation paper to try and constructively address the growing concern of why Canadians are following its Southern neighbors in growing rates of obesity in both children and adults. In fact there are is a doubling in obesity in adults since 1980 and children’s obesity rates in this country have tripled in that time. This report was a breath of fresh air from a government group that many today look at with question of why they are even there.
As a Pharmacy owner that discontinued sale of such products in September of 2014, this story caught my eye. Anything having something to do with sugary beverages is a hot topic with the media, as I abruptly found out that day a year and a half ago. Even a small pharmacy in the middle of nowhere can make the national and international news by making “such a bold and forward thinking move” (as it was described) as stopping the sale of everything from pop, juice, vitamin water, sports drinks and chocolate milk.
Any talk of manipulating the sale of a staple in the Canadian diet will bring about cries of a “Nanny State move”. So when news hit that one of the recommendations from the Senate’s report was a proposed tax on such drinks, the naysayers came out of the woodwork, and along with them, the defenders of the plan. One of the first to press against the idea was Jim Goetz, the president of the Canadian Beverage Association who attempted to educate us in a biased way with stories of how this has been tried in other parts of the world and didn’t work, had no effect on obesity and resulted in lost jobs and increased grocery expenditures. Mr. Goetz is a name I learned back when I stopped selling these beverages and saw an article in rebuttal to this type of move. When I read of crazy claims that increased calorie intake had nothing to do with obesity, it really opened my eyes to the war that goes on in this category.
Granted there is no shortage of stories where an increase in tax on a target food group seemed to be a dud with respect to changes in obesity, even when the calorie intake did seem to drop. Denmark, Mexico, the United States, Finland, France, Hungary all are examples of stories where a tax was implemented with results that vary depending on who tells the story. In fact during a recent CBC Radio interview on the Senate report I gave recently, I was pressed on the success (or lack of) in such programs. I was quite persistent though on the complete irrelevance of the obesity outcome but rather we should focus on the fact that we need to pay for the adverse health issues that arise from the obesity that we know these beverages cause.
When I cross from Dartmouth to Halifax on either bridge, I expect to pay a toll. It doesn’t really cause me to take the long way around through Bedford, I pay the toll and drive over the bridge. I do it because I realize the upkeep of the bridge has to happen somehow and if I don’t pay it through tolls, I’ll sure as heck going to end up paying it some other way. It just makes sense for users to pay for that. When I buy tires for my car, I pay a fee that is to be used for the recycling of that tire at its end of life. You just do it because something has to happen to that tire when you’re done with it and that costs money to do.
If you agree that extra calorie intake results in obesity, then what is it that drains the healthcare budget of a country so quick when its population becomes more obese? Children with obesity are more likely to suffer from type 2 diabetes, hypertension and asthma. Adults with obesity have a higher incidence of depression, anxiety, heart disease and diabetes and also are more likely to be absent from work, pursue lower income jobs and earn lower overall wages (and in doing so pay less tax). Last year in the U.S., health care costs as a result of obesity reached $300 billion annually. A simple consideration in mathematics will show how this cost could be somewhat offset by a sugary beverage tax. Even though there are many reasons a nation becomes overweight, sugary beverages are one of them and you can consider it a user fee with that tax.
Lots of other great ideas came from the report, like an overhaul of the Canada Food Guide – without involvement from the food industry and one of my favorite recommendations, stricter controls on advertising unhealthy food and drinks for kids. Well done Canadian Senate!
Graham MacKenzie Ph.C.
Baddeck, Nova Scotia
In response to my decision to remove sugary drinks from my pharmacy in September of 2014, there seem to be the odd lingering claim that “…targeting the sale of one particular category is not going to have a significant impact [on obesity]”, and that “information – not restriction – is key.”
While we agree with the point that obesity is a complex, multifactorial problem, it is completely baseless, in fact hovering on outright deception, that extra calorie intake does not increase your weight. In 2013, the journal PLOS Medicine published a systematic review of systematic reviews, which are the most comprehensive forms of evidence that we have. This review by Bes-Rastrollo and colleagues found that 83% of reviews not funded by the beverage industry a relationship between sugar-sweetened beverage consumption and weight gain. On the other hand, 83% of the reviews that were funded by the industry found insufficient evidence to support a positive association between sugar-sweetened beverage consumption and weight gain or obesity.
Also keep in mind metabolic disease which has also been shown to increase with consumption of these drinks and is one of the main reasons we pharmacists see our customers (high blood pressure, increased cholesterol, increased abdominal obesity, and insulin resistance). For example, a 2010 meta analysis in the Journal of Diabetes Care of over 300,000 subjects found that those that consumed the most sugary drinks, one or two per day (pop, juice, vitamin water, iced tea and energy drinks) had a 26% greater chance of developing type 2 diabetes than those that drank none or 1 serving per month. They concluded that weight gain and metabolic syndrome correlates positively with consumption of these drinks. The New England Journal of Medicine published a study in 2011 which followed over 120,000 people and concluded that one 12 ounce sugary beverage serving a day increased their weight more than those that did not consume this beverage. Finally, a 2012 study in Circulation followed 40,000 men and found a 20% higher chance of having a heart attack or dying from a heart attack when one can of sugary beverage per day was consumed compared to men that didn’t. This was verified by a second study.
Calorie consumption from all sugary beverages combined has continued to climb each decade, especially among children and teens. By coincidence, today, the World Health Organization is changing its recommendation for daily total consumption of sugar to 6-12 teaspoons daily. This would be exceeded by consuming even one can of soda. Finally, we are seeing revised recommendations on sugar that follows science. The new recommendation now recommends free sugars being as low as 5% of total calories, meaning a serving of orange juice is off limits – imagine, a recommendation that pushes you to eat the fruit instead of drinking the juice. Brilliant! There is now a separation of total sugars and free sugars. The total sugar concept meant you could gobble up your calories with juice and pop, but now it’s considered free sugar.
The withdrawal of sugary beverages from Stone’s Pharmasave in Baddeck was not meant to “ban” pop sales, and I certainly do not expect to see a drastic change in obesity levels in my town as a result of my decision. I made this decision to help educate my customers on the effects of sugary drinks. I therefore agree that education is an important component of healthy eating. However, in keeping with recommendations from world experts in obesity research (see the 2015 Lancet Obesity Series), I am also aiming to move beyond education by starting to create an environment in my store that is supportive of healthy food choices. As a pharmacist, I know I shouldn’t sell tobacco, no matter what the industry claims. I don’t feel I should sell sugary beverages, either.
If you are timid about wading into the weight loss realm, either as a practitioner or as a user, there may be many reasons for that. One of the biggest may not be cost, confidence or will power, it may be the stigma of either paying someone for your weight loss or charging someone for your weight loss. There is a permanent black eye we have permanently imposed on both. Clearly it is a lose/lose situation. Either you have gouged someone for something they could have clearly done on their own with simple diet and exercise, or you have been ripped off by a snake oil salesman looking for a quick buck by a vulnerable audience with low self esteem that have come to the conclusion that they are worthless and in need to be capitalized on.
Well first of all, to all of you lifelong healthy weights who have little idea of the psychological reasons for weight loss and weight gain, if the simple, “go away and eat right and exercise” bit worked we would all look the same with such a simple set of directions. I have worked as a pharmacist in the same community for 22 years and have seen many people residing at the same BMI for the entire time and would still be there were it not for my intervention. I would see a typical customer and fill the same oral type 2 diabetic medication along with their high blood pressure medication for the entire time. Is this what we expect of our pharmacists. Who commits the bigger crime here? A pharmacist who quietly collects a dispensing fee forever without actively trying to reduce a patient’s weight or a pharmacist who takes the bull by the horns and aggressively works towards lowering a patient’s weight with careful body composition monitoring and nutrient intake for a fee for 6-12 months? The former is often left alone when in fact they are enabling the patient. The latter is left open to criticism even though they make the patient the hero in their weight loss and reduce overall healthcare costs.
Granted there are a lot of unhealthy weight loss programs out there. Ask your health care professional which one is a fit for you.
Anyone who looks at an overweight person as someone who is too lazy to try the correct eating and exercise route is completely blind to psychology. Have you been watching the Montreal/Tampa Bay series lately? A sure finish in the series by Tampa Bay began to fall apart because of a too confident feeling for Tampa Bay combined with a desperation mentality by Montreal, which completely changed the series. You could have said to Tampa Bay, just win one more and play like you did last game. That didn’t happen though.
Mentality has a lot to do with results and weight is no exception. There is no shame in asking for help, or offering it. I have many people ask me for help with weight loss as long as we keep it just between us. Imagine – someone wanting to get healthy but not wanting anyone to know it! There is no shame in this, regardless of the experts and seemingly intelligent advisors that warn against any regimented weight loss program. Is the weight loss program ensuring they keep the weight off? Well only if it has and end date. In that case, the weight loss program loses control. Eating right and exercising has no end date.