DebraSY

Posts Tagged ‘Arya Sharma’

Debra’s Gone Defunct (not entirely — I’m not dead)

In Weight-Loss Maintenance on October 3, 2011 at 10:10 am

Welcome, newcomers and old friends, to Debra’s Just Maintaining!  For roughly a year, starting September 29, 2010, this blog set about exploring the cultural mythology and science surrounding weight-loss maintenance, especially after “radical” loss (more than 10% of highest body weight).  As blog owner, I found myself moderating a discussion involving mostly weight-loss maintainers and size acceptance proponents, two seemingly disparate groups who ended up having more in common than any of us might have expected.   It turns out we are all betrayed by the myth that radical weight loss is some hard-won victory, to be followed (of course!) by maintenance, a less challenging, zippy “lifestyle” composed of tips and tricks.  It’s much more complicated than that. 

This blog is not a “big” blog, but big enough, and certainly has much heart.  Over the year it received just over 60,000 “views” of its various posts.  Many were repeat visits from people I came to regard as friends, dear friends.  We shared a sort of cathartic grief process as we stripped apart the mythology, and discussed from a lay vantage point some of the science surrounding weight-loss maintenance.   In addition to the maintainers and size acceptance advocates, we also entertained a scientist visitor from time to time, and a couple of trolls.

The blog is now mostly defunct because I have gone on to other time-consuming pursuits, and I also need time to be a good Mom, and to continue my weight-loss maintenance, an endeavor that I regard as a third- to half-time unpaid job.  To be competent at these things, something had to give. 

Since the blog is mostly defunct, it’s likely that you arrived here because someone sent you here or you conducted a search for “Weight-Loss Maintenance” or some topic discussed here.  A lot of people find this blog with searches to the effect: “Is obesity killing our children?”  If that is you, you are looking for this post.  Other people are apparently interested in a maintainer’s take on intuitive eating.  That would be here and here.  And a lot of people want to know what I think about journalist and anti-carb pundit Gary Taubes.  Those posts are here and here

If someone sent you here, it may be because you just lost a lot of weight and said something silly like, “If I can do it anyone can!”  Then that person wants you to start with the post subtitled Skiing as Useful Metaphor.

Other reasons someone may have sent you here: 

  •  You said something insensitive or rude about fat people being “in denial.”
  • You said something insensitive or dismissive of someone who works hard to maintain a particular weight – along the lines of “but certainly the rewards outweigh any effort you expend.” 
  • You said something definitively naïve, such as, “science has proven people are fat because of modern breakfast cereals.”  
  • You announced that you are embarking on a weight-loss process/diet (what number?), and a friend wants you to have a realistic idea of what lies ahead, more so than what some women’s magazine or morning news show may be touting today as a “breakthrough.”
  • You are struggling with weight-loss maintenance.  Perhaps your weight is sliding.  You need affirmation from a kindred spirit who knows how challenging this is, and doesn’t sugar coat it or pop off with “inspirational” platitudes. Read the rest of this entry »
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As Fearful as I Ought to Be

In Weight-Loss Maintenance on August 8, 2011 at 10:34 am

At the end of the last post’s comments, 9-year radical maintainer “mem” shared that her co-exercisers and Zumba clients at Curves sometimes say things to her to the effect, “You don’t even need to be coming here. You’re one of those people who probably couldn’t get fat if they tried.”  It is uncomfortable and disconcerting, and she knows it is important to tell them that she once weighed nearly 100 pounds more than she does now, and she appreciates remembering “the almost inhuman effort it took and takes to change that.”  She has to pop her acquaintances’ bubbles, in service to authenticity, because their words are framing one of the biggest and most disheartening cultural myths of weight loss and maintenance.  That it is easy, as easy as being naturally trim, once you get it figured out, once your brain or your metabolism has “clicked over,” or you’ve adopted the healthy lifestyle (with the secret handshake), or you’ve assembled just the right tips and tricks, or some other magic has happened.  

The idea that maintenance will be easy takes the fear out of the whole process of loss and maintenance.  That maintenance is easy, however, is the biggest, baddest weight-loss lie of all.

Most of you know, I follow Barbara Berkeley’s Refuse to Regain.  We don’t always agree to the letter, but we are sisters in spirit:  maintenance is complicated and individual.  Currently, in the comments of one of her posts, a woman is hawking a book to be released next year.  With great gall, Ms. Libby Florence tells Barbara how she used to believe as Barbara does, but now Ms. Florence has seen the light. 

Perhaps Ms. Florence is self publishing.  I would find that less tragic because the lapse in judgment would be singularly hers and not a publisher’s too. 

Or perhaps she found a publisher because she’s selling the party line:  weight loss and maintenance are effortless, once you have the “key.”  It’s all very easy, doncha know!  Her comment, before she gives the book’s website URL, ends as follows: Read the rest of this entry »

The Plate

In Weight-Loss Maintenance on June 6, 2011 at 11:01 am

It’s the topic of the day (or recent bygone days) at many blogs and websites:  The new US dietary guidelines replacing the old Pyramid, aka “My Plate.”

Knowing full well that I’m howling in the wind, I just blasted off the following missive to the “Contact Us” email address.

Warning to my size acceptance friends, restriction talk, could be triggering.  I also apologize for using the “O” word.  Had to consider my audience, and “fat” wouldn’t fly with them.

No Salutation.  Email address is Support@cnpp.usda.gov

Thank you for your hard work to date.  Here are suggestions for the new plate, which is better than the pyramid, but still inaccurate.  I hope you will integrate them into a new improved plate in the future:

1.  Refined grains have no place on the plate, they should be off the placemat in a distant place (that may look like an ice cream stand or some such) called “now and then treats.” 

2.  Replace the “grains” category with “nutritious starches.” Corn, legumes and baked potatoes are better switched out with the whole grains, not with the green leafies, etc.

3. Change the Dairy glass to “Dairy or Alternative” and link to your alternative section.

I’m not an RD, but I am an eight-year radical weight-loss maintainer (27% of my body’s highest established weight), which is probably more rare.  I think most RDs would agree with my adjustments to your plate. The milling and baking industry and dairy farmers might have a bone to pick, but you serve the broader citizenry, yes?

Regarding your weight-loss advice:  it is outdated and based in the cultural mythology that weight loss is routinely permanent.  Empirical science does not support this.  You would do more to promote health if you shared that weight maintenance is noble, challenging and rare enough in itself.  Most adults over 30 gain 1 to 2 pounds per year.  Preventing that would be helpful.  People should live joyfully most of the time, eat healthfully most of the time (following the revised plate I’m suggesting), exercise most days, then treasure the body that happens, regardless of its BMI category.  Read the rest of this entry »

Let Us Name the Enemy

In Weight-Loss Maintenance on June 3, 2011 at 6:32 am

In the forums over at Big Fat Blog, there’s a discussion going on about the 15 South Florida OB/Gyns (out of 105 that the Sun Sentinel surveyed) who limit their practices to women who weigh less than 200 pounds (and additional practices that set other, slightly higher weight limits, 250 lbs., e.g.). 

Dr. Yoni Freedhoff has also blogged on this news,  which is proving itself worthy enough for west-coast coverage

The offending doctors claim they’re discriminating because their equipment or exam tables are inadequate and that fat patients are at higher risk for complications and should go to specialists. 

Many of the voices chiming in, both at Dr. Freedhoff’s site and BFB are jumping on the blame-the-lawyers bandwagon.  In other words, the enemy is our litigious society.  Doctors are afraid of lawsuits.  This makes me uncomfortable.  We common citizens should think HARD before throwing away our legal protections.  Conflict alert:  I am married to a lawyer.  I’m also the daughter of a lawyer, and the sister of a lawyer, and sister-in-law of a lawyer.  My family is lousy with lawyers. Though I am not one myself, I am fond of lawyers.  Even if I wasn’t, however, I think this blame-the-lawyers thing wouldn’t pass the smell test.

For one thing, the assault on “frivolous lawsuits”  strikes me as overblown, exaggerated and wrong-headed as the “war on obesity.”   The Duke Law Review has the best summary I could find of the “frivolous lawsuit” scare, and it makes a measured argument for how exaggerated it is.  Brief summary:  Those cases that are, indeed, frivolous are rare but over-reported in the news media, simply because they are more interesting than the millions of run-of-the-mill claims that get settled every day.  Moreover, often these cases are oversimplified in the mainstream media (imagine that!) and outright misrepresented by insurance spokespeople and the like who benefit by portraying them as “frivolous,” when a closer examination of the facts would reveal otherwise. 

Frivolous claims are not some great industry for legit or competent attorneys, because judges already have the power to throw out “frivolous” cases and even issue $anction$ against the attorneys who file them.  Some pro-business legislators have suggested that attorney’s “game the system” by filing frivolous cases on the notion that corporations will “settle” in order to avoid going to court.  That’s ridiculous and backwards.  Corporations keep their attorneys on retainer, so it’s no additional cost to them to go to court.  More often, corporations (including insurance companies) routinely deny claims, even when legit, because they know how difficult and expensive the claim will be for a lone citizen.  A claimant has a hard enough time securing an attorney for a good but marginal case; finding an attorney stupid enough to take a “frivolous” case and risk a judge’s $anction is enormously difficult.  Finally, if a claim does make it to a jury and receive what sounds like an extreme or “frivolous” judgment, often an appeals judge later lowers the award, but this fact never becomes part of the story that creates a particular case’s urban legend. Read the rest of this entry »

Quickie Post

In Uncategorized on May 27, 2011 at 8:10 am

Apologies that this week I just didn’t get anything posted.  Yesterday and today I must catch up from a wild early week.  On Monday, I finally got that colonoscopy (after the gastroenterologists had postponed THREE times).  It was as uneventful as everyone had promised.   (Thank you for your support!)  And Movi-prep, the power laxative of my Doctor’s choice, is as gross as advertised.   Hint to those who follow me in this procedure:  it’s a little more tolerable if you suck on a lemon drop between doses.  In the way of good news:  the afternoon nap one takes upon arriving home after the procedure is wonderfully restful!  And, most pleasant of all, I got a good result – no polyps, no surprises, no biopsies – I can check this off my list for another ten full years.  Hooray.

Had an out-of-town guest Tuesday, and waved goodbye to her on Wednesday, just before the rotating storms rolled in to the Kansas City area.  Went to my safe place, with a bag of dog treats, assuring that I would be followed by my companion, Karma.   She is so named, by the way, so that when I praise her I’m spreading “Good Karma” and when I must discipline her I am reminded to concentrate on the offense and not her character, lest I spread the opposite.  (Advisory note:  For the reason cited, Karma is probably a great name for a dog, if it is a golden retriever.  It is an unfortunate name for a small terrier with big issues.  I must hold my tongue through enormously stressful moments of terrier judgment.)

Please note that Diane Finegood herself is checking in on the Let’s Help Diane post, so if you haven’t checked back there, please do.  I would suspect that Dr. Sharma may peek in on us also, even though he has said we are not his audience (his colleagues are) and we aren’t representative of his patients, many of whom are, in his judgment, beyond the scope of a Health at Every Size (HAES) approach to self-management.

 Have a great weekend!  I’ll be back in the saddle next week.

Hey, Everybody: Let’s Help Diane!

In Weight-Loss Maintenance on May 17, 2011 at 12:12 pm

First of all, thanks again to Dr. Sharma for hooking us in to the private world of obesity research where the erudite players who affect our lives talk about us.  Specifically, today he linked us to the Canadian Obesity Network Presentation Portal for the Second Annual Obesity Summit held in Montreal April 28 – May 1 of this year. 

Let’s give these CON-RCO people kudos for facility and detail.  If you click on the presentations, you receive a split screen with the speaker, in focus and centered, on the left and his or her Power Point Notes on the right.  How inviting!  Whatever trouble that took, please know it is appreciated!  Hooray.  

I scrolled through the selections to find some interesting conversation fodder, and my heels came to a screeching halt on page two, where speakers were talking about weight discrimination and bias.  I first was drawn in by this title:  So I am Biased, Now What Do I Do?  Michael Vallis, the co-director of the Capital Health Behaviour Change Institute and Associate Professor at Dalhousie University spoke well, and we may want to talk about him another day, especially how he seems to ice skate between talking about solving bias/discrimination and solving obesity – interesting and discomfiting.   He also talks about Motivational Interviewing, which we have talked about some in these pages’ comments.  As I listened to him I wore Hopefulandfree’s filter:  is this just sophisticated manipulation?  I don’t think he intends it to be, but I can see how it goes there.

But I digress.  TODAY, I want to talk about Diane Finegood’s talk, Weight bias and discrimination through a complex-systems lens.   About 22 minutes into the 26-minute speech, she presents us with a question, and with an earnestness that I think calls for reply.  I think we might be able to help her.

Diane Finegood is a professor at Simon Fraser University and Executive Director of the CAPTURE Project (CAnadian Platform To increase Usage of Real-world Evidence).  She’s also a radical weight-loss maintainer.   

Her presentation, in simple terms:  It ain’t easy to change a paradigm on a complex system, such as obesity bias as it relates to health care.  You’ll want to watch the whole thing, as she starts with a complex map of the issue and then reduces the problem downward several times to arrive at five steps.   The most important:  shifting the stinking paradigm.  This has to be done by attacking lower level issues – structural elements, goals, etc.  But at the very top is that paradigm, or root assumption.  She makes a stab at one-sentence statement to express what that paradigm should become, but she’s clearly uncomfortable.  Even her Powerpoint notes have a question mark.  Her attempt at a statement:

? “Obese people are no different because of their size.” Read the rest of this entry »

Why I Will Continue to Read Arya Sharma’s Blog

In Weight-Loss Maintenance on May 11, 2011 at 12:47 pm

In yesterday’s post, I was pretty hard on Dr. Sharma.  I also contacted him by email and let him know that he had provoked a munity among a chunk of the HAES community who read his blog and respect his opinion, if not always in full agreement.  He responded thoughtfully and at length. 

My thoughts: 

Blog’s are written quickly.  Dr. Sharma says he is often asked whether his is ghost written (as I did).  It is not.

Now, regarding his emails, he didn’t apologize for his posts of May 9th or 10th.  Following is the closest thing he offered to an apology (note that you are “they”):

Their anger, trauma, suffering, frustration, disillusionment with the medical ‘establishment’ is all very real and understandable – in short – I can fully see ‘where they are coming from’.

So while some of them may now be hurt, frustrated and disillusioned by my post (which, really was not a personal attack, but rather a reflection of the kind of ‘uncritical’ thinking and arguments that I see reflected in some of the comments left on my site), this is not really the audience that I write for or even see in my practice. I am not out to talk anyone out of HAES or Fat Acceptance or anything else that they are happy and comfortable with.

I primarily write for my colleagues, to try and help them keep up with the latest research in this fast moving field, and perhaps over time change their understanding of obesity and their attitudes to people with obesity, who may wander into their practice.

Now, while we aren’t his central audience, he isn’t completely unappreciative of us.   He says that people who come to his blog and (respectfully) disagree with him “represent an interesting and important view point, which although by some standards extreme, certainly serves as a reality check to me and other readers – a reminder that there are other opinions out there.”

So, what set him off?  If we aren’t his central audience, I don’t think it was us.  (Even though some of us have been less than entirely respectful.)  I think, and this is only speculation, that we were hit by the shrapnel of a bomb aimed mostly at Linda Bacon.  Admittedly, in my first email to him I singled her out:  “Some HAES commenters are prickly about you, including Linda Bacon herself, but most have appreciated that you’ve kept an open mind despite unknowable pressures from others in your field.”  So, while the following paragraph may be revealing, my words may have provoked it.  (Attempt to read it aloud at your own peril.) Read the rest of this entry »

Irony

In Weight-Loss Maintenance on May 2, 2011 at 11:44 am

Jimmy Buffet in Concert in Kansas City, April 30, 2011

I really wanted to share with you, my blog friends, my fun weekend, but was at a loss as to how to tie it to the core subject of this site.  Then, once again, Dr. Sharma came to my rescue (that later).

Not only was my weekend fun, but it was steeped in irony.  I had floor tickets for the Jimmy Buffet concert in Kansas City.  Here I am with my husband. 

Fashion Faux Pas: no parrot hats.

 Here are our dear old friends, who came from Columbia, Missouri, to join us.

Randy and Nanci at Jimmy Buffet

The event was ironic in that NO ONE who could afford floor tickets could have possibly been the drunken, deadbeat, pothead losers that we were all celebrating ourselves to be.  It was all a stinking ruse.  We were, in fact, middle aged (or upper middle aged) mostly professional types, many sporting Hawaiian shirts.  Here are some pictures from the crowd. Read the rest of this entry »

“Experts”: Phooey

In Weight-Loss Maintenance on March 22, 2011 at 2:18 pm

Well, my colonoscopy has been postponed.  Yeesh.  And it wasn’t me; I didn’t chicken out.  The nurse called and the doctor is taking a day off on Friday.  I got all wound up, and now I’ll wind down until April 18th – prep day, followed by the no-big-deal procedure on the 19th.  Thank you for all your well wishes.  When it FINALLY happens, I’ll let you know how it goes with more subtlety and decorum (but less humor) than Dave Barry.  Thank you, alert reader, Mulberry for the link.

I am especially pleased to learn that many maintainer friends did not experience a weight shake-up from their colonoscopies.  Had I not heard from you, I wouldn’t have taken it for granted.  I don’t trust the words of doctors and other “experts.”  With regard to weight management and weight rebound, simply, they’re out of their depth.  What’s more aggravating, they don’t acknowledge how out-of-their-depth they are.

Regular reader, Ali, just recently ran into an “expert” (chiropractor) who dismissed her dietary choices (which were working pretty well for her) in a conversation that lasted less than ten minutes.  With the pseudo-scientific authority granted by the likes of journalist and weight-loss opportunist Gary Taubes, she stated simply, “you must go low carb.”  Well, Gee, lady.: thanks but no thanks.  Low carb works for some people, and I’m happy for them, but if it worked for everyone we’d all be trim.  Anyone over the age of 20 in this country saw the rise and crash of the New Atkins Revolution (which nearly killed our grain markets and bankrupted our grain farmers at the beginning of this century). Had the Revolution worked for everyone, I’d have jumped on board too.  Instead, most of us witnessed sad stories of radical weight loss and rebound among earnest, disciplined people.  The few who succeeded then must now work at least as hard as I do to maintain their losses in a carbolific society (who pushes them to portion control, while pushing Ali and me to drop our bananas).

One sure sign that you’ve found a person who knows something is that they are secure enough to acknowledge that they don’t know everything.  That’s why Arya and Yoni have charmed me.  And I especially love this post from Barbara Berkeley, The Perfect Diet:  Does it Exist?   The one word answer is “nope.”  People who have earned their bona fides do not pretend to have the one and only answer.  Read the rest of this entry »

I Have Good News, and . . .

In Weight-Loss Maintenance on February 21, 2011 at 7:23 am

The year is 2050.   Two women with a BMI of 40 sit waiting to meet with their General Practitioner, Doctor Pense.  The nurse calls the first patient, and does not take height and weight.  The appointment takes place in the doctor’s office, not the exam room.  The initial exam and lab tests are done.  The Doctor speaks first.

“Well, Donna, I have good news for you, mostly, and some bad news.  The good news is that your type of obesity is one that is medically insignificant.  Your fat does not compromise your health.  You may, in the future, have some joint issues, arthritis.  You may need new knees or hips.  However, for now, there’s nothing medically indicated.  That means the bad news is that insurance won’t pay for further treatment at this time, and I know you were hoping for some help with weight loss.  Insurance will pay for those joints as you need them.” 

“Medically insignificant?” 

“Yes, your fat composition, disposition is not likely to create any more medical problems for you than if you were naturally trim.  Your life expectancy is the same as a naturally trim person’s of your age.  Your fat is cosmetic.  Did you find that pamphlet I gave you on hygiene and special care of the fat body helpful?”

“Sure, Doc.  It’s helpful.  Uh . . . I’m still . . .  Do you know why I’m fat?”

“That would require more testing.  All I can tell you now is that it’s benign.”

“So, you’re saying I have to live with this enormous butt?”

“Oh, Silly, you . . .”

“No, seriously, I’ve had to buy special furniture for my house.  This isn’t funny.  The trend recently has been for stick furniture, and it’s been a nightmare trying to find good, sturdy stuff.  And that’s just the beginning of . . .” 

“Yes, yes.  I’m sorry.  That’s an unfortunate trend.  But it is only fashion.  You know, back at the turn of the century, some doctors’ offices didn’t even have chairs to accommodate people of different sizes.   That wasn’t a fashion statement, it was ignorance.” Read the rest of this entry »