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I took a week off work this week, but it’s more like a staycation than a vacation. The pregnant foster cat was considerate enough to give birth yesterday morning, so now I can get to that impossibly long to-do list I’ve been mentally tabulating since, oh, February. I probably won’t be online much this week, so I thought it would be a good chance to revisit some of the more popular posts featured on the blog in the three-plus years it’s been online. The first to be (re)featured is this November, 2007 interview with Gina Kolata, award-winning science and medicine reporter with The New York Times and author.

Gina Kolata is an award-winning science and medicine reporter for The New York Times and the author of many books, including, “Clone: The Road to Dolly and the Path Ahead”, “The Baby Doctors: Probing the Limits of Fetal Medicine“, “Sex in America”, the best-selling “Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It” , and “Ultimate Fitness: The Quest for Truth about Health and Exercise.”

Her new book is “Rethinking Thin: The New Science of Weight Loss — and the Myths and Realities of Dieting.”

Kolata’s career in journalism began when she joined Science magazine in 1971, where she selected reviewers for manuscripts. She eventually became a writer and then senior writer. She also wrote for a wide variety of newspapers and magazines, including Science Magazine, Smithsonian, GQ and Ms. Magazine. She earned her bachelor’s degree in microbiology and her master’s degree in applied mathematics from the University of Maryland. She studied molecular biology at M.I.T. in a Ph.D. program.

In Ultimate Fitness, you set out to discover the truth of the exercise industry and found much of fitness claims to be misleading. In your most recent work, Rethinking Thin, you blast those in the obesity industry, who promote the idea that overweight is unhealthy and diet and exercise to be effective. What prompted your interest in the study of diet, exercise and weight-loss?

I got interested in the exercise industry because I spend a lot of time exercising and at gyms and I kept hearing all sorts of things that did not seem to make a lot of scientific sense, like the “fat-burning zone.” I was interested in diet and weight loss because of my experience as a reporter. I have been writing about major research on weight and weight loss for decades, and these often involved discoveries that seemed pathbreaking. Yet the public, and the diet industry, kept on saying that all you have to do to lose weight is just eat less and exercise more.

What are some of the biggest core beliefs of dieting and weight-loss that you found to be incorrect?

The idea that anyone can be arbitrarily thin is at the top of the list. Then comes the idea that thinner people could easily be fat if they just let themselves go. Or the idea that people gain weight because they have emotional problems and are using food to fill an unmet need. Or that if you just walk for 20 minutes or so a day those unwanted pounds would melt away. Or that if you take junk foods out of the schools and re institute pe kids would not gain weight.

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In a strange twist to the usual Photoshopped models debate, a British magazine has ‘fessed up to digitally manipulating an image of a shockingly thin model to make her look… heavier.

Jane Druker, editor of the ironically titled publication Healthy, admitted to airbrushing model Kamilla Wladyka’s cover shot on the April edition of the mag, explaining that the model initially *appeared* to be in good health, but had lost so much weight in the week between casting and shoot that airbrushing became necessary.   As the Daily Mail UK reports, editors added 2-3 stone, or 28-42 pounds, to Kamilla’s photo to make the 5-foot-10-inch, British size-6 model look “a little bit bigger, to make her look like she was a size ten as opposed to a size four” out of concern for the magazine’s commitment to promoting “health and wellbeing.”

‘There were plenty of clothes that we couldn’t put on her because her bones stuck out too much,’ Druker said.  ‘She looked beautiful in the face, but really thin and unwell. That’s not a reflection of what we do in our magazine, which is about good health.’

Good health?  Really?

In its defense, the magazine acted transparently and stated that they do not normally airbrush images of models to give the false illusion of health.  Yet if this model appeared to be so unnaturally thin and unhealthy that digital airbrushing was required, why wasn’t she sent home immediately and another healthier model used instead?  Oh, silly me… I forgot.  Healthy magazine, like so many others, determines health and wellbeing on almost the sole basis of appearance. And as everyone knows, thin=healthy but too thin=unhealthy, so instead let’s just made the model LOOK like she doesn’t suffer from raging anorexia, actual health be damned.

Yes, it’s a good thing that magazines and advertisers are beginning to take heed of the tragic and dangerous social implications of showing images, altered or otherwise, of super-skinny models.  But the solution is not to simply airbrush the same radically thin models into some slightly higher, but more socially-acceptable vision of conformity, but rather to actually seek out and hire models whose body shapes and sizes require very little to no airbrushing in order to meet these standards.  As eating disorder activist Susan Ringwood, who has campaigned for the use of diversely-sized fashion models, told Britain’s Daily Telegraph:

There’s a fundamental difference between using camera work to make someone look polished, and changing the shape and size of someone’s body in order to portray them looking differently, to conform to whatever ideal.  It’s just not helpful and puts huge pressure on people to keep up a hyper-perfectionism that isn’t real. If you can’t trust the health industry to be healthy, how can you expect the fashion magazines to put their house in order?

But, then again, what do we really expect from a “health” magazine that also advertises weight-loss advice on the same cover as the same gaunt-thin model airbrushed to look heavier?

MSNBC interviewed U.S. Surgeon General Regina Benjamin about weight and fitness and her “vision for a health and fit nation.”  Benjamin, you may recall, was attacked and criticized for her weight after her nomination (she appears to be about a size 18).  But while Benjamin is enthusiastically joining the “nation’s war on fat,” I’m glad to see that she’s more even-keeled and sensitive about it than, ehem, others.

So how do you reach more people?

If you talk to the average person, what’s clear is we need to give them tools to make it easier. We need to get people to make good health part of their lives. I’m showing my age, but I remember going out dancing, doing the hustle and sweating off my makeup. That was fun. People need to exercise and eat well because they enjoy it and they want to be fit. It could be taking a walk in a park. But we need nice parks. We need people to buy better foods. But a lot of communities don’t have access to fresh produce. Right now, it’s very difficult to find a meal that’s healthy and competes with a “dollar meal” like a burger and fries. We need to ask the communities and food manufacturers to offer more healthy choices not as alternatives, but as first choices.

Your weight was made an issue when the President picked you for the post, and you said it was hurtful. So how do we talk to our kids about a sensitive topic like weight?

I’m very secure in my own self esteem, but yes, it was hurtful. There were some mean comments. But what about those kids who will be looking at me as a role model? They may be very discouraged by some of those comments. I exercise regularly, at least four days a week. If I didn’t I probably would be a big blimp. And I try to eat pretty healthy, as much as I can. I know the things that I’m doing. I tend to stay on the elliptical as long as other people. I’m not out of breath. You can be healthy and fit at different sizes. The real message is that you don’t want to limit yourself by your dress size. You need to be comfortable with yourself and have a good body image. Don’t have some dress manufacturer tell you what size to be. Be a size that makes you fit.

I dislike Benjamin’s near exclusive focus on obesity — as if Not Getting Fat is the only worthwhile reason to encourage people to make healthier choices — and I am vehemently against workplace wellness programs and challenges, which she also promotes, but I’m glad to see that not only does Benjamin appear to support HAES, she also seems to recognize the racial, environmental and socio-economic forces at play that contribute to body weight.  Now if we could only get her to heed her own words and redirect her health and fitness outreach efforts from just fat people to all people.

On a lighter note this week, MSNBC has a story out today on embarrassing gym mishaps, the bulk of which appear to occur in January by amateur gym-goers armed with freshly made new year’s resolutions.

Last year, there were more than 1,500 reports of exercisers landing in the emergency room after run-ins with workout equipment, according to data collected by the federal Consumer Products Safety Commission.

The agency estimates that when extrapolated to the rest of us, more than 50,000 people are treated in the ER each year after falling off exercise balls, getting snapped in the face by resistance bands, dropping heavy weights on their toes, tripping over jump ropes or flying off treadmills. Especially flying off treadmills.

When I moved from a graphic design position into a reporter role, one of the managing editors interviewing me asked why I think I’d make a good reporter.  I replied that I’ve publicly embarrassed myself so many times now that I have no qualms speaking to anyone about anything.  And yes, one of those embarrassing moments sadly involved me being propelled off the treadmill before an audience of early morning gym rats.  It was back in 2003, when I had finally achieved a fitness level in which I could run for more than a few minutes before collapsing in a huffing pile of red-faced exhaustion.  I had just upped the speed on the treadmill from a brisk power walk to moderate jog while reading a magazine to ward off the dreary monotony I’ve always found comes with running.  You know those annoying little subscription cards magazine publishers strategically place throughout that have the end result only of annoying readers?  As I flipped through the pages, a few of those cards spilled out onto the belt of the treadmill.  Fearing that I’d step on one and trip, I tried to strategically swoop down and flick it off all without losing my stride.  Yep.  You can imagine how this story ends.  I tripped, my headphone line got tangled in with the emergency stop button cord and I ended up ejected onto the floor with scrapes to my elbows and knees and a badly bruised pride.  All I could do was just sit there and laugh as a couple of concerned weight-lifters rushed to my aid.

How about you?  Do you have any embarrassing gym mishaps to share?

From the station that helped destroy the Gosselin’s marriage comes a new series called “One Big Happy Family.” The series, which premiered last month on TLC, documents the efforts of a black North Carolina brood, in which all four members weigh in at more than 300 pounds, to slim down. The show’s producer, Mike Duffy, likened it to the TLC show “Little People, Big World,” saying that “One Big Happy Family” is instead “about big people living in a little world — fat people living in a skinny world.”  Show clips are available here.

The Boston Herald calls it “TLC’s latest attempt to exploit a family for ratings.” Monsters and Critics says, “Trainwreck reality TV doesn’t get much bigger than the TLC effort, One Big Happy Family.” Variety says, “One Big Happy Family joins a TLC lineup that often seems devoted more to pithy titles than anything else.” And a CNN report last week drew attention to “big” concerns whether or not the show is “potentially exploitive of the family, whose ‘fat and happy’ attitude has drawn comparisons to the comedic Klump family from the Eddie Murphy film ‘The Nutty Professor.’”

Granted, the Cole family’s attempts, at times, can seem like buffoonery. For instance, in the clip above, the family is shown eating a voracious amount of pancakes, which mother Tameka says the family can work off later with a walk around a local water park (an excursion undoubtedly suggested by show producers). Once there, they indulge in a big, sugary piece of funnel cake. Chairs break beneath their weight and the family is turned away from a water park ride for their size. But weight-loss reality shows are, by their very nature, exploitive, which begs the question of why the sudden concern and criticism over this weight-loss reality show.

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Spam.  It’s the bane of anyone with an email address.  We all loathe and despise it, but does anyone actually buy the often ridiculous and over-the-top products being shilled?  It  turns out that when it comes to weight loss spam, young adults who think they’re fat swallow it en masse.

Researchers Joshua Fogel of Brooklyn College and Sam Shlivko of New York Law School conducted a survey of 200 New York college students about their experiences with spam email for weight loss products (published here in the January edition of Southern Medical Journal).  Participants were asked, “Do you believe that you have weight problems?”  One-third answered that they did and responses were then compared along those lines.  Keep in mind that the study only asked for a yes-or-no response as to whether someone believed they had a weight problem, meaning that this group could have realistically included both students who are certifiably fat or those who just think themselves the size of a landbarge.  Of those students who reported to have weight problems:

• 85 percent said they had received weight loss spam over the past year, compared to 73 percent of those without weight problems

• 42 percent opened and read spam email advertising weight loss products versus just 18 percent of those without weight problems

• 19 percent said they had bought a weight loss product from spam — as did five percent (!) of those without weight problems.

Researchers also measured participants’ psychological stress according to the Perceived Stress Scale and the Rosenburg Self-Esteem Scale.  Not surprisingly, students who reported weight problems had lower self-esteem and higher perceived stress, which, in part, influenced their proclivity to open, read and purchase weight loss spam.  In all, after adjusting for other factors, students with reported weight problems were about three times more likely to receive and open weight loss spam and to buy the products pitched.

So, what’s the big deal, some might ask.  We’re constantly bombarded with the mantra that “diets don’t work” and the only thing these students have to lose is their money, right?  Wrong.  As Fogel noted in his report, there is no quality control for products advertising in spam emails.  The current law on dietary supplements gives the FDA jurisdiction only after the products go on the market.  And instead of reviewing the supplements and approving them for sale, as the agency does with drugs, the FDA is limited to spot-checking manufacturers and distributors and testing products already on store shelves.  In February, the agency issued warnings for 70 weight loss supplements found to contain unlisted and potentially dangerous ingredients — see the complete list here.  And this list, most of which are imported from China, represents only a teensy tiny fraction of the dangerous and often ineffective diet pills available in what is a $1.7 billion dollar a year market.  The FDA itself admits that it simply does not have the resources to identify what may be hundreds of other drug-contaminated weight-loss supplements for sale. Some spam emails even advertise and sell prescription medications without requiring proof of a valid prescription.  And not addressed in the report is the more alarming consideration that responding to weight loss spam only reveals what may be a larger and more shadowy pattern of disordered eating and fad or yo-yo dieting, all of which take their toll on health and may even ironically lead to even greater weight gain.

Products purchased via weight loss spam can also take a blow to one’s pocketbook and even credit ratings.  Since posting my expose on one acai berry diet scam more than a year ago,  responses — 139 as of this posting — continue to trickle in from duped buyers who report being scammed charged hundreds of dollars in unauthorized expenses for “free” trial offers and when they call to cancel, either find that the customer service number has been disconnected or are put on hold for an ungodly amount of time by agents who often refuse to refund their money and sometimes even to cancel their orders altogether.

Researchers note that the findings indicate that young adults with weight problems are “apparently not seeking or not satisfied with evidence-based treatments available from physicians… or other health care providers.”  And therein lies the problem, for as physicians, scientists, researchers and specialists admit, there is no proven way to make — and keep — fat people thin.  The National Institutes of Health and other studies show that, on average, 95-98 percent of people who lose weight gain it back within five years. Only 2-5 percent of dieters succeed in keeping their weight off while 90 percent of those gain back more weight than they lost.  Even those who undergo weight loss surgery mostly become less fat, with weight regain rates both high and common.

Trust me.  If some virtuoso discovers that enchanted unicorn horn dust will magically whittle our waistlines, he/she would be hailed as a global fat-fighting hero, invited to the White House for a few cold ones (all lite, of course), awarded the Nobel Prize amidst international fanfare and be secretly masturbated to by MeMe Roth.  Insurance companies everywhere would cover these miracle pills in full without reserve; they’d be added to the water supply with fluoride and the government would pass them out like candy.  But as the old adage cautions us, if it’s too good to be true — and it’s peddled by spam-mongers — it probably is.  My advice?  Invest in a good spam filter and save yourself some time, money and sanity.

It’s estimated that some 10 million females and one million males in the U.S. have an eating disorder.  Shocking numbers, but what about those who don’t meet the clinical requirements for a diagnosis?  A new study by the University of Montreal and the Douglas Mental Health University Institute reveals that those kinds of cases may be more prevalent than you might think.

Investigators completed a phone survey of 1,501 women.  The average age of these urban-dwelling participants was 31, the majority of respondents were non-smokers and university graduates.  Not one participant was classified as having anorexia.  Researchers found that some 13.7 percent of women interviewed reported binge eating one to five days or one to seven times per month; 28 percent of women completed intense exercise twice a month with the sole objective of losing weight or influencing it; and 2.5 percent of women reported forcing themselves to vomit, use laxatives or use diuretics to maintain their weight or shape.    The study also established a link between problematic eating behaviors and self-rated health.  In other words, disordered eating behaviors are more likely to occur in women who perceived themselves to be in poor health (considering the daily barrage fat people are subjected to in which they’re constantly told that they’re one doughnut away from death’s door regardless of actual health, is it surprising, that disordered eating is more prevalent among those who perceive themselves to be unhealthy?).  In all, researchers found that “maladaptive” or disordered eating behaviors and attitudes affected 10 to 15 percent of the women.  The study is published in the International Journal of Eating Disorders.

“Our results are disquieting,” says Lise Gauvin, a professor at the Université de Montréal Department of Social and Preventive Medicine.  “Women are exposed to many contradictory messages. They are encouraged to lose weight yet also encouraged to eat for the simple pleasure of it.”

“We practice a sport for the pleasure it provides, to feel good, but when the activity is done to gain control over one’s weight and figure, it is indicative of someone who could be excessively concerned about their weight,” says Gauvin. “Our data suggests that a proportion of the female population displays maladaptive eating patterns.”

This study is actually quite conservative in its estimates, owing perhaps to the relatively small sample size and demographic polled.  A recent online survey of 4,023 women by Self magazine in partnership with the University of North Carolina at Chapel Hill revealed that 65 percent of American women ages 25-45 harbor some degree of disordered eating and that another 10 percent suffer from an outright eating disorder.  Even more frightening is that 53 percent of the respondents said they were already at a healthy weight and were still trying to lose more!  For a breakdown of those results, read here.

So, what distinguishes disordered eating from the occasional quirky eating?  In a nutshell, it’s the purpose and consistency behind the behavior and whether or not the person maintains a sense of free choice with regard to eating behaviors.  The greater problem now is not only the prevalence of disordered eating; it’s the fact that disordered eating has become normalized and repackaged as healthy eating.  Carbohydrate restriction, obsessive calorie counting, strict food rules, thinking inordinately about food, daily weigh-ins, eating a lot of no- or low-calorie foods, adopting a vegetarian or vegan diet solely for weight loss, juice or water fasting, taking diet supplements to encourage weight loss… how many of these helpful “health” tips have you seen recommended by commercial diet programs, health magazines and even doctors and nutritionists?

It’s important to note that not all who have disordered eating will go on to develop an eating disorder.  While I consider disordered eating to be mostly a cultural phenomenon, eating disorders have been shown to have far more complex origins, including biological and genetic factors.  But considering that most eating disorders begin as a simple diet gone horribly awry, these findings take on an entirely new significance.  After all, it only takes one misstep for those already teetering on the edge of extremity to fall down the rabbit hole.

This is a post I’ve had simmering on the back burner now for a few months and am just now getting around to posting…

My older brother has always been a husky guy. He’s lost and regained the same 50-60 pounds or so several times in his adult life. Some months back, he went to see a new doctor for a check-up, which surprised me given Jim’s phobia of all things medical (he spent several weeks in ICU as a teen for severe asthma and pneumonia and has been doctor-wary since). Other than slightly elevated cholesterol levels, Jim checked out A-OK health-wise. Then the doctor decided to give him “the talk.”

Yeah, fat folk everywhere know what I’m talking about.

Jim said that the doctor seemed very nervous and after some fumbling, finally told him that his BMI was XX and asked if Jim knew what that meant. “Yeah,” said Jim with a laugh, “It means I’m fat.” If my brother is self-conscious about his weight, he doesn’t show it. He’s one of those kinds of people who will tell you that he’s a big fat cliche (sedentary, supersized fast food diet, regular soda drinker) and doesn’t apologize for it.  Jim’s thick-skinned attitude seemed to break the ice and the doctor then discussed his options, or rather thereof. “Have you ever considered weight-loss surgery?” he asked.  “You’d be a good candidate for…”  Jim stopped the good doctor mid-sentence. “I’ve lost weight before by eating healthier and exercising,” said Jim. “Weight-loss surgery isn’t even a consideration for me.”

I find it disturbing that the doctor’s first recommendation was not for Jim to improve his diet or exercise more, but rather to go under knife and rewire a perfectly functioning digestive system. Of course,the best way to a patient’s wallet is through his stomach — simply eating healthier and moving more won’t pay for the good doctor’s Lexus.

What was once considered to be a last, desperate option reserved only for those with life threatening weight-related health issues has now become so ubiquitous that at least one weight-loss surgical procedure (lap-band) is now considered to be an elective, cosmetic surgery and is being marketed by some facilities to people with just 30-40 extra unwanted pounds.  The National Institutes of Health states that bariatric surgery should be reserved for those with a BMI of 40 or more or those with a BMI of 35 and a weight-related co-morbidity, but “co-morbidity” here is a vague term that can be — and is — used to describe any condition from headaches to depression in order to circumvent the strict requirements insurance companies set for qualified candidates.  There were 220,000 bariatric surgeries performed in 2008 (in the U.S.), up from 205,000 performed in 2007.   Despite the economic recession, one healthcare market research firm estimates there to have been 350,000 procedures performed worldwide in 2009, which translates into sales of $517 million for surgical devices used in bariatric surgery, or a 21.6 percent increase over 2008 sales.  And the profiteers are hard at work devising new markets and demographics to drain. Health News Digest has a rundown of some of the disturbing bariatric surgery trends we can expect to see in 2010:

• Grand Opening: New Surgical Weight Loss Program for Teens — As the list of benefits of weight loss surgery in teens increases, we will see more surgical weight loss programs for teens popping up at hospitals across the map.
• Surgeons will be offering revision surgeries such as the transoral ROSE to people who have previously had weight loss surgery but have gained the weight back – a growing population both literally and figuratively.
• Weight Loss Surgery Not Just for the Obese — As studies highlight the curative powers of bariatric surgery, there will be a push to offer it to people with even lower body mass indexes (BMI). …if people who are just moderately obese also have diabetes, they too should be considered candidates. [Even the government isn't convinced that WLS for moderately overweight people with diabetes is beneficial.]
• Hourglass Figure Possible After Massive Weight Loss — More and more people are undergoing bariatric surgery to lose weight, only to be left with hanging fat and flab in visible areas. As plastic surgeons put on their thinking caps to better address these issues, expect to hear about many new procedures, including the corset trunkplasty. [Surgeons' fees average $1,400 to $1,800 for gastric bypass, but some bariatric surgeons also offer offer tummy tucks and other cosmetic procedures to remove excess skin, charging up to $14,000.]

No mention is made of a trend amongst doctors in recommending a major surgical procedure that carries a litany of serious medical risks, many longterm and including death, (up to five percent of WLS patients die in the first year, according to one doctor) as a fat patient’s first and only choice in healthy weight management, but it is, no doubt, a phenomenon not only occurring in just my brother’s doctor’s office.  Patient beware.

So, I had just dozed off again yesterday morning when my cat, who usually sleeps next to me each morning, tried to jump up on the bed.  Sweet, right?  Not so much… I was hugging the side of the bed and she nailed me instead above my eye.  Three inner stitches, five outer ones and a tetanus shot later, I’m sporting the Frankenstein look this week.  There were seven people ahead of me in line at the Urgent Care office, so I had lots of time to peruse through their fine selection of health magazines and found these snippets to share.

Can I get an amen?: Abby Sher, who used to perform with the comedy troupe The Second City, takes a comedic look at her struggles with obsessive-compulsive disorder and anorexia in her new memoir, Amen, Amen, Amen.

Hello, body; goodbye, loathing: Body image expert Sarah Maria is the author of the new book, Love Your Body, Love Your Life.   The self-help guide gives readers five steps to help end negative body image obsession and start living a confident and empowered life.  Bonus: Check out an interview with Maria at the blog Weightless.

Goodbye workout ruts!: Score fresh fitness DVDs for free when you trade in old ones at SwapADVD.com.

Down dog with eating disorders: A pilot study, recently published in the Journal of Adolescent Health,  found that yoga was effective in treating adolescents with anorexia, bulimia, and ED-NOS

Why you can’t eat just one: A group of neuroscientists have discovered a reason for why we (or rats, at least) can’t seem to get enough candy or junk food: we’re addicted.  Their study found that pleasure centers in the brains of rats on high-fat and calorie diets became less responsive as the bingeing wore on, making the rats consume more and more food.

Sink your teeth into this: Market research firm Mintel predicts the top five dining trends for 2010 will include healthier dishes, seasonal ingredients, lesser-known ethnic cuisines and a back-to-basics approach to old-fashioned foods such as burgers.

I’m sitting at my favorite local indie coffeehouse staring at a large plate of cottage cheese and fresh fruit atop a bed of leafy greens paired with a side of steaming spiced apples and wishing I had my camera because the presentation is as much artistic as it is yummy.  That its menu is vegetarian-friendly is one of the reasons why I love this coffeehouse so much, but despite its array of veggie offerings, I sometimes find myself craving the delicious synergy of pineapple and large curd cottage cheese.

Cottage cheese has gotten a bum rap in the past few decades.  For too many, its pebblelike curds suspended in a milky mixture conjures up images of diet food or maybe food for the old and senile.  There’s even a cottage cheese fad diet that guarantees weight loss if you only eat it straight for one week.   I always find the association of cottage cheese as diet food a bit amusing considering that during my eating disorder days, I decided it way too high-cal to eat and labeled it a “bad” food.  Salad, another diet food dismissal and a personal favorite, also seems to get no respect.

As I sit here alternating between typing and downing forkfuls of cheese curds, I wonder about other foods considered to be worthy of consumption only when in the pursuit of weight loss.  Are there any “diet foods” that you like and have reclaimed as part of your non-diet diet?