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I’ve mentioned several times here that I have ADD. Like many women with ADD or ADHD, I wasn’t diagnosed with the disorder until adulthood in my early 20s. At the time, I was also in recovery for my eating disorder so my doctor was hesitant to prescribe some of the most common drugs to treat ADD. Why? Because popular ADD drugs like Adderall are amphetamines. And amphetamines, as a side effect, suppress the appetite. The information was news to me, but as Allure magazine reports, its old hat for an increasing number of girls and women who don’t have AD/HD and yet are taking Adderall to induce weight-loss (see also this March ABC story).

Since 2002, the number of prescriptions for all amphetamine-based drugs used to treat ADD — including Concerta and Strattera — have skyrocketed. Sales for Adderall XR (extended release) have more than doubled in the past five years, from 4.2 million in 2002 to 9.5 million in 2007, according to IMS Health, a health-care information company. And online, Adderall ranks right up there with Viagra in most-hawked pharmaceuticals on the Internet; indeed, type in the words “Adderall abuse” and you’re likely to be directed to a site that sells the stuff.

Adderall, a central nervous system stimulant prescription medicine that uses a patented blend of mixed amphetamine salts, is approved solely for the treatment of AD/HD. I began taking Adderall (or as I call it, my legal crack) last fall for my ADD after trying both Concerta and Strattera, which are, I believe, what they fill the candy dishes in hell with. I’ve had no adverse reactions to Adderall, and although I have noticed that I don’t get hungrier until later in the day, I haven’t experienced the mythical weight loss, either.

Once, while speaking with my therapist of the time about my concerns that I had the disorder, she asked me if I had ever tried cocaine. “Of course not! I’ve never even been drunk,” I replied indignantly. My therapist apologized and then explained the question. For people with ADD, stimulant drugs like cocaine do not induce the manic highs seen in people without ADD; instead they feel a sense of mental clarity and a focused sense of normality. This is because ADD sufferers have an imbalance of three chemicals in the brain: dopamine, norepinephrine and serotonin. Cocaine, amongst other things, acts as a dopamine reuptake inhibitor and a serotonin reuptake inhibitor, or in plain speak, it inhibits the absorption of these chemicals so that the synapses soak longer in them. It is the stimulation of dopamine – or pleasure – center of the brain that causes appetite suppression.

For people with AD/HD, the drug is completely safe. But for those abusing the drug, health risks abound. Adderall’s sister drug is crystal meth – both are amphetamines, though with different molecular structures. And since it’s defined as a class II narcotic – the same as cocaine – illegal distribution of Adderall is a felony. My doctor can only prescribe the drug in 30-day prescriptions because it can be both psychologically and physically addictive. My brother used to work for manufacturer Shire Pharmaceutical and he says the warehouse vault the drugs are stored in rivals that of a prestigious bank.

Often people find that they build up a tolerance to Adderall and some long-term users need to take increasing amounts to get the same appetite suppression. High doses of stimulants can result in an irregular heartbeat, dangerously high body temperatures, the potential for cardiovascular failure or seizures and can lead to eating disorders. In 2005 Health Canada (the equivalent of our Food and Drug Administration) suspended the sale of Adderall XR after a manufacturer’s review submitted to the agency found 20 sudden and heart-related deaths and strokes in adults and children taking prescribed doses since the introduction of Adderall in 1994 (Adderall manufacturer Shire Pharmaceuticals disputes this). For others, taking high doses of some stimulants repeatedly over a short period of time have been shown to induce hostility or feelings of paranoia. And appetite suppression is just one side effect of Adderall; there are many more unpleasant ones, including dry mouth, headaches, trouble sleeping and an increased heartbeat. People who have AD/HD usually do not become addicted to Adderall and usually do not need to worry about withdrawal symptoms.

Speed diets are nothing new; Adderall is just the latest drug used by people dying (literally, in some cases) to lose weight. The only difference is, Adderall is easier to obtain – legally or otherwise – than cocaine, crack and heroin.

I really like Tara Parker Pope of the New York Times and I like her even more now that she’s posted an 8-minute podcast with fellow staffer Gina Kolata. Kolata, of course, is the author of “Rethinking Thin: The New Science of Weight Loss — and the Myths and Realities of Dieting” and was featured in an interview here last year. Here’s Kolata’s advice to people who struggle with their feelings about their weight:

“Don’t always blame yourself, and don’t beat up on yourself,’’ said Kolata. “It’s obviously really, really hard. Don’t say, ‘I’m a weak person and it’s my own fault.’ ”

Instead, Gina says some people who have tried unsuccessfully to lose weight may decide to say to themselves, “I can be attractive. I can buy clothes. I can be fit. I can be healthy. I can have a good life, and I may not be skinny, but so what.”

We need more people like Gina Kolata to help put the emphasis back where it belongs — on health and not the appearance of health.

Roni Caryn Rabin — yes, the same Roni Caryn Rabin — has an article out on MSNBC about the newly enacted New York law which mandates chain restaurants to post the calorie counts of each food on its menu in the same size and font as the price. Restaurateurs have not yet exhausted their legal challenges to the law, but the city will start fining violators up to $2,000 beginning Friday. Officials say the law will help reduce the number of obesity in New York by 150,000 over the next five years, and will prevent some 30,000 cases of diabetes.

New York restaurants are already feeling the squeeze of the new regulations. One TGI Friday’s restaurant ran out of its Classic Sirloin — one of the lowest calorie items on its menu — before the dinner rush. Other patrons are reporting “sticker shock” at the newly-revealed calorie counts of their favorite foods, with many choosing to forego them altogether. Some restaurant customers have even requested old menus, sans calorie counts, so they can continue to eat in calorie-free bliss.

I’m kind of straddling the fence on this new law, which may be surprising to some given my past eating disordered history, but in all fairness, I will make cases for both before offering up my final thoughts. Read the rest of this entry »

Over at The-F-Word messageboard, we’ve started threads compiling notable, influential and otherwise good reads in several different categories. Know of any great books or articles for the categories below? Please post the citation information in its respective thread so we can begin building our virtual library of resources!

• Eating Disorders Studies books
• Eating Disorders Memoirs/Fiction
• Eating Disorder Self-Help books
• HAES books/online resources
• Fat acceptance books
• Body-positive (Size-acceptance) books

Have an idea for a different category not listed above? Don’t hesitate to start a new thread! (And you can always discuss books of other genres that aren’t related to the site’s themes of food, fat, feminism or eating disorders.)

Health at Every Size is a rather relative health approach that can mean very different things for different people. The Association for Size Diversity and Health is an excellent resource for information about HAES, but since the paradigm is not trademarked, owned or otherwise dictated by any one group, personal questions about HAES still abound. What is Health at Every Size? Is it possible to “fail” at HAES or “not do it right?” How can one incorporate HAES in their own lives? These are all questions I see raised time and time again, both on eating disorders blogs and blogs that promote fat acceptance.

Longtime readers of The-F-Word may be familiar with the interview format I use in which I pose 10 questions for field professionals, authors and people with relevant experiences. This time, I’m switching things up a bit. Nancy Kuppersmith, a dietitian at the University of Louisville who promotes the Health at Every Size approach, has agreed to be featured in an interview here on this site. But instead of me posing the questions, I’m going to allow readers here to submit those burning questions they have about HAES to be answered by a medical professional.

So, c’mon… what do you want to know about HAES? Post your questions below and they may be included in the list I send to Nancy!

Back before I got into blogging, I was a total messageboard fanatic. I moderated a rather large graphic design community and I’ve always liked the coffeehouse nature a messageboard provides. So, I started one as part of the Grand Master Plan for this site.

The messageboard link is here: www.the-f-word.org/discuss

I get lots of emails from folks who suggest great and interesting topics for me to blog on - ideas that I don’t always have the time or energy to follow up on - and a messageboard allows you to start topics on those tidbits and get feedback from both me and others. You can discuss news and current events or chitchat off-topic. You can also share recipes, talk about your favorite books, or show off some of your more creative works of art. One of my favorite forums is The Boutique, where members are encouraged to discuss fashion trends, and also to swap clothes that don’t fit and flatter their bodies for clothes that do.

I’ve also included support forums for those with eating disorders and caregivers of people with eating disorders, along with forums to get advice on self-esteem issues and relationship problems. There are forums to discuss women’s health related issues, like pregnancy, infertility and PCOS; HAES-inspired fitness and nutrition; or to talk about mental health issues like AD/HD, Asperger’s Sydrome, Autism and self injury or physical health issues like thyroid deficiencies, diabetes, digestive disorders or physical trauma.

Please read the board rules first before introducing yourself in the Introductions forum and joining in on the conversations. And if you’re interested in becoming a moderator for the site, please send me a note at Rachel (at) the-f-word (dot org) telling me a bit about yourself and why you’re interested, along with a brief recap of your online experience with messageboards and communities. Preference will be given to those with blogs and/or other established presences elsewhere on the ‘net.

Wow! So, the husband and I watched Glenn Gers’ new film Disfigured last night. Glenn was kind enough to send me an advance copy to screen before the film’s July 29 release. I’ve been intrigued by it ever since I saw the trailer and the film did not disappoint. My review of the film, along with an interview with Gers, is forthcoming.

In formulating the interview questions for Glenn, I browsed through the press kit bios for the highly talented actors and actresses featured. Ryan C. Benson plays Bob, the love interest of the fat protagonist - here is his MySpace page. If the name sounds familiar, that’s because Benson was also crowned the winner of the first season of The Biggest Loser in 2005. In just 12 weeks, Ryan lost 122 pounds from his 330-pound frame for a total weight loss of a staggering 37 percent. In short, Ryan lost about 10 pounds a week.

Perspective: Most doctors and nutrition and exercise organization recommend a weight loss of 1 - 2 pounds per week for a healthy and sustainable weight loss. Losing more weight than this is usually due to a loss in water or muscle mass, both of which can cause weight regain and is detrimental for one’s health.

According to the NBC description for the show, The Biggest Loser “challenges and encourages overweight contestants to shed pounds in a safe and recommended manner through comprehensive diet and exercise as they compete for a grand prize of $250,000.” Emphasis mine. Yet here’s how Ryan explains his astonishing weight loss in an entry posted last February on his MySpace blog:

What I now know is that the show was just a quick fix for me. …I wanted to win so bad that the last ten days before the final weigh-in I didn’t eat one piece of solid food! If you’ve heard of “The Master Cleanse” that’s what I did. Its basically drinking lemonade made with water, fresh squeezed lemon juice, pure maple syrup, and cayenne pepper. The rules of the show said we couldn’t use any weight-loss drugs, well I didn’t take any drugs, I just starved myself!

Twenty-four hours before the final weigh-in I stopped putting ANYTHING in my body, liquid or solid, then I started using some old high school wrestling tricks. I wore a rubber suit while jogging on the treadmill, and then spent a lot of time in the steam room. In the final 24 hours I probably dropped 10-13 lbs in just pure water weight. By the time of the final weigh-in I was peeing blood.

Was this healthy? Heck no! My wife wanted to kill me if I didn’t do it to myself first. But I was in a different place, I knew winning the show could put us in a better place financially and I was willing to do some crazy stuff. All this torture I put myself through has had no lasting effects on me (that I know of) and at the time it was sort of a fun adventure for me – but I am sure it reeked havoc on my system.

In the five days after the show was over I gained about 32 lbs. Not from eating, just from getting my system back to normal (mostly re-hydrating myself). So in five days I was back up to 240 – crazy!

Perspective: Even diet doctors don’t recommend the Master Cleanse diet. Writes self-described “celebrity diet doctor” Dr. Marc Lawrence: “Once the diet is over, you will quickly regain the weight and possibly more as your resting metabolism is slower due to the loss of metabolically active muscle lost during the fast.” And starvation and bloody urine? We don’t need a doctor to know that this is also vastly unhealthy and downright dangerous.

And Ryan isn’t alone. According to this Time magazine feature, other contestants also resorted to drastic and dangerous weight loss methods and then quickly regained some of the pounds they lost:

Matt Hoover, 31, a motivational speaker based in Seattle, had a 16-pound rebound within a day of winning Season 2. Last season’s runner-up, Kai Hibbard, 28, an aerobics instructor in Alaska who says she spent the night before her final weigh-in hopping in and out of a sauna for six hours, consumed only sugar-free Jell-O for several days and wolfed down asparagus, which is a natural diuretic. “It’s amazing the things you learn in a weight-loss competition,” she says.

The show purportedly discourages such behavior with the threat of penalties, but has not issued any violations yet. Apparently starvation, malnutrition, dehydration and bloody urine are all acceptable measures in the name of weight loss entertainment. In fact, one of the few participants to maintain their Biggest Loser weight loss is Kelly Minner, the first-season runner-up who went on to lose more weight after the show. How did she do it? Oh, by exercising up to four hours a day, six days a week.

Perspective: At the height of my eating disorder, I spent 2 hours at the gym each day, followed up by another hour of other physical activity. Kelly Minner exercises more today than I did when I was actively anorexic. Such a rigorous and extensive exercise regime is not realistic for the average person and even more unrealistic for those who juggle families and careers.

I’m sure The Biggest Loser and its team of nutritionists and drill sergeant fitness instructors do not recommend such disordered behaviors or actively promote them, but when you factor in a $250,000 cash prize, coupled with the national spotlight on you and your weight, all bets are off. Added to this is the fact that weight loss on the show is usually achieved through total exercise immersion in a strictly controlled environment and any such results are even more unrealistic. The average viewer, however, does not see the extreme and dangerous measures that go one behind the scenes — and I’m quite certain that NBC does not tout those contestants who lost big and then went on to regain the weight — and again, the public is left with a distorted sense of weight and weight loss.

So, exactly who is the Biggest Loser? The answer is simple: viewers.

There are those who come to this site and don’t seem to quite *get* why it is an eating disorders awareness and education site rails against issues of weight-based discrimination and promotes fat rights. A story on Canada.com articulates one of my primary reasons for doing so nicely.

The thrust of the story is that some Canadian doctors and researchers are frustrated at the inattention given to eating disorders, even though they say up to 38 percent of Canadian children suffer from some degree of an eating disorder and that 1 in 10 sufferers will ultimately die from them. Here’s Dr. Leora Pinhas, a psychiatric director for the eating disorders program at the Hospital for Sick Children in Toronto:

Pinhas dismissed the attention being given to childhood obesity rates - which she says have not increased since 2003 and have not increased in any clinically significant way since the late 1990s. The most disturbing thing about the constant news about obesity rates is it’s likely fueling eating disorders, Pinhas said.

“Dieting is the gateway to eating disorders. If you have people encouraged to diet because being fat is so bad, you’re only giving them an intervention that will make them fat, or give them an eating disorder or make them feel bad about themselves.”

Still not convinced? Chew on this… Read the rest of this entry »

I received my Special Health Issue from Time magazine yesterday and eagerly read through its multi-article coverage on childhood obesity.

All the problematic language was there, including such eye-rollingly banal descriptors like “ballooned” and “packed on the pounds,” as well as the old reliable calories in/calories out equation and the as-yet unattributed and unproven theory that today’s kids will have a shorter lifespan than their parents. But I also found Time’s coverage to be remarkably well-rounded compared with commentary published by its multimedia peers, and I think the magazine brings up good observations about contemporary nutrition or lack thereof, sedentary lifestyles and school lunch programs. There’s discussion of socio-economic factors, including race/ethnicity, geography and the role of poverty. Genetics, too, comes into play although while it’s mentioned by quoted doctors and researchers, Time writers never seem to pick up the genetic ball and carry it through. There’s even an article on “fit at any size.” Most encouraging of all, several of the articles reiterate that dieting shouldn’t be promoted or encouraged for overweight kids. The consensus amongst all articles instead suggests that parents model healthy role models and behaviors for their children in an approach that sounds very similar to the Health at Every Size paradigm.

So, read through the articles at your leisure - there’s several of them. And then feel free to discuss any part of the series in the comments below.

How America’s Children Packed on the Pounds

It’s Not Just Genetics

School Cuisine

Living Large

Watching What They Eat

Weighty Issues for Parents

Fit at Any Size

10 Tips on Getting your Kids Moving

We often hear weight-loss success stories paraded about in the media with as much fanfare as if a cure for cancer had been discovered.  But amidst all the “I can do it and you can, too!” trite, what we don’t often hear are the ugly side effects of dieting.  Luckily, we have the British Record to remind us.

Here’s what writer Brian McIver has listed as some of the not-so-pleasant side effects of dieting:

Saggy skin - Yep, got it.  And nothing short of a tummy tuck or entire body plastic surgery will get rid of it, either.

Bye bye boobies - Breasts are made up fatty tissue and are often the first to go with weight-loss.

Dog breath - Often a symptom of starvation or malnutrition.

Dieting blues - When a person cuts essential vitamins or nutrients from their diet, it can wrack havoc with brain chemicals so even if you reach that fabled size 6, you might be too depressed to appreciate and enjoy it.

Lizard skin - Dieting can reduce the health of skin, making it appear older, dryer and less healthy.

Fertility or rather, infertility - Periods can stop, your hormones are affected and you are not eating enough nutrients to help grow a healthy baby.

Osteoporosis - A poor diet can strip bones of calcium and minerals.

Obsession & risk of eating disorder - According to the article, people who diet are five times as likely to develop an eating disorder.

Hair loss - When you’re suffering from a mineral deficiency, the body sheds any non-essential function, like hair.  I experienced this during my eating disorder.  It’s not fun to see clumps of hair fall out in the shower.

With an estimated 95 percent of dieters poised to not only regain the weight they lost, but more within five years, one has to wonder why anyone would embark on fad dieting.  Especially when there already exists a paradigm that doesn’t include such ugly side effects, is healthier, and allows people to settle within their own bodies’ natural setpoint weight range: Health at Every Size.

How about you?  Have you suffered from any of the above or other side effects during your dieting heydays?  Or, if you had an eating disorder, what were some of the side effects or physical problems you encountered?