Fat shaming needs to stop!

27 August 2014

Hi All,

This is an opinion piece by Dave Shaw a Dietitian on the way society treats obese individuals.  I think he is right in suggesting that with the spotlight being put firmly on Obesity in our community, there have been insidious changes in the attitude of society towards obesity.  There is some need for attitudes to change so that a healthy BMI looks 'normal' to the average person, but there is the risk that the changes swings too far to the negative and obese people bear the brunt of unhelpful opinion.  There is often a lot of detrimental self talk and image issues that go hand in hand with morbid obesity and adding baggage to this is not helpful.  And inversely, there are a lot of positive steps that can be taken to improving issues around obesity and generational obesity and these are the tactics as a society, that we should be focussing on.  Hope you are all keeping warm - not too much more winter to go! Regards,

Steph

Shame is no friend to health promotion. Yet, the way obese people are seen by the public is becoming increasingly similar to how we view smokers - almost shameful. And although aiming to achieve a healthy body weight is important, stigmatising and ostracising our bigger community are not effective motivators for change.

And for these reasons, a recent video has sparked a great deal of controversy as it crudely depicts the lifestyle of an obese individual.

 http://www.nzherald.co.nz/lifestyle/news/article.cfm?c_id=6&objectid=11313863

No doubt, we all have our opinions about health and how we should look. In some way, we are all biased. Which is why I write this to ask you, with no intention of being suggestive, have we lost sight of what a healthy body weight actually is?

Admittedly, many of us do need to change our perception about what a healthy weight looks like. Our obesogenic society has a tendency to consider being overweight as normal. I know, just as well as you do, it's not.

On the contrary, one could argue that many healthy people believe they are overweight when, in fact, they are not. But if statistics are anything to go by, then one argument heavily outweighs the other.

This may seem provocative, but are we simply too sensitive as a population to call a spade a spade and say, "you're too fat" or "you're too thin", and leaving it at that? No stereotyping. No stigmatising. No ostracising.

Therefore, no shaming. If this were the case, would those who did need to lose a few kilos be able to break through societal stigma to rectify the situation they have found themselves in?

Evidence shows shaming and blaming does not grow motivation. Obese women are a group constantly in the firing line of stigmatising messages and as a result, there could be devastating consequences on their mental wellbeing. Evidence also suggests that despite people believing controversial messages raise public awareness, individuals who feel ashamed of their weight engage in behaviours that reinforce weight gain or prevent weight loss.

Einstein once said, "we can't fix our problems with the same thinking we used that created them". A lack of public awareness, action and support has led to the demise of our health. To fix this, we have to change the way we think.

So, how do we help New Zealand children make healthy choices, when many adults are struggling themselves. How do we make the healthier choice the easier choice, when food manufacturers prioritise money over wellbeing?

Wagging a finger at the parents of obese kids isn't a step in the right direction. The increase in childhood obesity doesn't necessarily mean parental or medical neglect. But it does question whether enough action is taking place.

Wendell Berry, an American novelist, said "people are fed by the food industry, which pays no attention to health, and are treated by the health industry, which pays no attention to food". What do you think?

How many doctors actually ask their patients whether they need healthy eating advice and refer them to dietitians?

I believe most of us have the power to change and with great power comes great responsibility. However, being empowered requires knowledge, and at this stage, what the government and food manufacturers are doing to improve our education is not enough. Even with their earnest attempts to do so.

For me, diet is numero-uno, but I'll admit I'm biased. On some level, there is shame in feeding our loved ones with soft drink and chips everyday, when we know the destruction they cause. Knowledge underlies responsibility and it is our responsibility to care for those around us the best way we know how.

We don't all come from the same sperm and egg. So, we can't all eat the same and expect to look the same. There is no shame in asking for help. Obesity is not one-dimensional and we can't sit here waiting on the world to change. Small steps are crucial. The first step is changing the way we think about obesity.

Obesity raises risk of 10 common cancers

19 August 2014

I think you would all agree that this is fairly shocking reading!  Hot off the press from the NZ Herald this morning, this is a landmark study that has been published in a landmark Journal (The Lancet).  Population type studies are very costly and not frequently performed (because of this).  This one includes data from 5 million patients in the UK ie more than the population of New Zealand.  They also, if performed well, produce very powerful data that is generally quoted for years to come.  This is shocking and just provides more evidence for why the obesity epidemic should be treated very seriously.   Steph Ulmer

More than 12,000 new cases of cancer every year can be attributed to the patient being overweight or obese, the biggest ever study of the links between body mass index and cancer has revealed.

Overweight and obesity was closely linked to 10 common cancers, researchers said. Every five-point increase in BMI - equivalent to an increase in weight of around 17.5kg - was associated with a 62 per cent higher risk of cancer of the uterus, a 31 per cent increased risk of gallbladder cancer and a 25 per cent increased risk of cancer of the kidney.

Having a higher BMI was also linked with a greater overall risk of liver, colon, ovarian and breast cancer, the study by experts at the London School of Hygiene & Tropical Medicine (LSHTM) and the Farr Institute found.

While it has been known for some time that higher weight increases the chances of contracting certain cancers, risk levels have never been determined in such detail before.

The study, which is published in The Lancet medical journal, analysed the GP records of more than five million patients in the UK.

The researchers estimated that, if current trends in overweight and obesity rates continue, then by the mid 2020s there could be more than 3,500 additional cases of cancer every year.

"The number of people who are overweight or obese is rapidly increasing both in the UK and worldwide," said study leader Dr Krishnan Bhaskaran, of LSHTM. "It is well recognised that this is likely to cause more diabetes and cardiovascular disease. Our results show that if these trends continue, we can also expect to see substantially more cancers as a result."

Excess weight may account for as many as 41 per cent of uterine cancer cases, and 10 per cent of cancers of the gallbladder, kidney, liver and colon.

The study also found some evidence that, for prostate cancer and for breast cancer in young women, a higher BMI actually reduced the risk.

Precisely how fat could impact upon cancer risk is not fully understood. Dr Bhaskaran said that the variation in its impact across different forms of cancer said it must be affecting risk "through a number of different processes, depending on the cancer type".

Tom Stansfeld, health information officer at Cancer Research UK, said: "This study of over five million people has found new and stronger links between obesity and several different cancer types, highlighting the number of cancers that obesity causes in the UK.

"Although the relationship between cancer and obesity is complex, it's clear that carrying excess weight increases your risk of developing cancer. Keeping a healthy weight reduces cancer risk, and the best way to do this is through eating a healthy, balanced diet and exercising regularly."

- Independent

Dangerous Diets!

30 July 2014

This is an article from yesterday's New Zealand Herald.  And yes, it sounds dramatic but very restrictive diets are not only uninspiring and a short term fix only, but in addition, can be detrimental on your health!  The main problem with diets (and I'm sure anyone who has been successful with diets will agree) is that they are not sustainable.  This means that when you go off the diet the hard-earned weight that you have lost, comes back... and generally with a few extra kilos as well.  This is one of the most significant upsides to Sleeve Gastrectomy surgery for weight loss - you return to eating a 'normal' diet. This is why weight regain is less of an issue following Bariatric surgery than it is with dieting.  If you want to discuss surgical options more - feel free to ring my rooms for an appointment and I will walk you through Bariatric surgery.  Look forward to hearing from you. 

Regards,

Steph Ulmer

Cutting sugar completely could kill you

With the UN warning sugar could be 'the new tobacco' because of its risks to health through obesity, you might think a diet that cuts it out would get the thumbs up from experts.

But a group of scientists has just consigned a trendy sugar-free anti-ageing plan to a list of fad diets it dismisses as a waste of time and money, and potentially dangerous.

While dieters can forgo sugar in yoghurt, ready meals, dessert and biscuits, for example, having none at all is almost impossible.

"Cutting all sugar from your diet would be very difficult to achieve," said biochemist Leah Fitzsimmons, who even warned that such a drastic approach could be fatal.

"Fruits, vegetables, dairy products and dairy replacements, eggs, alcohol and nuts all contain sugar, which would leave you with little other than meat and fats to eat - definitely not very healthy."

The sugar-free diet was one of five assessed by dieticians, biochemists and other experts for the charity Sense About Science.

They also dismissed the caveman diet, said to be favoured by actor Matthew McConaughey, which holds that because we evolved eating a limited number of foods, we should return to our evolutionary roots and eat berries, vegetables and lean meat, while eschewing modern fare such as cereals, lentils, beans and dairy products.

But archaeologist Erika Nitsch said: "While it is true that fluffy white loaves of sandwich bread won't have been known to our hunter-gatherer ancestors, if you are worried about a healthy diet, have lentil soup, but skip the Mars bar."

Also rejected were diets that claim to selectively slim parts of the body by influencing hormones. For instance, it is said love handles are caused by an insulin imbalance and can be shrunk by eating less sugar.

However, biochemist Madeline Burke said: "There is no evidence linking hormone synchronisation and weight loss."

Read more: You are what you eat: How diet affects mental well-being

Meal-replacement drinks were also found wanting. Rob Hagan, a biomolecular scientist, said we need variety, not least to avoid 'losing your enjoyment of food' and becoming depressed.

The bizarre clay diet was also considered a health risk. Its followers believe a spoon of clay a day detoxifies the body, boosts the immune system and balances acidity levels.

However, dieticians warn it can cause problems from constipation to poisoning and say 'detoxing' is a marketing myth.

Sense About Science, which has created an online quiz on the issue called Spoof Diets, says: "People actually introduce malnutrition through overly restrictive diets... and they lose heart following unsustainable diets."

Catherine Collins, of the British Dietetic Association, said: "Fad diet promoters never let sound nutrition get in the way of persuasive marketing to promote their myths and generate profit."

- Daily Mail