Cactus Juice

The Lancet Obesity Issue

The August issue of The Lancet features an editorial and a set of articles on obesity.  An excellent point from the editorial:

"One important premise is that the increasing weight of people worldwide is the result of normal response by normal people to an abnormal environment."

The editorial goes on to advocate for a meaningful public health response to the obesity epidemic, but acknowledge that this has so far been lacking.

Meanwhile, an article gives hope that the scientific analysis of obesity, which has also been... lacking, might be arriving at a new found sanity.  The article, "Quantification of the effect of energy imbalance on bodyweight" discusses the gap between advice and calculations of calorie deficits and the actual response to calorie deficit that occur in dynamic biology.

In other words, what we already know: weight loss is not a linear calories in vs. calories out because we are flesh and blood.  Calories in vs. calories out is for diesel engines and nuclear reactors, not human beings.  The article accompanies a web-based model of the authors' mathematical calculation of how weight loss actually works.

I was actually sick?!

 Last week I alluded to how I have been dragging about. I thought I was a little depressed.  I had, after all, spent three months working with a computer program that I had named "The Depression Machine."  By the end of those not-so-fun days The Depression Machine was taking less and less of my time and naps more and more.  I was pretty sure what I needed were Life Goals and Planned Structure and, most importantly, a New Job.  And then I slept through a good part of Las Vegas and Miami, which seems like a pretty meaningful commitment to depression to me.

So I saw a doctor, and it turns out I was actually fairly sick.  So a week on a psycho-making medication, no sunshine, no chocolate after 2PM because it interacts with the psycho-making medication, no crab dinners (srsly?... same reason) and I'm going to be shipshape shortly.

Who-da-guessed.

Dear Rabbit, This Ain't Wonderland

Hello strangers, where ya been?  Oh, right, the issue is where I've been.  Down a deep dark hole that did nothave a colorful magical kingdom on the other side.  Apparently when you have near unemployment (I was being paid, but that whole meaningful activity part was missing), zero carbs and oppressive heat, the land can simply disappear from beneath your feet.

Oh well.

The treatment has been turning off the TV and reading dime novels, adding in a planned starch per day, and getting off wheat for the 43598443939 time in my life.  And going to the gym and laying in the sun and a vaction that you'll be seeing shortly.

And blogging.  There will be blogging.

Sex and Vegetables and the Teen Doc Chat

Recently on Salon, a physician essay about the teen "private chat."  From the essay and the comments, some parents and some teens don't want the chat because it's going to be about sex, and since everyone knows that it isn't even private.  Which is great cover for the chat the doctor should be having:  Kiddo, your parents are fat and you will be too.

This is the chat my physician had with me over the years, except he was clever enough that he didn't tell an eleven-year-old she was fat (and I wasn't, but my mother was).  He told me I needed to eat more vegetables.  That I should always be concerned about eating more vegetables.  My mother did ask me what we talked about (the post-doctor inquisition is apparently standard, per the essay comments) and I don't think she believed me about the vegetables.

We lived in a small town; the physician was well-served by sticking to the vegetable talk and not getting into anything he didn't want to know about.  I think the Salon essay is a bit preposterous and presumptuous actually: how much of a safety net is a physician that a child sees once a year?  When I got my first yeast infection, I knew what to do from the ads on TV.  When a high school friend was raped, she drove to Planned Parenthood in another town.  I think they had TV ads also.  Now the kids have Google.

The vegetable talk didn't do much for me.  My problems were so much larger than vegetables.  Neither my parents nor my physician were in a good space to understand the hypoglycemia that made the structured school day so impossible that everyone looked the other way when I ate food behind my opened clamshell desk.  Better than having a classmate prop me up for the walk to lunch!  I still don't see anything designed to make life for the growing number of children with hypoglycemia/early diabetes better and quite a bit (myplate anyone) to make it worse.  It is officially ranked #4 in the tortures of the life of loafingcactus and I wish I could do something about that.

But the vegetable talk was a good idea and ahead of its time.  I could see that going somewhere.  If it were successful and created the generational reversal that is needed (a generation skinnier than their parents would practically be Woodstalk baby!), I could see parents quizzing the doctor to make sure she only plans to talk about sex.

Can you still be an American if you lose weight?

There's an old joke that that the Japanese eat little fat, the French eat lots of fat; Indians drink almost no red wine, the Spanish drink lots of wine, yet their heart attack rate is less than in the United Status.  Conclusion? What kills you is speaking English.  It's been turned into a YouTube commercial for French language school.  The Mayo Clinic has validated it and a linguist has deconstructed that validation.  (Image: Potato eating contest.  As American as apple pie!)

This week, new evidence published in the New England Journal of Medicine.  The article, "Changes in Diet and Lifestyle in and Long-term Weight Gain in Women and Men" (limited preview available), followed more than 120,000 men and women from 1986 to 2006 and ranked the diet and lifestyle datapoints associated with weight gain and loss.  Agendas on all sides have been rankled by the findings and the authors note that many of the associations are not that strong (although when you look at their chart, the fries pop out big time).  At the end of the day the most significant finding is the one that the study presupposed: As a group, the study subjects got fatter and fatter.

Per the article, "Whereas weight change associated with any single lifestyle factor were relatively modest in our three cohorts, in the aggregate changes to diet and physical activity accounted for the largest differences in weight gain."*  In other words, the simplest outcome of the study isn't that a particular food or lifestyle factor affects weight, but that Americans are getting fatter all the time.

I've said before that losing weight is positively un-American.  There are a host of other social and economic factors that come into play, and for the most part I'd rather leave those to the playground of the policy wonks and conspiracy theorists.  The study also noted that TV watching itself is not responsible for the weight gain, but promotes behaviors associated with weight gain.  Every day we face a culture that promotes weight gain and obesity.  The individual costs in terms of health expenditure, job discrimination and inability to work are clear, but the individual benefits in terms of social cohesion and purchaser reward should be just as clear.  The benefits to being fat and the ties that bind us into obesity are strong: how else would more than half our population be motivated to commit group suicide?

Forming a different tribe is part of the answer; trends away from obesity are contagious.  Weight Watchers helped me lose a large amount of weight, mainly because for the first time I met people who had done so.  These people are rare: you might see them in the paper, but a chance to speak to one day after day after day is less common.  A string of ailments left me feeling a little hopeless again, but still I've got my tribe: Someone I know has recently lost 40 pounds.  The boyfriend has lost enough weight for his coworkers to notice.  Another friend has kept her weight off for more than five years.  These people, including the policy wonks and conspiracy theorists (God bless em!), are the people who bring individuals back from the brink.

Think not that I am come to send peace on earth: I came not to send peace, but a sword. For I am come to set a man at variance against his father, and the daughter against her mother, and the daughter in law against her mother in law. And a man's foes shall be they of his own household. He that loveth father or mother more than me is not worthy of me: and he that loveth son or daughter more than me is not worthy of me. And he that taketh not his cross, and followeth after me, is not worthy of me. He that findeth his life shall lose it: and he that loseth his life for my sake shall find it.
-Matthew 10:34-38^

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*One fascinating surmisal of the study authors is that the benefits of behaviors associated with weight loss may be underestimated in longitudinal studies because people who have gained weight in the study interum period or who are responding preemptively to a tendency to gain weight may engage in more behaviors to control weight.  In other words, the people who most need to eat vegetables or hit the gym to control their weight are the people doing so, therefore behaviors which are in fact beneficial nonetheless show up as things fat people do.

^My priest spoke well on this passage Sunday.  It is one that every good Ellul-reading conspiracy theorist should know.

Growing Stronger in the Midst of the Diet Wars

No matter where you are--Atkins, Weight Watchers, Paleo, Primal, OA, vegitarian, vegan--there is a crowd busily pointing out how misguided or just plain stupid the other program is. For emphasis, the other people are unhealthy for some scientific reason and you can tell they are unhealthy just by looking at them. There is so much not going for this attitude, but one thing in particular is that many of the people doing the disparaging came from one of those programs.

An unending need to kick where you came from in the teeth represents an attack not just on that situation, but on yourself. If anyone came out of any of those programs and didn't learn anything useful, that's their fault and not the fault of the program. Even if that is what happened, isn't it time to forgive yourself and move on? This isn't to say that the programs shouldn't be judged on their merits. The recent U.S. News and World Report diet ranking, which was based on opinion rather than outcome, was the kind of travesty that is typical of how food plans have been evaluated over the last century. Bash that all you want.

But if you tried to eat according to the Food Pyramid and got fat, this tells us something: you learned what fats, proteins and carbs are and you learned how eating a high carb diet makes a person fat and possibly even diseased (hopefully you got out before then, if not at least you got out). A person who tried to follow the pyramid and failed is several steps ahead of a person who has no idea what they are eating, what nutrition is, and therefore no idea what needs to change. A person who has realized that none of this is working and wants to change is ahead of them all.

I followed Weight Watchers and ended up with serious difficulties, but I learned a lot about portion size and food management and how to take control over my own food. Since the Weight Watchers program depends entirely upon those skills, no one else does it better. If you need to learn those skills, you couldn't do better than to apprentice yourself to successful Weight Watchers members. Amazingly, you can do this for free on the Weight Watchers chat boards. Read and learn.

I'm currently hanging with the Primal people, and if I hadn't had my Weight Watchers experience I would be in very big trouble. I certainly would not be moving in a good direction with my health. I'm doubly fortunate, both because I did learn a lot from Weight Watchers and because I know it. On this day after Father's Day, I would encourage everyone to give themselves the gift of this same good fortune, not just in food but in life.

Rocking the Grok-ing

So I was wrong: Myplate.com has already helped one person lose weight!  Seeing that website made me feel like a complete fat chump.  Closing in on one dead chump.  I know better, but what does that matter if I actually do sort of eat like that?  So I engaged in some serious de-chumpage and got back to eating properly.  My body is happy, my mind is happy, and I feel much less chump-like.

Except that I still am.  The "shop the perimeter of grocery store" bit doesn't work any more.  I already know about the nutrient deprived eggs and meats (omega-3 "enriched" eggs still have less omega-3 than the eggs your great-grandma ate... the food looks the same but it is not).  Now I'm learning a bit more about the vegetable insanity, like the sugar-enriched onions.  So, I'm being as non-chump as possible but agribusiness is still out to kill the rich (while saving the poor with increased crop yields, darn them).  In so many ways the fattage is stacked against me...

And there is also the matter of standing on the head of my food addiction.  Anyone with these issues knows that it is exactly as the Bible described it: you stand on the head of the serpant, and you better not move your foot or that snake will kill you!  After almost two years with the beloved watching me lose it over "just the once" or "this is a special treat/moment/event" he seems to actually get that now.  Which is very, very, very nice.  Now he can look on sympathetically each time I re-wrestle that snake into captivity instead of just looking puzzled.

And yes, I know I wrote a blog post a while about wanting to have a normal relationship with food.  Sure.  I want to have a relationship with something that is trying to kill me.  Sometimes people talk nonsense; there's an example.

And! I found the primal people, who are a bit more goofy but a bit less shrill than the scientific honestly people.  I like them!  Found here: http://www.marksdailyapple.com/.  I like these graphics: http://www.marksdailyapple.com/how-to-succeed-with-the-primal-blueprint/.  I'm not even that primal with my Diet Sierra Mist (has handily replaced Starbucks,  may they rot in hell), my cheese (um, and more cheese people!) and my olives (OMG give me salt!).  But I am free of addiction foods and the poison found on a myplate, and losing weigh.  So, as the inventor of Grok would say, bite me Myplate.com.

Myplate: Ignore or stab out eyes with a fork?

It is so awful I would rather just crawl under my desk and pretend I never saw it.  One diabetes magazine editor noted wryly that every nutritional study that came out the week of its issue contradicted it.  Today's "helpful hint" on the Myplate website is something directly related to causing obesity. CNN is hosting an amusing iReporter contest which illustrates just how absurd it is.  There is nothing good to say.

The antidote: Gary Taube's Good Calories, Bad Calories.  It's a bit of a scientific slog, but at least it isn't complete...

Right then, I should just be ignoring it.