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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.

This month is Black History Month and this week is National Eating Disorders Awareness Week, and Stephanie Armstrong addresses both in an interview on “Saturday Mornings with Joy Keys,” an interactive, live Internet talk-radio show that focuses on “providing people with tools to enrich and advance their lives mentally, physically, monetarily and emotionally.”  Stephanie  is the author of the new memoir Not All Black Girls Know How to Eat: A Story of Bulimia, in which the now 40-something, recovered, married mother of one daughter and two stepdaughters documents her descent into bulimia in her early 20s and describes her struggles as a black woman with a disorder consistently portrayed as a white woman’s disease.  The Brooklyn native also examines the “bootylicous” black woman stereotype and why the black community’s “code of silence” often leaves black women with eating disorders suffering in silence.  The work is being hailed as the first book by and among black women about eating disorders.  You may remember that Stephanie also answered the-F-word’s questions a few months ago.

Guests included Stephanie and Laurie Vanderboom, program director for the National Eating Disorders Association, which sponsors and coordinates National Eating Disorders Awareness Week.  A few interview highlights

Joy: What do you (NEDA) see when you have these programs?  Do you see a lot of African American women coming to the programs?

Laurie: We’re just beginning to and we’re just beginning to reach out.  There’s so much shame involved in an eating disorder that people hesitate to step up.  Stephanie, wouldn’t you agree that no matter what your racial make-up…

Stephanie: Absolutely, but especially coming from a culture that doesn’t support therapy, that doesn’t support getting outside help, and risking falling outside of the strong black woman archetype that we’re raised believing and have to become.  It’s hard to disassociate yourself with that image to get the help you need.

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Stephanie: One of the things I always talk about, especially in the black community, is that we don’t have an awareness of what exactly bulimia is.  It’s like you go to someone’s house and they’re drinking that dieter’s tea.  That’s bulimia.  Laxative abuse is bulimia.  Diuretic abuse is bulimia.  Compulsive exercising is bulimia.  It’s like we think it’s just throwing up, but it’s not just throwing up.

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Joy: I was talking with a professor of mine and he mentioned that psychologists don’t diagnose African American women properly with eating disorders, because they’re not used to seeing a African American woman coming to their office with this issue. Stephanie, do you feel that that’s the case?

Stephanie: Absolutely. Absolutely. I am constantly talking to women — some who are therapists, some who are young — who are constantly misdiagnosed. I’ve had doctors say, ‘Oh, you don’t have an eating disorder. African Americans don’t have eating disorders.’ I had a young woman call me yesterday – she goes to Clark Atlanta College and she’s at the American University in DC working on an exchange and she’s doing a paper in journalism and decided to do a paper on blacks and eating disorders because her aunt was bulimic and died from it. She calls me up and she said her teacher said, ‘Well, the problem is that there aren’t really that many black women with eating disorders, so that’s going to be a hard paper to do.’ It’s that overall belief that we don’t exist. (she briefly cites a rundown of research showing the prevalence of eating disorders among black women and girls, including this study) …the research is seeping in, but it’s still not getting the attention.

And it’s not just black women with eating disorders who are thought to be virtually non-existent.  Running Tiptoe recently posted a review of a recent “Intervention” episode featuring an Hispanic woman with an exercise addiction and a history of bulimia.  In her review, she offered this link to this 2006 study of “eating disturbances among Hispanic and native American youth,” in which it was found a much more significant pattern of disordered eating behaviors than previously thought.  There are more stats and studies on Hispanic women and eating disorders listed in this 2003 news report.*

Despite all the evidence to the contrary, eating disorders continue to persist in public opinion as a disease young, white girls from middle-class and wealthy backgrounds develop.  But eating disorders are the great equalizers: food is one of the few legal “drugs” out there; everyone needs it to survive;  and in industrialized nations, at least, is widely available and relatively cheap.  That, combined with the constant affirmations of weight loss as morally good and idolization of thinness saturating virtually every facet of our lives, and it’s no wonder that  those with emotional issues and unfulfilled needs might turn to food and the body to express a pain they cannot put into words.

Black girls and women with eating disorders.  Hispanic girls and women with eating disorders.  Adult women with eating disorders.  Boys and men with eating disorders.  Orthodox Jewish girls and women with eating disorders.  Poor girls and women with eating disorders.  We. All. Exist.

* For more information on eating disorders amongst non-white populations, see here.

You’ve heard the aphorism, “You are what you eat,” right?  Well, here’s an interesting project that seeks to expose our innermost selves.  In a creative exploration of hunger, photographer Mark Menjivar photographed the contents of strangers’ refrigerators and posted them to his website along with a brief description of the contents’ owner.  From the virtually empty refrigerator of a person living on a meager fixed income (image 2) to the refrigerator of a female short order cook who can bench press 300 pounds with a coiled snake resting on the top shelf (really! it’s image 15), it’s certainly an interesting peek into the lives of diverse people from different regions and backgrounds.  In his artist’s statement, Menjivar explains:

For three years I traveled around the country exploring food issues. The more time I spent speaking and listening to individual stories, the more I began to think about the foods we consume and the effects they have on us as individuals and communities. An intense curiosity and questions about stewardship led me to begin to make these unconventional portraits.

A refrigerator is both a private and a shared space. One person likened the question, “May I photograph the interior of your fridge?” to asking someone to pose nude for the camera. Each fridge is photographed “as is.” Nothing added, nothing taken away.   These are portraits of the rich and the poor. Vegetarians, Republicans, members of the NRA, those left out, the under appreciated, former soldiers in Hitler’s SS, dreamers, and so much more. We never know the full story of one’s life.

My hope is that we will think deeply about how we care. How we care for our bodies. How we care for others. And how we care for the land.

So, what would the refrigerator of a eating disorder-recovered, vegetarian, health-conscious 30-year-old journalist from the Midwest look like?  Here’s a peek into my own fridge.

If we are what we eat, what does your fridge say about you?

When I was younger, our parents would have us fill out our Santa wish lists weeks before Christmas.  As the sole bookworm in the family, I, of course, always requested a long list of books — Oliver Twist in the third-grade, Shakespeare at the age of 9 and later, in my teen years, Stephen King.  My list must have not made it to the North Pole because instead I got things like a makeup brush kit or a t-shirt screenprinted with a picture of a black labrador.  One of the joys of marrying a man who used to do all his Christmas shopping at Walgreens on Christmas Eve is that now all I do is fill out my Amazon wishlist and know that most, if not all, will be wrapped and waiting under the tree.  I’ve already devoured the two fiction books I received — Stephen King’s new book, Under the Dome and The Strain, coauthored by Chuck Hogan and Guillermo del Toro — and am now ready to dig into my non-fiction gifts.  In no particular order…

• Sherrie Inness, Secret Ingredients: Race, Class and Gender at the Dinner Table

• Sander L. Gilman, Fat: A Cultural History of Obesity

• Jessica Weiner, A Very Hungry Girl: How I Filled Up on Life… And How You Can, Too!

• Stewart Lee Allen, In the Devil’s Garden: A Sinful History of Forbidden Food

So, what’s on your reading list?  Any recommendations for the rest of us?

So I just watched the trailer for Precious, a new sledgehammer of a film by executive producers Tyler Perry and Oprah, and it sent chills down my spine.

The film is based on the book, Push, by Sapphire, about an abused fat teenage black girl in Harlem, and seems to encapsulate the range of feminist topics: domestic abuse, racism, sizeism, poverty, sexual assault, illiteracy… I’m not a fan of Tyler Perry’s fat-lady drag slapstick comedies, but it appears as if his and Oprah’s role is mostly that of lending it their public support. The film appears to depict the stereotypical “black welfare queen” (played by Mo’Nique), but while the inspiring teacher (Paula Patton) is near supermodel perfection, at least she isn’t the tired “Nice White Lady” cliche. And newcomer Gabourey “Gabby” Sidibe, who plays Precious, is an Actual Fat Woman and not some thin star swimming in a fat suit. The film opens in theaters in November and is said to be an Oscar contender.

Stephanie Armstrong is the author of the new memoir Not All Black Girls Know How to Eat: A Story of Bulimia, in which the now 40-something, recovered, married mother of one daughter and two stepdaughters documents her descent into bulimia in her early 20s and describes her struggles as a black woman with a disorder consistently portrayed as a white woman’s disease.  The Brooklyn native also examines the “bootylicous” black woman stereotype and why the black community’s “code of silence” often leaves black women with eating disorders suffering in silence.  The work is being hailed as the first book by and among black women about eating disorders.

A playwright and screenwriter currently living in Los Angeles, Stephanie’s commentary on black women and eating disorders, “Digesting the Truth,” has been featured on NPR.  Her work has appeared in Essence, Sassy, Mademoiselle, and Venice magazines, among other publications. She authored the screenplay for Contradictions of the Heart (20th Century Fox), starring Vanessa Williams, and her plays Three Stories Down, The Outside Sisters, and The Long Journey Home have been performed in theaters in Los Angeles and New York.  Her essay on bulima, “Fear and Loathing,” is included in the forthcoming anthology The Black Body (Oct., 2009).  She also sold a TV treatment, Kimchi and Cornbread, which led to a talk-show deal with MTV.

Now in a must-read interview, Stephanie takes the time to respond to questions from me and the-F-word readers.

Read the rest of this entry »

Ever since I found out a few months ago that I was severely deficient in vitamin D, it seems that it’s there’s been a barrage of health articles on the subject.  But this Washington Post article (via MSNBC) is the first to link vitamin D with not only diabetes, but also the big bad obesity epidemic.

The lede reports the alarmist find that: “Millions of U.S. children have disturbingly low Vitamin D levels, possibly increasing their risk for bone problems, heart disease, diabetes and other ailments…”  Never minding the fact that my doctor told me that most people are deficient in vitamin D, the researchers of two new studies on the subject go on to make value-based judgments on why this is so:

Low Vitamin D levels are especially common among girls, adolescents and people with darker skin, according to the analysis of a nationally representative sample of more than 6,000 children. For example, 59 percent of African American teenage girls were Vitamin D deficient, [Michal L.] Melamed’s study found.

The researchers and others blamed the low levels on a combination of factors, including children spending more time watching television and playing video games instead of going outside, covering up and using sunscreen when they do go outdoors, and drinking more soda and other beverages instead of consuming milk and other foods fortified with Vitamin D.

“This appears to be another result of our unhealthy lifestyles, including a sedentary society that doesn’t go out in the sun much,” Melamed said.

I’m not debating that too little vitamin D is harmful for children — I’m a big proponent of vitamin D after being prescribed it myself and feeling a surge of energy return just days after taking my first supplement.   Instead, what I question are the assumptions the researchers come to as to why children today are deficient.  Keep in mind that an accurate measure of vitamin D levels appeared only 15 years ago and that it has taken 5-10 years for it to reach widespread use.  The tests are so new, in fact, that doctors are still debating the government’s official guidelines for recommended daily intake.  Before this, the only indicator of a vitamin D deficiency was rickets, a deformative softening of the bones condition that is usually brought on by a severe case of vitamin D and also calcium deficiencies usually as the result of famine or starvation.  Most people who are deficient in vitamin D don’t even know it as the symptoms can be so vague and are often attributable to other conditions/factors.  Children today may be no more deficient than their peers of yesteryears; it may be that we are only now able to accurately measure these widespread deficiencies.  Let’s dissect these so-called “unhealthy lifestyles” researchers say are now to blame for childhood vitamin D deficiency:

1. Sedentary lives leading to insufficient sunlight exposure:  Vitamin D is often called the “sun vitamin” because our bodies produce it upon exposure to the sun, but sunlight is unreliable and several factors influence its ability to induce vitamin D production: angle of the sun, latitude in which one lives, skin pigmentation and use of skin-care products containing SPF.  A MedPageToday article on the two studies notes that researchers lacked information on the children’s exposure to sunlight, so no causality can really be established here.

2. Sunscreen use: This is an “unhealthy lifestyle” choice?  Really?  What’s unhealthier?  The leading type of cancer –skin cancer– or a vitamin D deficiency?

3.  Increased soda consumption/Decreased milk consumption: The fact that low vitamin D levels are especially common amongst people of color isn’t surprising considering that 95 percent of black people and the great majorities of other people of color are lactose-intolerant –a genetic fact that is never mentioned in either article (or in milk-drinking campaigns and government guidelines).  Many people of color lack a digestive enzyme needed to digest the sugars in milk and while this intolerance usually doesn’t manifest itself until adolescence or adulthood, it can still pose problems for children of color.  The fact that the still largely milk-white medical community still recommends fortified milk consumption for healthy vitamin D levels demonstrates a classic case of lingering racial discrimination in health care.  Research has shown that an inability to digest milk is not a genetic mutation, but rather a genetic norm — the gene for lactase normally switches off as children are weaned and only a small percentage of humans (namely, white folks) in whom the gene is not turned off are able to drink milk into adulthood.  This is why some in the medical community have begun to regard us milk-drinking anomalies as “lactose persistent” instead of labeling those who can’t digest milk as “lactose-intolerant.”

Apart from fortified milk, foods naturally rich in vitamin D are scarce –seafood tops the list, along with some cheeses, yogurts, cereals and juices.  Since food is not a reliable source of vitamin D, doctors usually recommend taking supplements, which are available over-the-counter in low doses and by prescription for high doses like mine.  The supplements aren’t overly-expensive, but can be pricey for families on a budget when you consider that it first requires a doctor’s visit to determine if a deficiency exists and what dosages are needed, along with seasonal follow-up appointments to determine future dosages.  Since people of color tend to be disproportionately poorer than white people, it stands to reason that this may not be a lifestyle “choice” as it is a socio-economic fact of life.

Even more interesting are the medical findings of the studies, which are listed in more detail on the MedPageToday article:

Children with low levels of 25-hydroxyvitamin D were more likely to be overweight and/or obese (P for trend <0.001 for both), but even after the researchers adjusted for age, gender, race/ethnicity, body mass index, socioeconomic status, and physical activity, they found that low vitamin D was often accompanied by high systolic blood pressure, high blood sugar, and metabolic syndrome.

These conditions, which are all risk factors for cardiovascular disease, were present regardless of whether the children were overweight or not, the researchers said.

Missing in both articles is the mention that a chief symptom of metabolic syndrome is weight gain.  This may be because many in the medical community believe weight gain not to be a symptom of metabolic syndrome, but rather a cause of it.  WebMD’s page on metabolic syndrome states matter-of-factly: “Metabolic syndrome is caused by an unhealthy lifestyle that includes eating too many calories, being inactive, and gaining weight, particularly around your waist.”  Since the studies are the first of their kind, more observation is needed, but it stands to reason that if so many children are deficient in vitamin D, then just as many, if not more, adults are also deficient.  And if a vitamin D deficiency has been linked to metabolic syndrome and high blood sugar independent of weight, then perhaps not all people with the condition are just lazy, Twinkie-munching couch potatoes with a spare tire or two.

Fat people, especially fat women, already face discrimination in the workplace — see here and here for more. As if that weren’t enough, Dr. Victor Dzau, chancellor for health affairs at Duke University and chief executive of the Duke University Health System, has an ingenious way to further discriminate against fat people and others who don’t meet arbitrary standards of “health” in the workplace. Read the rest of this entry »

Part of Michelle Obama’s agenda will be to stress the importance of healthy eating and to encourage Americans to provide fresh, unprocessed and locally grown foods to their families and the families of the neediest in their communities. Reports the New York Times:

White House officials say the focus on healthy living will be a significant item on Mrs. Obama’s agenda, which already includes supporting working families and military spouses. As the nation battles an obesity epidemic and a hard-to-break taste for oversweetened and oversalted dishes, her message is clear: Fresh, nutritious foods are not delicacies to be savored by the wealthy, but critical components of the diets of ordinary and struggling families.

The First Lady’s emphasis on healthy food consumption and Victory Gardens is a great one, although I wonder if she plans to put any kind of oomph behind the rhetoric to ensure that this actually happens. Like, oh, convincing her husband and Congress to make changes in the Farm Bill to help eliminate food deserts and subsidize locally-grown fruits and vegetables so that they are both more affordable and accessible to people at all socio-economic levels.

Ever the role model, Michelle Obama invited cameras into the White House kitchen where only fresh food — nothing canned or processed — are prepared by the First Family’s chef. And in the November issue of Parents magazine, she and her husband described their decision to ditch juice boxes and processed foods. Their motivation? Malia was getting fat.

“A couple of years ago — you’d never know it by looking at her now — Malia was getting a little chubby,” Mr. Obama told the magazine.

They took action, Mrs. Obama said, when “her doctor — he really monitors this type of thing — suggested we look at her diet. So we cut out juice boxes, sweets and processed foods.”

Ruth Reichl [editor of Gourmet magazine] would like the White House kitchen to issue regular news releases that describe what the first couple and their daughters are eating. (Then parents across the country could tell their children, “You know, Malia and Sasha were eating salad yesterday. …”)

I’m sure that Michelle Obama equates fat with unhealthy, especially since the family doctor seems hypervigilant on these kinds of issues, so it’s possible that the First Lady’s concern was for the health of her child and family. Nonetheless it strikes me odd that these so-called health concerns and nutrition advice did not arise until OMG, MALIA IS GETTING FAT!! If you eat a steady diet of fast-, junk- and processed foods and yet are genetically blessed to remain thin, does this mean you’re healthy?

Improving the family’s diet is great — all families should be so lucky as the Obamas to be able to eat such a healthy diet, not to mention, have the luxury of a personal chef. Still I wonder how little Malia felt after her mother drastically changed and restricted the entire family’s diet all because she was getting a “little chubby.” I know from personal experience that being singled out in a family for weight is an emotionally crushing experience for a kid. My mother once announced at the dinner table that she was putting me and me alone on a diet, despite the fact that most of my family, including her, were (and still are) fat. I would find out much later that my mom was also teased about her weight in school and that she was probably just trying to shield me from the same harassment, but at the time, it had the opposite effect: I was determined to eat even more of the things she placed off-limits in a show of rebellion and bodily autonomy.

Add in a national spotlight and I can’t even begin to imagine the anvil-like pressures. How will these girls feel in having their diets broadcast in official White House press releases* to a global audience, in effect, involuntarily thrusting them into the spotlight as anti-obesity role models? Has anyone even asked them what they think or feel about this? Will they be able to indulge in a cheeseburger without fear of judgment and condemnation from public food purists? Will tabloids and gossip mags turn their voyeuristic eye to them next, splashing their images on magazine covers while speculating on the perceived dips and spikes on their digital scales?

After the Obama girls were invited to star on the Hannah Montana show, HuffPo blogger Casey Gane-McCalla pointed out the dangers media intrusion can hold for child stars and children of presidents and politicians:

Undo media attention and the pressure of the spotlight has negatively affected many children who have sought or been thrust into the media spotlight.

Sasha and Malia should receive media attention for being part of the first family and not as separate entities to themselves… Let the kids be kids… They should be sheltered from the media not thrust into it.

The Obama girls will have plenty of challenges and obstacles to overcome in having the most normal childhood as possible. Let’s not add disordered relationships with food and body to that list.

* Sadly, “What’s For Lunch at Sasha and Malia’s School” has already made headlines.

Remember the One Dollar Diet Project in which a couple lived on a dollar-a-day food budget to draw awareness to issues of poverty? Another couple are embarking on a similar project, this time to fundraise for their upcoming mission trip to Zambia, a country where living on just $1 a day is the norm. Karla and Amy started the organization Hope Heals to aid people around the globe who are in need. They begin their One Dollar project in January, but have already started blogging about their preparations and goals here. Complicating the project is the fact that Karla is gluten-allergic, but the couple plan to stick to their rules of accepting no free food or coupons. Their goal is to raise $5,500 by May. For more information or to donate money, contact the couple here.