Can obesity be “cured” by eating less and moving more? Here’s why It’s complicated.

September 6, 2024September 23, 2024 ~ Green Apple Dietitian ~ Leave a comment

I can still hear Marie Osmond in an old weight loss commercial saying, “If I can do it, you can do it,” as pictures showing her before and after weight loss splashed across the screen. In another commercial, she said, “I’d almost given up on myself. I needed help. I was overweight and that was unacceptable.” Ever since I’ve witnessed hundreds of similar messages encouraging folks to dislike what they see in the mirror. What we see in our reflection isn’t just our body, it’s also our life story.

Marie was a celebrity endorsement as someone who lost weight using the same program. In her script, she made a promise to the TV audience that could never be fulfilled. The claim missed the mark in so many ways. The biggest one was that most of the audience didn’t live the unique lifestyle she did. It was a time when we didn’t know as much about nutrition as we do now.

Behind the phrase “If I can do it, you can do it,” is a living breathing human being. In her book Behind the Smile: My Journey out of Postpartum Depression, Marie discusses a busy and stressful childhood in show business. She led a life encouraged by the folks around her to do for others but never for herself. It’s not surprising to learn she eventually lost direction and needed to get help.

In her book, she talks about the time when women were expected to follow traditional roles while never discussing their troubles. Women were not only solely responsible for the household and raising children they were also pressured to maintain the perfect thin ideal by strictly managing their weight. For Marie growing up in the public eye, the criticism must have been magnified a thousand times.

You are not responsible for your body weight

It’s understandable if these words make you feel uncomfortable, or emotional as your brain tells you how wrong it is. Every one of us was born into the anti-fat mantra which over time has taught us to believe we are not allowed to gain weight. Ever.

As early as I can remember, I was a girl who compared myself to others. In sixth grade, I was taller than most other kids in class, even the boys. As an adult I still find my thoughts wandering into wishes that I was younger and smaller. But I remind myself of what’s outside my control, which helps me direct my thoughts to other important areas of my life.

I suspect the so-called obesity epidemic was engineered to focus on body weight for reasons other than public health. Newspaper advertisements, TV, social media, holistic alternative treatments, and even traditional medicine demonize it. There’s a gray area that science doesn’t have full explanations for. Particularly the rise in eating disorders.

Generalizations about ultra-processed foods, sugary drinks, and the lack of exercise remain at the top of the blame game, yet nothing has been done to reduce their availability. More of these options are available than ever before. Instead, full responsibility is pushed on the consumer left to their own devices to make decisions based on an overabundance of misinformation. Something doesn’t add up.

There are plenty of scientific studies proving that weight loss has health benefits. Yet with all the expert discoveries maintaining life-long weight loss isn’t sustainable. Successful studies usually end with test subjects losing weight while achieving a positive health outcome. However, I have yet to find any follow-up studies proving the longevity of the results and whether the subjects are still engaging in the behaviors that resulted in the positive outcomes.

Why are you not responsible for your weight? Because body weight responds to many factors other than just calorie intake. Stressors like working long hours, getting older, getting injured, having a chronic illness, taking a new medication, having a baby, starting menopause, becoming depressed and anxious after losing a loved one— you get the idea.

Body weight is not completely controllable by voluntary decisions to eat less and move more. Everyone’s metabolism is influenced by multiple factors. How our bodies digest food is not under our voluntary control. Unless you’re an elite athlete, exercise contributes about 30% to the total energy expenditure compared to the metabolic rate which is 60-80%. The thermal effect of food (digestion) accounts for another 10%.

Aging also comes with many biological factors outside of our control. All kids go through the tanner stages as they become adults that will then go through the aging process. In each stage of life, hormonal changes are involved, which no doubt, affect our body size. So, encouraging beliefs that we have complete control of how much we weigh is ridiculous.

You are, however, responsible for your choices

Here are my thoughts based on the experiences I’ve gained while helping folks improve their nutritional intake, not for weight loss.

When it comes to your body:

You are indeed responsible for your food and lifestyle choices. Your body weight responds accordingly to whether it receives adequate nourishment or is deprived of nourishment. It also responds to periods of activity or inactivity. There’s no doubt some actions promote health while others deteriorate it, e.g., adequate daily exercise vs. smoking cigarettes. Building healthy habits as early as possible benefits you in some ways as you get older.

When it comes to your mind:

Good health usually doesn’t happen for someone with a negative outlook. Self-improvement comes from a place where an individual can forgive themselves for their missteps and treat their body with kindness. When they give themselves credit for the things they’ve accomplished and what they’ve learned along the way. It happens when there’s more empathy for mistakes made because of what wasn’t known before. When they can get to a place where there’s less self-doubt and criticism and approach life with an open mind. No expert practitioner can make a patient healthier unless the patient can act upon the options given to them. But sometimes folks need to take care of other things before that can happen.

How to uncomplicate bodyweight

Life is much more than a simple input and output equation. To eat less and move more lacks the basic understanding of human nature. So why does this advice still come with high expectations of it being so life-changing? Paying more attention to where these messages come from can give us a better clue because they don’t always come from a place that benefits the receiver. As Marie Osmond described in Behind the Smile… advice from people around you can have all the good intentions but usually isn’t a one-size-fits-all-all. Especially when it comes to body weight.

So where do you start?

Take the focus away from your body shape, and instead focus on your hunger. The human body needs to refuel every 3-4 hours. Become more accepting of when you feel hungry then eat soon after. Don’t wait too long to feed yourself or skip meals. Even if you don’t feel your hunger cues, it’s still important to schedule meals around the same time every day. Everyone feels hungry in different ways, so give yourself time to discover what your hunger signals tell you. When you gain a solid understanding of your hunger you will eat more often when your body needs nourishment and less for other reasons.

Keep your body’s need for fuel a high priority and your will weight trend where it’s supposed to. At its healthiest for you. A body appropriately fed means, at least from a nutrition standpoint, your mind functions at its best. After a while, you will feel more positive about what you see in the mirror.

DISCLAIMER: The Green Apple Dietitian blog/Substack provides nutrition information for education only and is not intended to offer medical advice or cure any health conditions. The content should NEVER be used as a substitute for medical advice, diagnosis, or treatment of any health condition or problem. Any questions regarding your diet and health should be addressed to your specific healthcare providers. NEVER disregard professional medical advice or delay seeking treatment because of something you have read here.

Green Apple Dietitian makes no warranties expressed or implied regarding the accuracy, completeness, timeliness, comparative or controversial nature, or usefulness of any information posted or shared on this blog/Substack. Green Apple Dietitian does not assume any risk whatsoever for your use of any information contained herein that was posted or shared on this blog/Substack in the past, present, or future. By accessing this blog/Substack, you agree that neither Green Apple Dietitian nor any other affiliated party is to be held liable or otherwise responsible for any decision made, or any action taken or not taken, due to your use of any information presented on this blog/Substack website.

As a Registered Dietitian, I Don’t Tell People How to Eat and Why You Shouldn’t Either.

July 30, 2024July 30, 2024 ~ Green Apple Dietitian ~ Leave a comment

Doing what I do for a living makes it hard to ignore the plethora of horrendous nutrition advice I hear from people around me or on social media. The hardest truth I try to accept is how my knowledge as a dietitian means nothing to someone with an agenda. When patients seek advice about healthy eating, it often involves something more complicated. Something no meal plan can fix. A negative sense of self makes folks vulnerable to misinformation and unsolicited advice that misses the mark.

I hate the word healthy as it relates to food. As I watch others preach about healthy eating all I see is an obsession with weight loss. While others act with a sense of entitlement, they dramatize and incite fear around what we eat. Most general nutrition advice people share is a culmination of inaccuracies or partial truths. Whenever I ask where they heard that, I hear something like “I don’t know, I heard it somewhere,” or “I saw it on TikTok.”

It behooves you to awaken your inner critic and question what you hear within today’s landscape of advice overload. The most educated choice will be one that’s made after careful examination of both sides of a story. Let’s take carbohydrates. If you’re unwilling to listen to unpopular evidence of why you don’t want to completely avoid carbs, you won’t learn what they can do to benefit your health. But there may be other reasons driving your choice to avoid carbs.

Most folks giving health advice don’t consider behavioral health a vital component of food choices. A patient with an eating disorder avoids calories for fear of weight gain, while another with OCD who loves animals becomes vegan to avoid feeling shame around eating meat. Both have less to do with healthy eating and more to do with a distorted view of themselves. These are serious mental health issues that often lead to severe malnutrition if left untreated. This is where dieting misinformation and unsolicited advice becomes irresponsible and self-serving. You don’t know what you don’t know, so it’s better to keep unresearched opinions to yourself.

The word healthy means different things based on who’s teaching it. For a vitamin supplement company, it’s nutrition supplements. For a dieting company, it’s weight loss. But not everyone needs a supplement or should lose weight. As a dietitian, answering the question, “How can I eat healthier,” is not easy to answer because everyone has their own set of core values tied to their food choices. Telling a patient what they should be eating won’t be as helpful as they would like to believe. The greatest success I have with patients is by not acting like I know best about what they eat.

Unsolicited advice doesn’t help in fact, it can be harmful

It’s natural when we perceive something is wrong, we want to fix it. Let’s say Anne noticed Sally gained weight recently. Anne cares about Sally’s health. She lectures her on how obesity leads to chronic illness and that she should find a way to lose weight. Sally was already aware of her weight and never asked Anne for advice about weight loss. Sally has been meeting with a therapist every week to work on her emotions around eating since her father died. Anne was not aware of that. Even with people who are close to us, we don’t know everything they struggle with.

Lately, it feels like everyone believes they know everything about everyone else’s health. So, it’s hard to explain why well-intentioned diet advice from Aunt Edna at the family picnic is short-sighted. But here goes.

Why I won’t tell others what to eat

People often don’t do what they say they’re going to do. It’s not because they’re lazy or they lack willpower. It’s because they haven’t gotten to the root of the real issue. Often folks believe weight loss will make them feel better about themselves. But what they want is to go back to a time when they were more active, had less responsibility, and felt happier. Even patients as young as eighteen reminisce about an easier time in their life. Growing up is hard.

Food choices often have nothing to do with eating healthy. Eating disorders are complicated mental health issues that often hide in plain sight. Consider a person who loses a lot of weight, and now everyone around them is saying how good they look. Senseless judgment, criticism, and unsolicited advice are detrimental to the person who is suffering. I don’t blame people who don’t know better, I blame our society that stigmatizes mental health and drags its feet in distributing helpful information to folks who need it.

Rigid thinking gets in the way of making lasting lifestyle changes. If there’s a reason not to do something, you’ll always find it. If you’re looking for negativity, you’ll find that too. The fear of uncertainty that comes with change is often why we talk ourselves into doing nothing. Getting out of your comfort zone is easier said than done, but there’s more power in changing your view of yourself instead of asking me how you should eat. What drives your actions is how you think and what you believe.

When my career was in its infancy, I made a lot of mistakes while stumbling over my personal biases to figure out the best way to help someone. The more I learn the more I realize there’s so much I don’t know. My experience came with paying attention and listening, not lecturing on nutrition facts. Unless a patient is willing to share their story, what I say means nothing. Giving unwanted or the wrong medical nutrition therapy is a useless waste of everyone’s time. Chances are great that many patients sitting in front of me thought I didn’t know what I was talking about. When it came to their personal experience with food, they were right.

GLP-1 agonists promise weight loss, but what about the consequences of perpetuating the thin ideal?

June 7, 2024June 8, 2024 ~ Green Apple Dietitian ~ Leave a comment

Over the last few years, the medical landscape has turned completely upside-down. With all the recent hype around GLP-1 agonists, we don’t need any more proof the world’s gone mad.

Semaglutides are effective for significant weight loss and may have other health benefits. Many great resources explain their effectiveness, so I won’t discuss them here. The main thing to know is they slow down the stomach’s digestion and curb appetite, which can result in weight loss. However, some people lose their appetite completely and stop eating. This is where I have a problem.

Losing your appetite is a serious side effect that can lead to severe consequences

Significant weight loss in a short amount of time puts patients on the fast track to malnutrition. Fat cells don’t go away, they shrink. Unintended loss of lean muscle mass diminishes strength, stamina, and resting metabolic rate.
Dehydration and constipation are major side effects of weight loss that need immediate attention.
Gastroparesis which is claimed to be a rare side-effect of GLP-1 should be assessed by a health practitioner.
Significant weight loss and meal restriction are associated with depression, anxiety, and disordered eating.

No one is immune to the pressures of the ideal body weight

I’m not pretending that I understand another person’s struggle with weight or health issues. As a female living in the US, I’d be lying if I said I never experienced negative thoughts like feeling bad about my body size, being unhappy about what I see in the mirror, or feeling guilty after eating certain foods. Conducting medical nutrition therapy sessions over the years has fine-tuned my ability to pick up on the hatred of fat in our society, and how people sell themselves short because of their body size. Let me tell you it’s no picnic to inform patients I don’t specialize in weight loss. The conversation often comes to an incredibly uncomfortable abrupt end. It’s an emotional hot button that’s impossible not to push.

The psychological perspective is always ignored

We all know there are consequences for our actions. The likelihood of maintaining a healthy weight decreases If you are clinically depressed and anxious. There’s no doubt in my mind that mental health issues affect normal eating patterns. So, chances are your weight will go up or it will go down. No matter the direction it won’t be healthy or sustainable if you don’t find a way to deal with reoccurring issues in your life that are holding you back. A healthy mind usually follows a healthy body. Usually. If someone spends most of their time dieting, there’s no way they feel good about themselves. That’s where the focus should be, not on body weight.

What adds to this is when well-intentioned friends, loved ones, and health practitioners validate a person’s bad feelings about themselves and comment on their weight. If you’re somebody who comments on other people’s weight stop it. It’s not helpful and you’re not earning points by doing it. It was once said that if shaming worked everyone would lose weight. Well, it doesn’t. So, knock it off. If people in larger bodies bother you, maybe you should find out why that is.

Are GLP-1 agonists the cure for obesity?

I don’t believe obesity is a disease the way social media preaches it. It’s way too complicated for medication to “make it go away.” As I see it the medical profession continues to ask people in larger bodies to sacrifice way more than thin people to be healthy. As much as it’s proclaimed that side effects are not the norm for most people, it isn’t comforting to those who’ve taken the drug and experienced gastroparesis gotten so bad they couldn’t get through the day without vomiting to the point of severe dehydration. For them, the “rare side-effects” have made a huge impact on their lives. Either way, it’s a lot to expect from folks when there are so many other factors that cause ill health other than obesity.

It’s too early to know what the long-term efficacy will be

If you don’t have an eating disorder, there’s reason to believe you could develop one while taking semaglutides. Medically induced appetite suppression still leaves us with many questions. But what we do know is that severely restricting dietary intake and losing a significant amount of weight messes with the brain and creates an unhealthy obsession with food.

If you’re considering semaglutides for weight loss, you still need to make major lifestyle changes. It’s not a magic pill. You are still responsible for the outcome. An adequate diet and exercise will be necessary to get results. Don’t do it alone. There are plenty of great dietitians out there. Remember no one can predict how your weight will trend within your lifetime. You might need to take the drug for the rest of your life. With the recent shortages, you might not be able to take it the way it’s prescribed. Most importantly, think about how you might feel if your weight doesn’t trend the way you want it to. Semaglutides won’t do much for your mental health.

Increase your awareness by being a devil’s advocate

For every practitioner prescribing this drug, there’s a pharmaceutical company with an inexhaustible marketing budget earning record profits. Semaglutides are already in a nice comfortable space within the diet culture which has welcomed them with open arms. You can be sure there are plenty of weight loss companies vying for the extra dollars by adding them as a weight loss option.

As a consumer, you have the choice to take the wait-and-see approach. Dig your heels in. Don’t let the catchy jingle on the commercials or the celebrity weight loss stories give you false hope. Learn about every side-effect and don’t be afraid to ask the tough questions. In the grand scheme of things, you are the strongest advocate for your health and well-being. No one knows more about what you need than you do.

DISCLAIMER: The Green Apple Dietitian blog provides nutrition information for education only and is not intended to offer medical advice or cure any health conditions. The content should NEVER be used as a substitute for medical advice, diagnosis, or treatment of any health condition or problem. Any questions regarding your diet and health should be addressed to your specific healthcare providers. Never disregard professional medical advice or delay seeking it because of something you have read on this blog.

Green Apple Dietitian makes no warranties expressed or implied regarding the accuracy, completeness, timeliness, comparative or controversial nature, or usefulness of any information posted or shared on this blog. Green Apple Dietitian does not assume any risk whatsoever for your use of any information contained herein that was posted or shared on this blog in the past, present, or future. By accessing this blog, you agree that neither Green Apple Dietitian nor any other party is to be held liable or otherwise responsible for any decision made, or any action taken or not taken, due to your use of any information presented on this blog website.