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Monday, December 20, 2010

Weight Watchers Beware!

Ecstatic to freely eat bananas, for the first time in years—this was the sentiment at Thursday’s meeting. Finally able to select salmon—previously too pricey by their point system—this made them rejoice.

Most of my readers care little about Weight Watchers. But I’m writing this post because whether we realize it or not, whether we are “Weight Watchers” or not, their messages infuse into our culture and into our beliefs. They impact our thoughts about what’s acceptable to eat for health and weight management, whether they are myths or truths. Hearing some myth-information recently, I decided I needed to cut it short, before it spreads. I also wanted to point out a side of diets that most lose sight of—the damage they do.

Unlike those in attendance at their meetings, their cheerleaders who are pleased with their program and their successes, I get to see another perspective.

No Lifetime Membership for Sharon

Sharon came to see me for the first time this week, having never struggled with her weight. That is, until the past few years when it began to slowly climb.  That led this smart, level-headed woman to Weight Watchers. She followed their plan 100%, yet still gained weight. Encouraged by their new program, she figured maybe the old program just wasn’t for her. Two weeks into the new Points Plus system, she arrived frustrated and distraught in my office, and for good reason.

Sharon’s climbing weight made perfect sense to me, and with the recommendations we discussed I am confident she will turn things around. But I mention her because of how she changed as a result of the Weight Watcher’s diet.

Her whole life, she ate what she wanted, in moderate portions. She’d have ice cream at night—when she felt like it—but only as much as she needed. She had wine with dinner some nights, but just a glass, and she listened to and trusted her body. And it worked for all of her 38 years. Only recently, the balance wasn’t there.

Enter Weight Watchers. Her weight continues climbing, and now she is thinking about food all the time. She avoids the normal foods she always had, the moderate portions of foods she truly enjoyed, opting instead for lots of fruit (free on the new program). She moved from trusting her body, which had always worked for her, to trusting the program. And even if it had worked, it has totally impacted her relationship with food, and her ability to be normal. And this can happen with any diet, not just Weight Watchers.

So I went to a meeting. Yes, I decided to put on my journalist’s hat and collect information. I wanted to be fair and not misrepresent their program, to hear it from the horse’s mouth, so to speak.

Lori goes incognito

They were prepared to sign me right up, on line, and at the meeting. It didn’t matter that my BMI was in the normal range (I do have issues with using BMI, but we’ll take that up at another post). No one questioned the appropriateness of my joining, in spite of my normal weight. I could only imagine the damage done, if an eating disordered individual, also in the normal weight range, showed up. The messages, in my estimation, run counter to those supporting a healthy relationship with food.

Here’s what I saw and heard. Upon checking in, your progress is assessed. Behaviors? Thoughts? No, no, simply weight. Progress is measured solely in pounds. It doesn’t much matter how your weight changed.  No, the group leader isn’t inquiring whether you binged, then restricted all week, or if you purged before the meeting. You are praised simply for the weight change.

Now hopefully, those of you dealing with eating disorders or even weight management, in another setting, have experienced a different approach. When you see your team, progress should be measured not only by weight change, but by improvement in your thinking and preoccupation with eating and weight, by changes in your vital signs, and your energy level and sense of well-being.  Weight may not change one week, but we may see breakthroughs in how you cope with challenging situations without relying on food and disordered behaviors.

Those of you who really know me would have been so proud! I work hard to filter my thoughts, when they’re inappropriate, and to think before I speak. I could be sharp tongued, at times, when something really pushes my buttons. But at this 7:30 meeting I asked some naïve-sounding questions, and truly tried to listen to the answers. And I bit my tongue really hard.

It’s not about the calories? It’s about eating for health? Really?

“Can you tell me about the new point system?” I asked. “We’ve learned so much about weight loss,” the meeting leader replied. “It’s not just the calories, it’s the macronutrients,” she tells me, “the protein, fat and the carbs, besides the fiber, that determine your points.” Hmm. Has anyone taken basic biochemistry? Or maybe just high school biology?  Those calories in foods come from (drum roll please) those very macronutrients—protein, fat and carbohydrate.

Let me remind you that energy balance and weight regulation is about the calories. In a large Harvard study, they again showed us that weight change is the same whether following a low carbohydrate or low fat diet, by one year’s time, calories being equal. And similarly, for those on the other side, the weight gain is no worse regardless of which component of your diet you increase, calories being equal. And then there’s my favorite Dr. Haub study (see previous post).

What is true, is that certain food choices may make us more full in the short term. But this is not the wisest choice. We may find ourselves in situations getting too hungry, when that volume from liquid and fiber they promote, passes. That doesn’t help us sustain our bodies and our energy. And if we are struggling to recognize hunger and fullness, lots of water and water-filled foods will only mask your ability to listen to your body and its needs.

“It’s about promoting choices based on what we know about eating for health, so we encourage whole grains and less processed foods”, I was told. “It’s not about calories.” And yet, the unprocessed, whole grain brown rice has the very same point value as white rice. To me that would send a message that they are equal, no? And why is a glass of wine so high in points? Science does, in fact, support a glass of wine. And dark chocolate, I might add. Have they not seen that science?

Cocoa and chocolate, concentrated sources of polyphenols, have received much scientific interest and study. In fact, health benefit evidence regarding cocoa and chocolate were reviewed by the Dietary Guidelines for Americans Committee (2010). This session will review the cocoa bean's composition as well as the population-based and dietary intervention studies supporting the cardiovascular health benefits of consuming cocoa and chocolate. (from the American Dietetic Association 2010 conference guide).

Yet Karen, the leader, said “have the fruit first and that may satisfy. Then if you really need it, have the crap.” No, she didn’t use those words exactly, but that was what was implied. You know, “good food” first. In other words, don’t have what you really feel like.  Yet ultimately, after yearning for what you really want, you’ll eventually end up eating it having consumed both the calories from the fruit and the calories from the other item.

Not a diet?

Their materials work hard to convince us that it’s not a diet, but a lifestyle. They’ve got to be joking!  You’re given a plan, a number of points, and ways to count foods. And you’re encouraged to have all your points. There is little focus on self -regulation, eating what you need, as just as much as you need, based on your hunger and fullness. How can they not call this a diet?

They do, apparently have a plan that has you listening to your body, but that plan was largely dismissed at this meeting. And to truly be supported in that approach, an approach I completely support, it takes time, and exploration of eating triggers, and stress management tools, and one-on-one guidance.

So here’s the thing. There’s a place for sensible guidelines. These just weren’t so sensible. Adding structure to our day’s intake helps us not get too hungry, and I certainly support regular meals and snacks. And if you are at a place where you mask your hunger (with anything form large volume, low caloric-density items to coffee and diet sodas) than listening to your hunger with be a challenge—for now.

For those of you who don’t listen to your body’s hunger and deny your needs, a meal plan may have its place—for now. You should re-learn the tools to self manage, to listen to your hunger and your fullness, and trust them. Move out of your head, away from all the rules and information you’ve picked up. Work on becoming mindful—of what you eat and how it tastes. And tune in to what is making you eat—or stopping you from eating, in spite of hunger awareness.

That’s the work we have before us. And counting points isn’t going to resolve it, or improve your relationship with food.

It’s my hope that none of you need a lifetime membership. Let’s work on making changes that can change our relationship with food and our trust in ourselves, to help us for a lifetime.





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