Dispelling nutrition myths, ranting, and occasionally, raving


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Is mom the TA for calling out her sister for buying her daughter a food scale?

I don’t have much to blog about lately. All of my usual sources of inspiration have been dominated by covid-19 for the past few months. My life revolves around my baby and we don’t go anywhere. I can’t even glean inspiration from the grocery store because I haven’t been there in over 10 weeks (11 weeks? I’ve lost count). I pretty much only check Twitter now to read posts from AITA (am I the asshole?) and Reddit relationships because it’s otherwise just an unending torrent of horror and frustration. So, I’ve now reached the stage of social isolation where I start to write about AITA posts. The one above really stuck with me.

Obviously the mom is TA (the asshole), as is the aunt. I started out on the mom’s side. Of course I would be super pissed if I had a teenaged daughter and someone bought her a food scale so that she can weigh everything she’s eating. And I 100% love the messaging that she can be healthy regardless of body size, not tying self-worth up with what her body looks like, and engaging in physical activities that she enjoys, not as a means to lose weight. However, I think both the mom and the aunt are giving the poor girl messages that are likely to lead to an unhealthy relationship with food and her body.

In the comments the mother says that she only cooks three kinds of vegetables, and only sometimes, because no one in their family likes vegetables. She states that they’re healthy but her comments indicate that the household engages in very little physical activity and doesn’t eat a balanced diet. She seems to be under the misguided impression that just because she’s preparing meals at home that they are de facto nutritious. Obviously, if she’s not including vegetables or fruit at every meal then they are nutritionally lacking (the current recommendation from Health Canada is to make half your plate vegetables and fruit). She also seems to think that vigorous exercise is unhealthy as she expressed concern that her daughter was sweating and out of breath from her home workouts. The current physical activity guidelines for children and youth (ages 5-17) start with a recommendation to “sweat” by accumulating at least 60 minutes of moderate to vigorous activity a day.

I think it’s extremely sad that the mother would discourage her daughter from engaging in physical activity and prevent her from eating a healthy diet. Let’s not let the aunt off the hook either though. Given the mother’s strange perception of what’s healthy and unhealthy I’m not sure that we can trust her assessment that the aunt has an unhealthy relationship with food and exercise. Whether she does or not, it was completely inappropriate for her to provide a 14 year old child with a scale to portion her food. Teenagers are growing rapidly and need sufficient calories and nutrients to support this growth. In addition, if she is weighing her food, the daughter is not learning to trust her own hunger and satiety cues. Teaching her that food is something to be restricted to attain a certain body size is only going to lead to longterm hang-ups when it comes to food.

Both the mother and the aunt are pushing their own agendas on this girl. If they truly had her best interests at heart they would support her efforts to eat a healthier diet and to safely engage in physical activity. Ideally, the mother would lead by example by role modelling a positive relationship with food, physical activity, and her body, but if she can’t bring herself to eat a green vegetable, the very least she can do is to provide them to her daughter as she’s asking.


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Lose the Weight Watchers

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Last year Weight Watchers rebranded as WW because they wanted to pretend that they were about healthy lifestyles and not just weight loss. This week they announced the release of their new weight loss app for kids (as young as eight!) and teens. They’re trying to frame it as “helping kids and teens build healthy habits” but when the central feature of the app is food tracking don’t be fooled; this is Weight Watchers points for kids and creating a “bad food” “good food” dichotomy is likely to do anything but help these kids build life-long healthy habits.

An eight year old tracking every morsel of food they eat with the sole aim of losing weight is pretty much the antithesis of a healthy habit. Rather than help kids develop healthy habits this app is far more likely to instil them with an unhealthy relationship with food and their bodies. And while I personally ascribe to the belief that weight is not indicative of health, I hope that all healthcare providers and parents can see why an app like this could be damaging to children whether or not they view “overweight” and “obesity” as a “problem”. Weight is not a modifiable behaviour and focusing on weight loss as an end goal doesn’t promote the adoption of healthy behaviours. Rather, it promotes restricted eating and quite probably disordered eating habits in order to attain that goal.

Given that very few adults successfully maintain intentional long-term weight loss, I find it baffling that WW claims that their new app is “evidence-based” and will somehow be more successful (if you are measuring success by pounds lost) in children and youth than similar programs have been in adults. It also makes me sad to see the quotes around “stopping arguments about food” so that parents and children get along better. Placing the responsibility for food choices in the hands of an app rather than working on fostering a healthy food environment at home may seem ideal but this doesn’t truly promote healthy behaviours. I know not everyone can afford to work with a registered dietitian (and not all RDs ascribe to the same school of thought when it comes to body weight); however, I recommend Ellyn Satter’s books which can be found at your public library if you want to help your child attain a healthy relationship with food.

It’s also important to keep in mind that WW is a for-profit business. They are not doing this out of the goodness of their hearts. They are doing this because there’s money to be made – one month use of the app is $69 USD. They’re doing this because a “fun” app is an easier sell to parents who are concerned about their children’s weight than working on the division of responsibility, role modelling healthy behaviours and positive relationships with food, and cooking and eating nutritious balanced meals together as a family. They’re doing this because weight bias is so rampant in our society that many people can think of few things worse than being fat and parents are desperate to save their children from that plight. I get that. Parents just want their children to be healthy. Unfortunately, an app that encourages a restrictive diet mentality is likely to achieve the opposite of health promotion.


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A bit about that working mums make kids fat study

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This article: The Impact of Maternal Employment on Children’s Weight: Evidence from the UK came out a couple of weeks ago and I was appalled. Essentially, the article is blaming working mothers for making their children fat. As if working mums don’t have enough guilt dished out to them already. As if there’s a simple causal relationship between obesity and maternal employment. And as if there isn’t already enough unhelpful fat-shaming going on in our society. I was going to blog about it but a number of other people already have so why reinvent the wheel. Instead, check-out these pieces:

Working Mothers Don’t Make Children Obese by Gid M-K; Health Nerd on Medium explains why the reporting on this study was all wrong.

Aiming the Obesity Blame Game at Working Moms by Ted Kyle on ConscienHealth reminds us that correlation is not causation.

A TL;DR thread from Sean Harrison breaking down the many limitations of the study.

If you’ve come across any other great criticisms of the research (and media surrounding it) please share in the comments. I would especially love to see some from a weight-neutral perspective as the majority of the criticism has been around the study methods and sexism but I think that sizeism is a major problem with the research as well.

 

 


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What does “healthy” look like?

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A little while ago I wrote about the importance of representation and how the health care industry is failing at it. Of course, it’s not quite as simple as saying “we’re going to use more diverse images in our marketing and materials”. Most organizations don’t take their own photos. Instead, most use stock photography sites from which staff select images. It’s not just health care that has a problem, it’s all media, and it’s the sites from which we source our images.

So many of the images I come across on the stock photo site we use at work are problematic. I’m not going to name the site because it really doesn’t matter which one it is, they’re all the same. Search the word “healthy” and you’ll likely come up with a lot of smiling, slim, glowing, youthful white people outdoors wearing athletic clothing or eating salad. Of course there might be one older person, a black person, and a “normal” (i.e. not model thin) person in the mix but these are the exceptions that prove the rule. Fitness returns more of the same, minus the salad shots. On the other hand, when you search “fat” you come back with a bunch of headless torsos clutching their bellies, larger people drooling over fries, large people looking miserable, and a few “good” fat people engaging in physical activity – again, the exceptions that prove the rule. Then there’s the images of “healthy choices” in which the ubiquitous glowing youthful white woman is weighing a doughnut in one hand and an apple in the other as if this is all that healthy eating is about. Or how about the images of large women kicking “junk food” solidly away? How virtuous. Or the woman literally taking a pair of scissors to her stomach? Horrifying.

All these images do is serve to reinforce the popular beliefs that we hold around body size, health, and personal responsibility. To reinforce the stigma against larger bodies and the false assumption that smaller bodies are always healthy bodies and the result of healthy personal choices. It takes a lot of effort and consideration for people to choose images from these stock photo sites that don’t contribute to stereotypes. It’s worth that extra effort though to show that all bodies are good bodies and that your organization is for everyone, not just people who look a certain way.


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A smile doesn’t hide your weight bias

 

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I completed an online course on weight bias and stigma for healthcare professionals last week. There was quite a bit that was good but there were a couple of things that rubbed me the wrong way.

If you’re not already aware Obesity Canada states that, “weight bias refers to negative attitudes and views about obesity and about people with obesity. Weight stigma refers to social stereotypes and misconceptions about obesity. These social stereotypes and misconceptions include beliefs that  people with obesity are lazy, awkward, sloppy, non-compliant, unintelligent, unsuccessful and lacking self-discipline or self-control.” 

Weight bias and stigma can cause significant harm to fat people. In fact, they likely cause more damage to people than carrying extra weight itself does.

The course I took was very good about making this clear and provided the facts as well as showing how harmful weight bias can be to patients. However, there was a video with some experts that I felt undermined the message. Here are the quotes that bothered me:

“If weight loss was easy we wouldn’t have the current obesity epidemic that we have.” – Director of Research and Anti-Stigma Initiatives at the Yale Rudd Center

“People think that for someone who’s overweight all they need to lose weight is some self-control and trying harder to eat less and exercise more. If that only worked we wouldn’t have the problem that we have today. The causes of obesity are very complex…” – Director of Research and School Programs at the Yale Rudd Center

The Yale Rudd Center is well-regarded for their work in reducing weight stigma and both of these individuals quoted above are prominent in the field. At first glance what they’ve said seems innocuous. However, the fact that this was a course intended to combat weight stigma, the experts are saying that obesity is an “epidemic” and a “problem” runs counter to the message they’re trying to convey. It just goes to show how deeply ingrained weight bias is when the very experts trying to counter it are inadvertently perpetuating it. When you say that obesity is a problem then you are saying that fat people are a problem. And I don’t see how that’s not stigmatizing.

The other problem I had with the course were the case scenario videos they shared. There would be one video where staff and medical professionals were rude and unprofessional to patients regarding their weight. Then they would show a video that was intended to show a positive interaction. Really the only differences in the “good” videos were that the healthcare professional was all smiles and asked the patient if they could talk about their weight before advising behaviour change under the guise of promoting healthy behaviours rather than telling them directly to lose weight. To me, the message was the same, it was “you need to lose weight” delivered with a smile rather than scorn. There was still no looking at overall health to determine if weight loss was actually warranted, there was still no consideration of other causes of the presenting ailments, and there was still no recognition that simply telling people to eat healthier and move more (especially without first determining what their current lifestyle is like) is not an effective way to get people to lose weight.

Overall, I felt that the message of the importance of not perpetuating weight bias was lost when all the healthcare professionals were still delivering the message to their patients that they should lose weight. And yes, some people can benefit from losing some weight, but this should be determined with appropriate assessment and then weight management options need to be appropriately discussed with the patient. Simply telling someone, on the basis of their BMI, to eat less and move more with a smile is not helpful.

If you do happen to know of a good online weight bias course please let me know as I’m still looking!