I came across an excellent post today by blogger Tony “The Anti-Jared” Posnanski, entitled “Everyone Has A Bikini Body”. Tony wrote about Amini Terrell, a 260-lb. woman who dared to defy social prejudices against the overweight by strutting up and down Hollywood Boulevard wearing a bikini. Tony published a quote of hers that was particularly poignant. She said,

Because if people say you are too fat to wear one, then you will lose weight. Once you lose weight they will say you are too flat-chested for one and then get surgery. Once you have Double D’s they will say you do not have a butt for one so you will have more surgery. Then you will not be tan enough or tall enough or shapely enough.

I found this quite astute. Just about any woman will admit that there are parts of herself that she hates. That’s not “dislikes”, that’s HATES. The sad reality is that no matter how hard women try to look “good”, they are never good enough according to the unattainable expectations of our society. And those expectations are not driven by those who have our best interests in mind. They’re driven by those who have a financial interest in keeping us unhappy with ourselves.

But a reader’s response in the comment section was what really struck me. One particular woman wrote,

Well, I admire her for having the guts to do this. I wouldn’t if I was 135. That’s being said, I find it totally disgusting! That is what I would look like and fat women disgust me and I am one. I’m 56 years old and have given up ever being “hot”.

I read this through several times: “That is what I would look like and fat women disgust me and I am one.” That’s not just hating one part of your body, which is sad enough. That is hating all of yourself.

So, I wonder, what motivation would that woman have for choosing health-preserving foods or engaging in a life-improving exercise program? Forget looking “hot”. Hotness is a manufactured concept, superficial and inconsistent. I’m talking about respecting yourself enough to take good care of your body. It shouldn’t be all about losing weight so that you can fit into a certain size or style of clothing. It should be about keeping your body in a healthy state so that you can move freely and live a long productive life.

Would you do that for someone that you found disgusting?

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My kids have an extensive anti-bullying campaign at their elementary school. They’re taught to treat others with kindness. Ironically, sometimes the cruelest instances of bullying appear in how people treat themselves.

I don’t always agree with what journalist Gary Taubes (author, Good Calories, Bad Calories and Why We Get Fat) writes, but he hits the nail on the head in the following NYT opinion piece, in which he maintains that, in spite of hundreds of thousands of research studies, we really don’t know all that much about nutrition.

“Why Nutrition Is So Confusing”

I concur.

Prepare yourself for some ridicule. Because when you set foot in the gym, the “regulars” will look at you and roll their eyes. They might make comments. Or give you icy stares if you break the rules of gym etiquette. They might even be trying to intimidate you so that you retreat to a safe corner where the cardio machines are. When you do eventually give up going to the gym (yes, the odds are stacked against you) you won’t be tempted to even consider returning.

Here’s my advice: ignore them. I know this is easier said than done, but I want you to focus on this. You’re not embarking on an exercise program so that people like you. You’re doing it to save your life. You’re doing it so that you can be stronger, run faster, live longer. Your goals are yours, and yours alone. Others in the gym don’t care if you fail or succeed. But you do.

Those others? They were beginners once too. They might have done biceps curls in the squat rack or tried talking to someone who was in the middle of a set . But 9 times out of 10 even the “regulars” can be pretty clueless, and that includes the personal trainers. The seasoned veterans who DO know what they’re doing didn’t learn everything overnight. It took time and practice and a willingness to ask questions and search for accurate information. And yes, even make mistakes.

Please don’t give up. Our kids are growing up in a world where everyone’s getting increasingly more sedentary. Technology has provided us with myriad more opportunities to move less. What we need now are people willing to buck that trend and establish another that moves us in the direction of more activity and a healthier future. They are people like you, who choose the first of the year to start something new.

You can do that, but you have to keep going.  Little by little, bit by bit.

And all those naysayers at the gym? I hope you kick their asses some day. Metaphorically speaking, of course.

I’m counting on you.

Obesity: You'll know it when you see it...or will you?

We need to be careful with how we throw labels around — psychologists are particularly prone to this, and sometimes we don’t consider the repercussions from careless diagnoses, official or not. Some of these terms are derived in ways other than how you’d expect. A perfect example of this is the term “obese”. Interestingly enough, while we imagine an obese individual to be someone who is very fat, it’s possible for an individual with low body fat and a LOT of muscle (think Mr. Olympia) to end up in the same category. That’s because the official designation of “obese” is based not on fat, but on height and weight, using the Body Mass Index. But once you label someone as “obese”, our imaginations run off with what else that means…

In health terms, an individual is described as obese when he/she has a BodyMass Index (BMI) of 30 or higher. BMI is calculated as:

weight (kg)/[height (m)]2.

That’s all. It simply means that the person has attained a certain, greater degree of overweight that has knocked them into a certain category. Note that there is no direct measurement of fat involved, and in fact, the correlation of BMI with body fat is rough and imperfect, but “kinda, sorta good enough”. However, in the realm of public health, collecting reliable data is critical to making accurate assessments about populations, and it’s easier to measure height and weight (which are fairly straightforward measurements) than to try to gather body fat data (generally more time consuming and fraught with user-errors). And because of that “kinda, sorta good enough” correlation, the BMI is used to determine whether a person gets knocked into the “obese” category. The BMI was never designed to diagnose individuals, as has begun happening. If you’ve ever played “Wii Fit” and wanted to throw the balance board at your TV screen, you probably know what I mean — BMI is all over the place and being misused regularly. Wikipedia does an unusually good job of describing the problems with overinterpreting BMI here.

So the BMI, the measure by which we determine whether someone is, or isn’t, overweight/obese, is simply a number that doesn’t have anything to do with body fat, really. HOWEVER, Merriam-Webster’s dictionary defines “obese” as “having excessive body fat”. Doesn’t that seem wrong? “Fat percentage” is not a variable in the BMI formula (have I stated that enough times in one post?), but the word “obese” by definition is based on body fat. And the designation of “obese” as it’s used in our daily lives becomes painfully emotional to many people.

I came across an interesting article (via Twitter, thanks to @AliciaMarieBODY) about an obese woman who managed to avoid looking at herself as she gradually put on fat, thereby ignoring the changes to her body, only to be confronted by her physician with the reality of her physical state. She knew she was heavy, but grossly underestimated her actual weight. When her doctor told her she was obese, her response was,

“It may sound unlikely, but I was genuinely shocked. In my mind I was far from obese. To me, obese was beyond fat  –  with connotations of someone who was greedy, lazy and uneducated and that wasn’t me.”

Wow! To her, it wasn’t simply excess weight or even fat, it was something much worse than that. It was a character judgment. How frightening that a simple measurement (BMI), calculated from two very objective measurements (height and weight), would be interpreted so subjectively.

Even the word itself — “OH-BEEEESE” — sounds unpleasant and bears a resemblance to ‘obscene’, so it’s not surprising that there are several levels of negative connotations wrapped around it. Obese suggests extremely fat to the point of being a circus sideshow. It sounds hideous and evil.

So, we’ve transitioned from simple body measurements to their interpretation as body fat to something that’s nasty. The issue is no longer a number, but rather a reflection of who the person is as a human being. That’s a heavy emotional hit for someone who sees themselves as merely “carrying extra pounds”…and then is confronted with the loaded label of “obese”.

Taking all these things into consideration, it’s not surprising that the woman’s quote above reveals something more insidious that merits consideration: even the obese are prejudiced against the obese.

While I’m not recommending that we take “obese” out of the English language, I hope that people understand how that designation arose. And even more importantly, that it’s not an immutable life sentence. It doesn’t mean you’re bad, lazy, gluttonous, stupid or anything else negative that some people ascribe to that label. It does mean that you should take stock of your habits and see if you’re one of those who needs to reduce their body fat levels to get themselves out of a high-risk category for a number of diseases.

Do you really know what you want? Do you know what steps you need to take to get it? If not, you’re going to be at greater risk of being swayed from your goals. What happens at the point when we’re faced with a decision whether or not to engage in a behavior that may or may not be detrimental to our goals? Our actions will depend in large part on how meaningful our goals are and how attractive the other option is. In a way, it’s a balance of those two factors. Knowing exactly what you want will help sway things in your favor and keep you moving towards where you want to be.

If most people have an opportunity to (1) eat a doughnut or (2) abstain in favor of their fitness goals, which one will win out?

Eat like Homer, look like Homer. (www.sfgate.com)

My money’s on the doughnut, and here’s why: most people don’t have a truly clear idea of what they want as far as fat loss goes. They want to lose pounds or “get into shape”. Some just want to “look good”. What do all of those mean? They’re very fuzzy goals, and as a result, achieving them will be difficult. How will you know you’ve reached the point where you’re “in shape”? What if you think you “look good” but then pass a mirror or see yourself in a photo and realize that you don’t look as good as the person next to you? What if you still “feel fat”? All these things make it hard to claim success…

And that’s why the doughnut is such a formidable opponent. In contrast to the uncertainties of fat loss, you know what you’ll get with the doughnut. The melt-in-your-mouth sweetness, the sugar rush…the desire for more. Those pounds you want to lose are so far away. The doughnut is here and immediate. It’s tangible. You can practically taste it.

Add to that, it’s easy to justify eating the doughnut, right? How much of a difference will one doughnut really make?

All of this is why it’s important to not only have clearly defined goals for fat loss, but also an understanding of the day-to-day steps you need to take to get there. Success is determined by your daily efforts. Your daily efforts are determined by your long-range goals.

When you know specifically where you want to go, and are aware of what you need to do every day, resisting temptation becomes easier. When the sun sets every evening, you can claim victory for another day, and the resulting changes to your body become your reward.

The kids’ great-grandmother was visiting for the past week or so, which gave us the opportunity to eat out much more than usual. Since March is National Nutrition Month, I wanted to close out the month with a few brief thoughts.

IHOP: Come hungy. Leave in an ambulance.

It IS possible to eat healthfully at even the most questionable of restaurants. We visited the International House of Pancakes one morning, where, among all the 1000-calorie entrees (bless IHOP’s high-carb heart, they provide a basic nutritional breakdown — printed in unobtrusive light gray — on their in-store menu) I found some remarkably reasonable ones. I dined on a modest grilled tilapia fillet with steamed broccoli florets. Forgoing the Hollandaise sauce (which, bless them again, they serve in a small dish on the side), I sprinkled on mild jalapeno Tabasco sauce instead. I admit, it’s a more unusual choice for breakfast, but it worked for me!

My next point: the fish was wonderfully petite. It wasn’t worthy of any “Oh, you should have seen the SIZE of that fillet” comments. It was served on a plate, not a platter. And it was perfect. As a culture, we’ve become accustomed to expecting mega-sized entrees with enough food to feed a family in sub-Saharan Africa for a week. We expect to finish the meal stuffed, unbuckling our belts and leaning back in our chairs with a huge sigh. And, oh, do we love getting a great deal! So much so that at some point, we ignore the fact that the food may be of lesser quality, as long as we get a lot of it.

Having said all that, do you really even need to read what I’m going to type next?

Is it any surprise that as portion sizes have increased — as “value” has increased — so have waistlines and with that the incidence of type 2 diabetes, heart disease, sleep apnea, osteoarthritis and certain types of cancer? Factor in the cost of health care, and that “value” maybe a bit too expensive for all of us…

Recently, I participated in a discussion about a proposed tax on sugar-sweetened beverages, during which one person expressed frustration that a tax would impinge on our freedom of choice. This concern is not new and many have argued that the government oversteps its authority when it tries to discourage consumption of foods deemed to be unhealthy. However, I found the freedom of choice argument very interesting because, in fact, nothing could be further from the truth.

Used to be, there was one type of Oreo cookie. Now, according to NabiscoWorld.com, there are fifty varieties of Oreos to choose from. FIFTY. There is an entire aisle in the grocery store dedicated to breakfast cereals, and yet think of how many people skip breakfast altogether (the estimates I found ranged from 20-40%)! You can’t drive far without passing a fast-food joint, and the last time I went to Fedex something, they had several shelves of candy conveniently close to the cashier, lest you get hungry while standing in line. And the list goes on.

You want something, you can get it, and umpteen varieties of it. Food choices have greatly increased in the past 20-30 years, and this explosion in variety has been implicated as a factor in the increase in obesity: we are likely to consume more when we have a variety of foods to choose from rather than when our choices are limited (Physiol Behav. 1981. 26(2): 215-221.; Obes Res. 2005. 13(5): 883-890.).

Need help finding anything?

To make things worse, much of this variety comes in the form of prepared, processed foods that require little effort to consume. You can find several types of squash in the produce section, but that’s nothing compared to the mind-boggling selection of chips in the snack food aisle, ready to eat as soon as you get them out of the store.

And yet, there’s also choice when it comes to exercise. So many different exercise classes, an overabundance of weight machines for every muscle group, a wide array of training protocols and cardio equipment at which you can stand, sit and lie. A flavor to suit every potential exerciser. All this, but about 70% of Americans do not exercise regularly, citing “lack of time” as the main reason…so the myriad of choices hasn’t resulted in more interest…

…however, consider that cable television providers offer over 900 channels of distractions. With that kind of competition for your time and appetite, is it surprising that many people have difficulty establishing healthy food and exercise routines?

My take on this is that we’re nowhere near in danger of running out of choices. Rather, we have far too many selections of the wrong kind of stuff for our own good. Most people expect government intervention in the food industry so that they can be confident that their food is safe. At the same time, Americans freak out if the government proposes legislation to limit access to unhealthy food because that’s viewed as infringing on our personal freedom.

And besides, we’re all smart enough to make healthy choices. Right?