Sanity Starts in the North

In Weight-Loss Maintenance on March 9, 2011 at 12:06 pm

I think Canada may have a fighting chance at keeping its “COACH” program from becoming another thinly veiled fat hatefest.  This is because Dr. Arya Sharma is calling out his forces, and maybe some balance and sanity will prevail.  Here’s the link to today’s post for you who are only now-and-again visitors to Dr. Sharma’s blog.  It is especially vital for you to visit this post if you are Canadian.  Click the button within his post that describes you, and enter the fray to reclaim your COACH program.

I considered clicking, even though I’m a US citizen.  I can mispronounce “about” to sound like “a boat.”  I can end every third sentence with an “eh.”  But I’m sure, eventually, I’d be outed, and it would be horribly embarrassing.

The COACH program seems to show some signs of innate sanity.  Its Readers’ Digest condensed description talks about “resources to manage . . . excess weight” not resources to lose weight.  It acknowledges that “eat less move more” is not a panacea. 

I also like that the acronym they chose, “COACH,” which suggests a helper, advisor.  I would change the words from Canadian Obesity Awareness and Control Initiative for Health (which, technically, would be COAHIC, anyway) to Canadian Obesity Acceptance and Commitment to Health.  For one, obesity has plenty of awareness.  Every idiot knows about obesity and has an opinion.  Control is, well, too controlling.  And often impossible.  What the developed world lacks is acceptance of obesity, and the understanding that it can co-exist with health.  Perhaps if the COACH founders had started with different wording for their acronym, then the idiots wouldn’t be trying to hijack the program today, and it wouldn’t be so vital that you Canadians go join Dr. Sharma and try to claim it back.

Meanwhile, how’s public policy south of the border shaping up?  Well, we’ve got Michelle Obama’s Let’s Move campaign.   Sadly, in the US, for some crazy reason, we have reached a consensus (enforced by “the American People,” excluding Democrats) that a society governed by the people for the people is inferior to a society controlled by the corporate elite to benefit the obscenely wealthy.  Therefore, for a government program to have any credibility, it must have corporate sponsorship.  Enter the Healthy Weight Commitment Foundation.  Doesn’t it just take your breath away to read this:

“The Healthy Weight Commitment Foundation, a CEO-led organization, is a national, multi-year effort designed to help reduce obesity–especially childhood obesity–by 2015. It’s a first-of-its kind coalition that brings together more than 150 retailers, food and beverage manufacturers, restaurants, sporting goods and insurance companies, trade associations and NGOs, and professional sports organizations. The Foundation promotes ways to help people achieve a healthy weight through energy balance–calories in and calories out. It focuses on three critical areas–the marketplace, the workplace and schools.”

Wow.  All these corporate CEOs care about our health and weight!  And they are so much more knowledgeable than, say, doctors and other health care professionals and researchers in the field.  I know that as a proud American, I feel really secure that all these processed food purveyors are committed to helping us:  ConAgra, Kraft, Sara Lee, Coke, Pepsi, Hershey’s, Nestle’s, Mars, Kelloggs, General Mills, Post Cereals (now merged with Ralston), and Darden Restaurants!  (A more complete list is on page 13 of the annual report).  How are they going to improve our health?  Well, in addition to sponsoring “Let’s Move” to get us exercising, they’re going to help us eat less!     

They’re committed to lowering annual caloric consumption in the US by 1.5 trillion calories by 2015, and sustain that level, so that as our population increases, our average calorie consumption (and waist circumference) will decrease.  See?  What’s really nifty:  among their strategies, they’re going to package smaller amounts in their single-serving products (without lowering the price, I’m sure), providing both a financial incentive and a physical limitation for us common people who might otherwise eat too much product.  Moreover, this creates higher profits for those CEOs.  How clever!

In case you don’t feel secure with all these processed food corporations protecting your health, just look at paragraph seven of the news release. They have a watchdog that will report findings! 

“The Robert Wood Johnson Foundation (RWJF), the nation’s largest philanthropy devoted exclusively to improving the health and health care of all Americans, also will support a rigorous, independent evaluation of how the Healthy Weight Commitment Foundation’s efforts to reduce calories in the marketplace affect calories consumed by children and adolescents. RWJF will publicly report its findings.”

The man, Robert Wood Johnson, you may recall, was the founder of Johnson and Johnson, the pharmaceutical company that now manufactures the Realize laparoscopic band for bariatric surgery (see pages 22 and 23 of this review of medical devices and diagnostics that the company provides its stockholders).  In addition to their lap bands, Johnson and Johnson recently tried to get a new weight-loss drug, Qnexa, on the market.  (Oh, well.  Back to the drawing board!)  Now, I don’t doubt that the Robert Wood Johnson Foundation is devoted to “improving the health and health care of all Americans,” but I bet they have a tiny agenda as to how that is best done.  For example, it seems to me that as long as we keep the focus of obesity on weight-loss behavior – eat less, move more – and behavior reliably fails 97% of the time, then people are gonna look for solutions to obesity from, oh, pharmaceutical companies, eh?  Eh?!

Hey, Canadians, it’s a-boat time you go reclaim your COACH program, lest it become “Let’s Move”!

  1. I hate to say it, but anytime you get CEOs involved with anything to do with “health”, you can bet your bottom dollar that it has more to do with them making money than it does with actually improving our “health”. Insurance company CEOs are involved with this HWCF? Well then, why don’t they think about making insurance affordable for everyone, stop cutting people out of getting insurance because of BMI/pre-existing conditions, and make sure that health care is actually affordable? That would cut into their profits, you say? Well, no one ever said they were entitled to billions of dollars of profits at the expense of consumers, despite what they seem to think. Same thing goes for the CEOs of those retailers, food and beverage manufacturers, and restaurants. They’ve been making huge profits off the way they process/market/grow food and now that they’re being blamed (sorta kinda maybe) for making people fat, they’re all for jumping on the bandwagon to “help people make healthy choices” (as long as it makes more money for them and doesn’t cost them profits, of course). As for the professional sports organizations, cynical me says it’s all about their bottom line too. They want young people to be healthy and fit so they have a large pool of talent from which to choose the best players, and they won’t have that if 2/3 of the country is “overweight/obese” (never mind that according to BMI, most of the players in baseball, football, and basketball are anywhere from overweight to obese to morbidly obese by BMI alone, if you don’t consider fat to muscle ratios), and they don’t take into consideration that fat can be fit too (even when they see it in action on their baseball/football fields/basketball courts).
    And the Robert Wood Johnson Foundation is a joke when it comes to improving the health of all Americans – they think improving health means losing weight if you’re fat and any cost you pay isn’t too high (yeah, I don’t think I want them overseeing anything, they haven’t done such a good job so far).

    • Oh, yeah, Vesta. Preach it.

      Something else I forgot. This lovely marketing campaign is disguised as a nonprofit 501 (c) (3)foundation. That means, depending on the IRS subcategory they were awarded (public charity v. private foundation), that all the money that flows into this may be tax-deductible and all the necessary equipment to fuel the activity (office supplies, etc.) may be purchased tax-exempt. Because, doncha know, it’s serving a charitable purpose.

      • Did you have to go and add this “nonprofit” information Debra? Sigh. No. I’m grateful, really, because of course I knew all this unconsciously…after all, it is only logical and typical and the status quo. But. Jeez.


        Sometimes I’d rather float down Duh Nile for a bit longer…

      • You’ve launched your blog!!! Welcome to the world of open thoughts, open wounds. (Should I reveal your other name, or do you want people to guess? Or just follow along for the ride as you morph?)

  2. I read Dr. Sharma’s post this morning while on my break at work and I was blown away. Thrilled to bits. And then, I started reading the regular weight-loss fodder and just wanted to scream.

    Questioning the validity of “eat less-move more” has become just as heretical as (insert heresy according to your religious preference here). Aside from a very small handful of bloggers, NO ONE, truly NO ONE, dares to say that ELMM is not the holy grail and is in fact, leading many into the lowest depths of eating disordered living.

    Some bloggers are nice about it (“I can do it! You can too!”) while they lament the 5 walnuts halves that they ate in a moment of “insanity” and proudly announce that they have banked 762 calories that the machine says they burned off at the gym (the machine that’s calibrated to a 165 lb., 5’10” man with 15% body fat, in other words nothing like the woman who’s under 5’5″, with lots more body fat and who probably only burned off a couple of hundred calories. if that, while on the machine).

    Other bloggers are downright vicious in their disdain for anyone who’s not actively trying to starve to death in the pursuit of weight loss. One of my “favourites” links to the bloggers he despises so that they can get hate mail from his rabid followers. Oh, and one of his followers suffers from anorexia and on her own blog frequently mentions how hungry she is all the time.

    In the meantime, TV tells us that we are fat because we eat like pigs and watch too much TV (lol). All we have to do is cut down our food intake, stop eating junk food, and work out every day and everything will be fine. And isn’t that what Michelle Obama says too?

    Yes, I am a good Canadian and I will click on the appropriate button on Dr. Sharma’s site, but Debra, I’m feeling pretty sad and defeated by the tsunami of ignorance and hate that surrounds us.

    I know, I should stop reading these people and watching these TV shows. I guess it’s my form of self-mutilation. Could I have an intervention, please?

    BTW, I’ve been told that we say “a-boot” here in Canada. Of course, it doesn’t sound like that me.

    Signing oot now…

  3. In his novel, “Infinite Jest,” David Foster Wallace portrays a not too distant future when years are named after (sponsered by) products, such as “The Year of The Depend Adult Undergarment” and “The Year of the Trial Size Dove Bar”. Yep.

    Clearly, we are fast approaching *The Year of the Realize Laproscopic Band*, because, you know, we need corporations to keep our best interests front and center, we need SOMEONE to monitor and control people’s weights, and who better than an organization that has proven it can count into the billions?

  4. What we need is a way to monetize the HAES paradigm.

    Im going to incorporate and trademark “Health Watchers” and charge people 10 bucks a week to check their resting heart rate and blood pressure. Then we can have motivational discuussions about how much fun it is to dance around the house to vintage disco music and share recipes for tasty foods.

    Everybody will keep a weekly food journal never actually look at it unless something made them sick.

    Maybe once ever 8 weeks or so, we can take blood samples to do a lipid profile or check A1C levels, and we will have fun fitness challenges, like doing cannonballs in the pool at the gym, or ringing Jillian Michael’s doorbell and hauling ass before she answers.

    You get to become a lifetime member when you can’t remember what you weigh anymore.

    Once it’s a profitable enterprise to pay attention to actual health measures and outcomes, the rest is cake!

    • “…cannon balls…and hauling ass..”

      O lord, I can see it now, the HAES world tour!!!!…with stand up comedy by Bobbini, cultural commentary by NewMe and vesta44, short films and plays written and directed by none other…organized, of course, by Debra…and…and…

      Must. Catch. My. Breath.

      Some fantasies make me swoon. 🙂

    • I like the idea of a “weight club” that is sort of a speakeasy for HAES.

  5. Canadians do not pronounce “about” like “a boat”; it’s just that other people can’t hear the difference between the two. It’s called “Canadian raising”. (Sorry for the derail, this misconception is a pet peeve of mine.)

    Personally I’m not sure what any kind of program, COACH or other, can do in the long run. Don’t we need more massive kinds of change, so that we are no longer living in an obesogenic environment? Don’t we need lots of people working on different parts of the problem? Some people/organizations pushing for banning advertising to children, some people/organizations pushing for media to stop pushing unrealistic body expectations, some people/organizations pushing for healthy food to be available in low-income neighbourhoods, some people/organizations pushing for walkable neighbourhoods with excellent networks of bike paths, etc.

  6. Bobbini: sign me up!

    • Okay, as for Bobbini’s Fantasy future, I have a small terrier, so I can provide a sack of flaming dog poop for Jillian’s doorstep.

      @Canadian — I think what you’re describing is a vision of COACH in some people’s minds: getting these various groups all on the same page and mobilized. Other people, however, would be content to push forward with a simplistic ELMM mission, not unlike the USA’s “Lets Move” fiasco. That’s why you gotta go vote, go speak, go participate.

      And, everyone, I don’t know whether it merits a full post, but today Dr. Sharma has started playing with the idea of using “obesities” in the plural, commonly. His post is Canada Needs a National Strategy to Tackle Obesities. Is it my imagination, or is he comin’ round an important corner in his thinking? Maybe I’m inflating his importance in this particular marketplace of ideas, simply because I like him and think he’s important, but I think that if he started doing this, it could signal a major shift. I would encourage anyone who has a spare moment to go give him a pat on the back.

      Hmmmm. Update: I put in a comment of encouragement on Dr. Sharma’s post, and I notice it’s been held up for “moderation.” It was probably too long. Among other things, I told him I didn’t think it was ridiculous to consider renaming the site using the word “obesities” instead of “obesity.” Something like Dr. Sharma’s Obesities Spotlight. I just saved my comment as a Word document. If he chooses not to run it, then I’ll create a post here tomorrow.

  7. He posted your comments. Everything I post gets moderated, but I don’t think he’s ever rejected any of it. Maybe he recently turned on post moderation, or maybe he thinks we’re all a bit dodgy. Certainly, I never would have commented on his blog if I hadn’t started reading the posts you linked to. I don’t go out looking for weight lose sites to troll, but I sure do feel like a radical voice there.

    • He didn’t reply to me in the comments, but he responded to you, DeeLeigh. I’d like to think that what he’s saying is that he helps his patients get important treatments. When other doctors say, “Well, try losing weight first and then I’ll consider treating you . . .” I’d like to think Dr. Sharma says he’ll treat his patients and also, if it’s their choice, work with them on weight management strategies. He is always careful to talk about “management” and not loss. I know I’ve read in his pages that he feels preventing gain is often enough.

      He’s very different from the doctors who do weight management that I have vaguely researched locally (trying to find some help with my own issues). Most doctors usually flaunt the word “loss,” don’t even address maintenance, and often appear to be thinly disguised sales reps for some product line of supplements or other diet goods. They read like flim flam artists. The field is shabby, me thinks, and he’s a rare exception.

      Now, while he didn’t respond to my comments, as NewMe points out in the next comment, he’s done something else that makes me quite happy. Whether I helped get that to happen, who knows? But it makes me happy.

      • He obviously means well, but he’s also deeply enmeshed in the weight based paradigm. Doctors don’t really know how to deal with fat people who aren’t interested in weight loss, because they rarely see us. We avoid them.

        The fat people they do see are desperate to lose weight and blame every problem they have on their size. They talk about how miserable it is to be fat, are very down on themselves, and blame every problem in their lives (or at least with their health) on their weight. I know because I’ve listened to this shit from family members all my life. “Why don’t you try taking a 1/2 hour walk every day or swim laps a few times a week?” I ask, “that will make you feel better.” But they don’t want to feel better unless it means becoming thin.

        I’m not proud to admit that I only manage to drag myself in for a routine checkup every 2-5 years, because it is often a very unpleasant experience. I’ll never forget the doctor who grilled me about my diet, tried to pick on innocuous aspects of it (a tablespoon of maple syrup on my morning oatmeal? God forbid!) because it’s actually pretty healthy, then yelled at me and threw my test results at me when they came out perfect. She was actually angry that there was nothing wrong with my health. Shouldn’t a doctor be happy and supportive when a patient is healthy?

        Wow. I really do have a thing against doctors and their attitude toward weight. But, it is based on long experience.

  8. Debra, I really liked your answer to Dr. Sharma. Hopefully, he’ll respond.

  9. SHARMA ALERT! SHARMA ALERT! Dr. Sharma’s post today (Mar. 11) is peppered with the letters “ies” to denote the plural, as in: obesities.

    Yeah! Fist pumping! Hearty pat on the back to Debra!!!

  10. Ah, DeeLeigh, he says he’s keeping an open mind on HAES after reading the Bacon/Aphramor paper. I don’t think we could ask for anything better than that. And maybe your remarks have helped him to feel good about keeping that mind open.

    Think about it, he’s devoted his brain to both a PhD and MD specializing in bariatrics. Imagine the amount of the other side’s assumptions he’s had to read, analyze, accept, over the years. Imagine the colleagues he has to deal with every day who still cling to all those assumptions. And yet, because of his practice, he’s come to see the multi-dimensionality of his patients and the complexity of fat. And, unlike most of the doctors in his field, he doesn’t see adiposity as a mere thermodynamic equation, or any single issue. I think he’s the one who came up with the phrase “Nightmare on ELMM street” that NewMe quoted in these comments. He’s a good egg, and he’s got the attention of people in this field of inquiry who count.

  11. DeeLeigh, I’d like to respond to your Sharma comment here rather than on his blog because I think the conversation will be richer here.

    One of the things about the current public discourse on obesities that we see is how weighted (OMG, pardon the pun) it is in favour of certain profiles/stereotypes: the binge eater, the emotional eater, the super morbidly obese person, the “food addict” (I particularly hate this one, but I digress), the lazy slob who takes the car to go across the street, etc.

    Not only do these stereotypes have an effect on the general public’s view of people whose adiposity “seems” to exceed the norm, but it also has a terrible effect on those who live with extra weight and who swallow these stereotypes hook, line and sinker.

    I recently tried to deal with this issue on my own blog. I wrote a post called “Who Are the Fat People?” because honestly, I don’t know any of the profiles that supposedly account for why people “get fat”. I know lots of fat people like you and me, whose health is fine (I’m putting aside my hereditary arthritis and thyroid problems), who eat well-balanced diets, who like to walk and move their bodies, and who just happen to be somewhat to right of the bell-curve.

    I think I’d like to say a lot more but I’ll have to leave it at that for now. My (also overweight) hubby and I are about to go on one of our several kilometre tramps around the neighbourhood. I guess we’re not acting the way fat people are supposed to act.

    • Thanks, NewMe. Honestly, I think that maybe I’ve been too contrarian at Dr. Sharma’s blog. It’s my natural tendency. I love to argue, and I tend to think that people in positions of authority don’t need to be coddled with carefully qualified statements. But I think that my tendency to get annoyed with doctors who are fixated on weight (which bariatric experts are, by definition) makes it hard for me to be balanced in what I post over there.

  12. Oh – and my point was, it’s nice to know that you saw what I was trying to get it.

  13. Doctors are unable to accept that they do not have the answers (solutions) to *fixing* obesity because they would have to call into question their entire paradigm of knowledge (epistemology); they would have to entertain the possibility that if THIS area of knowledge can be so widely accepted and disseminated and researched and practiced and believed, AND YET SIMULTANEOUSLY BE SO WRONG AND SO HARMFUL TO SO MANY, then what area of knowledge is *safe*?

    What can they/we hold on to (“The center cannot hold…”) in a world where structures of power and unseen forces of domination construct everything they/we THINK they/we know as knowledge?….

    Weight loss and so called “weight management” is one of the most important sites of knowledge to interrogate because these socially constructed foci intersect and are inextricably woven throughout/with economic interests, political, social, interpersonal, intrapersonal, etc. They are external and internalized forms of domination, tyranny…and the status quo depends on their continued distortions.

    The threat of a so-called paradigm shift opens the door to a world where all the now-overlooked/accepted injustices and inequalities become open for closer inspection.

    Indeed, “…the center cannot hold…”

    We are witnessing something monumentally more critical than weight and/or weight management, which are (with deepest apologies to those who sincerely believe we are examining these surface constructs) incredibly petty issues. In light of the actual stakes in the *game*.

    We are watching our widening pathway to the destruction of humanity, or a slim and very delicate portal for our salvation.

  14. Wow, RNegade. Here I am tryin’ to figure out what to wear to the darned Arts in Prison benefit, and you come along and remind me that I’m probably going to need something for the small and delicate portal for salvation too. Yeesh. Life gets so complicated.

    But, seriously, you are right. Bariatrics is metaphor. Big ramifications? I don’t know. Will our generation will see the center blow apart? Hmmmm. We humans are capable of trudging along in ignorance for millenia.

  15. Hee hee. I’m so glad you sort of glimpse what I’m getting at. Makes it more pleasureable. (Of course, even I don’t completely glimpse what I’m getting at. Or what would be the point of continued exploring?)

    Still. An awful lot of positivistic assumption within the notion that because folks have been operating in a certain fashion for millions of years then there is some increased odds(?) indicating that we will more likely than not continue to do so…

    Boy, that is one very tempting illusion to climb within and pull a comforter up around. 🙂 Cozy. And *safe.*

    Slightly shifting here, but still on the trail of medical knowledge…a while back a *prominent* individual associated with the medical field took the time (wow! holy cow! and etc.) to respond to one of my comments here, I suppose in defense of his/her profession, not sure because I never heard of him/her before and don’t recall or care the specific individual’s name or association. Okay. So. You know what I’m referring to, perhaps.

    It was a fascinating exchange in domination psychology. Me, a nobody, without even the possession of a pulpit (blog), and before I had even posted as RNegade in any major blog (except yours) *somehow* provoked a strong emotional reaction from said individual such that a bunch of generalizations and assumptions were spread (o so respectfully, of course!) all over the things I had supposedly written against the medical profession.

    Really subtle stuff (domination) going on there in the form of rhetoric. Imagine, if you can, I in my cutesy little animal-bedecked uniform standing in a hallway or a patient’s room in front of said individual (or any number of similar individuals, profession-wise), and I DARED to call into question the slightest bit of (holy) wisdom issuing from said person’s mouth. Yeah, like that.

    Now, in the former case where I’m just a quietly weird commenter on an upstart blog, not really within the reach of power of anyone other than the blog owner, I am EVEN STILL a threat of some unusual, yet important, kind. You gotta grasp the full ramifications here.

    Then in the case where I am in direct subordination to the dude(gender neutral term), who can decide whether I’m a *team playa* or not, who can twist my words and play the rhetoric game and see that I don’t have much chance of seeing a pay check in THAT town again, can we keep pretending that unacknowledged forces do not have enormous power over the kinds of knowledge that is created and shared, and the kinds that are squished? (LOL, sort of some hyperbolic fun happening now. Even so.)

    It’s nothing like poking a bear to see where the tender spot might be hiding under the fur. Because, well, that wouldn’t be any fun at all, it would be pretty sadistic and meanasty, especially a bear in a cage.

    But. Wildly fun and enlightening when it isn’t a bear at all. When it only believes it is a great big scary fierce bear. 🙂

    Hey, do good at the prison art thing. Art may save us all.

  16. Art and mercy. Yup.

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