Thursday, October 30, 2008

Calories Do Count

By KIM SEVERSON

Published: October 28, 2008
The New York Times

This is a follow-up post to: "Read 'em Before you Eat 'em"

WHEN you’re young and tap dance for a living, you don’t have to think much about the caloric impact of your next meal. But when three performers who spent the day rehearsing for “Shrek the Musical” walked into a restaurant on 42nd Street recently, they saw on the menu that a Japanese-style beef bowl had 1,090 calories. They decided to head down the street for a salad.

"If Americans cut all processed food from their diet ... and focused on fresh, high-quality food in smaller portions, then that would be a real step in the right direction."

“Counting calories is so 1980s,” said Rachel Stern, one of the dancers. “But when it’s right there, it’s kind of hard to ignore.”

For the last few decades, the most popular diets were complex formulas that promised abundant eating with just the right combinations of fat, protein and carbohydrates. Now those regimens are starting to look like exotic mortgages and other risky financing instruments. And just like a reliable savings account, good old calorie counting is coming back into fashion.

“More and more, people are looking at calories in, and calories out,” said Dr. Terry Eagan, a Los Angeles psychiatrist, who for 16 years has helped people with eating disorders and other addictions. “I know some people want something that’s sexy and different and new, but there really isn’t anything new about weight loss.”

Evidence of the calorie’s resurgence is everywhere. The makers of Coca-Cola and M&Ms will soon print calories on the front of packages. Consumers, too, are paying more attention, like the diners who discovered that some meals at Applebee’s had more calories than advertised and filed a class-action suit this fall.

New Yorkers got a harsh dose of calorie reality this summer when restaurants with 15 or more outlets were forced to post the calorie content of food next to the price. The resulting sticker shock has brought parts of a great city to its knees, often to do push-ups.

The campaign has inspired lawmakers around the country to follow New York’s lead.

Restaurants and food companies are lightening recipes and portion sizes. Starbucks, for example, claims to have saved the nation 17 billion calories since last October by swapping 2 percent milk for whole. The 100-calorie snack is this decade’s answer to the fat-free SnackWell cookie, as more brands introduce tiny portions of things like Cool Ranch Doritos and Clif bars.

Dunkin’ Donuts recently added a low-calorie egg white breakfast sandwich, Così is using low-fat mayonnaise and McDonald’s large French fries have dropped to 500 calories this year from 570 last year. Quiznos is testing smaller sizes and less-caloric sandwich fillings in its New York stores. Cathy Nonas of the New York City health department said this is all a reaction to public-health pressure.

Restaurant corporations say consumer demand, not the threat of legislation, made them change. That’s why Yum Brands, which owns KFC, Taco Bell, Pizza Hut and other fast-food restaurants, will start voluntarily posting calorie counts for individual servings in its restaurants nationwide later this year, said Jonathan Blum, a company spokesman.

At Starbucks, a new set of “nutritional guardrails” were put in place over the last year not because of legal mandates but because customers wanted it, said Katie Thomson, the company’s nutritionist.

Products were reviewed for calorie and fat content. Bakers were encouraged to substitute healthier ingredients or, if that would compromise taste, to reduce portions, as the company did with its butter croissant. Starbucks also considered how much satiety items would provide, something increasingly important as people cut back on calories, she said.

For some establishments, having their menus exposed by the New York law forced some caloric housecleaning. At Le Pain Quotidien, which has 17 outlets in New York, several items were changed or taken off the menu, said Jack Moran, a vice president.

The popular quiche Lorraine was trimmed to 6 ounces from 11, with extra salad filling out the plate. Sweets like brownies may shrink, too.

But consumers who think smaller portions will mean smaller prices are likely out of luck. The prices on some of the chain’s newly slimmed down items haven’t dropped, but that doesn’t seem to be affecting sales.

“Everything we consider to have a good caloric rating is marching up the charts,” Mr. Moran said.

The Atlantic smoked salmon tartine, with 350 calories, was always a good middle-of-the-pack seller among the 15 open-face sandwiches that are a specialty at the chain. After the calorie counts were posted, it became a top seller, edging out the longstanding favorite, the grilled chicken and smoked mozzarella tartine, which has 690 calories and costs about $3 less.

Reducing calories is now a company-wide quest, and the chain is posting calorie counts in its restaurants in Washington and Los Angeles.

If reduced portion sizes remain popular with customers, it could help restaurant operators who have been bearing big jumps in food costs this year, Mr. Moran and other restaurateurs said.

Public health officials acknowledge that people rarely change their eating habits overnight, and that there is a lot more to good nutrition than simply counting calories. Still, they are trying to make sure consumers stay calorie conscious. Just to hammer the point home, the New York City health department earlier this month put signs inside subway cars pointing out that most people need only about 2,000 calories a day.

The number of calories in food shocked most New Yorkers, according to a September survey by the health department. A Starbucks blueberry scone delivers 480 calories. A Quiznos regular tuna melt is 1,270 calories. Wraps, the refuge for low-carb sandwich lovers, can top 800 calories. Bagels pack more calories than doughnuts. A large bucket of buttered movie popcorn has more than half the calories anyone should eat in a day.

Even people for whom nutrition is a way of life had no idea how many calories they were eating. Kate Adamick, a consultant who helps corporations and school districts improve their food, took a hard look at her Starbucks habit, which included bran muffins and chocolate cookies.

“Just because I work in the food world, I am not immune from this human tendency to self-delude,” she said. “I can look at a cookie that is the size of a man’s hand and think it’s only twice as big as a regular cookie, but it actually has the caloric content of four or five cookies.”

Posting calories on menus is a kind of Hail Mary pass for health officials trying to slow rates of diabetes and obesity. But it is catching on fast. California last month became the first state to require calorie counts, although that law is less restrictive than New York’s.

In all, nearly three dozen states, cities and counties have passed or introduced laws that would require calorie posting in some form. More are in the works, said Margo Wootan, director of nutrition policy for the Center for Science in the Public Interest, which frequently criticizes the food industry.

Two proposals moving through Congress would make calorie postings uniform nationwide. One, the Labeling Education and Nutrition Act, is backed by the restaurant industry and would give restaurants and grocery stores selling prepared foods a choice of labeling formats, including posters near the cash register or disclosures on the back of the menu. It would pre-empt tougher laws, like New York’s.

A second proposal, the Menu Education and Labeling Act, is supported by public health advocates and more closely mirrors New York’s law. It would not pre-empt more stringent local laws.

Of course, for the calorie’s comeback to be sustained, people who are not already focused on a healthy diet will have to begin paying attention.

At a Chipotle near Brooklyn Borough Hall, Daniela Castillo, 18, dishes up carnitas between classes at Brooklyn College. The customers talking calories, she said, are mostly women, and mostly slimmer older women. Men, especially the younger ones, just ask for everything, and often ask her to double the portions.

“I think it’s kind of a middle-age thing, counting calories,” she said.

People might be changing their eating habits, but some restaurant owners remain skeptical — especially those who have already offered lower calorie food only to see those items languish.

“We talk skinny and eat fat,” said Tim Ryan, president of the Culinary Institute of America.

And it has been that way for a century.

The first calorie-centric weight-loss guide, “Diet and Health, With a Key to the Calories” by Dr. Lulu Hunt Peters, was published in 1918 to great acclaim. Her weight-loss formula? Eat in 100-calorie portions, and no more than 1,200 a day.

Sunday, October 12, 2008

One Healthy Team


Husband and wife achieve weight-loss goals together

By Steve Palisin

Published: October 08, 2008
The Sun News - Myrtle Beach, Fl

Tonya and Newt Merrick of Longs tag team not only as teachers at North Myrtle Beach Elementary School: They've made getting into shape by their 50th birthdays next year their goal together this year.

After each day at work, where Tonya teaches second- and third-graders art and he teaches physical education, they hit the gym together to work out.

Sharing home-made pasta salad during a lunch break last week, the Merricks talked about their exercise routines. In a T-shirt and knit shorts, he already looked dressed for an after-school workout because of the gym classes he leads all day long.

Tonya Merrick likes to turn her workouts into combinations of activities. She uses free weights, elliptical machines and various classes, such as Pilates, her favorite.

Running is Newt Merrick's choice activity. It's how he got into regular exercise. He would run as far as he could, then walk, then run again, and so on. He said his latest run covered 4½ miles in 36 minutes.

Besides coaching boys' soccer at North Myrtle Beach High School, Newt Merrick plays soccer in an adult league he started, the Fat Man League.

"He used to be the 'fat man,' before he lost 60 pounds," Tonya Merrick said.
Her husband weighs himself daily, she weekly. He is down to 208 pounds and wants to get to 203.

The Merricks, married for 16 years, also play golf and tennis with their two children.
The couple find their energy level higher after a day in classes and the gym.
"It's a different lifestyle," Newt Merrick said. "You have to change everything."

Falling out of his running routine is out of the question, because weight gains would result.
"It's simple to put it on," he said. "It's almost impossible to take it off."

Tonya Merrick gets creative with exercise at school. She said because the students already might have spent time mostly sitting down in other classes or before recess, she gets them on their feet, using jumping jacks to spell out colors for instance.

"I talk about muscles, which are used for cutting and sketching," she said.
The children flex their limbs when looking for objects hidden around the room for a Picasso project, for example.

"I just try to intersperse movement in my lessons in some way," Tonya Merrick said.
The pair use their willpower with food; that's why they bring their own lunch.

"We still eat three meals a day," Tonya Merrick said, but in smaller portions. They try to avoid breads and sweets.

The cook between the two, Tonya Merrick grills and sautes a lot of vegetables, with only a little red meat and lots of salads.

Fruit serves as their snacks, and water their main beverage.
Even when they dine out, they usually share one entree.

"It's plenty," Newt Merrick said.

Sharing the lunch table with the Merricks, Megan Magnotta, the school's other physical education teacher, remarked on the couple's good influence for fitness and diet.

Magnotta munched on a salad and some warmed-up sliced potatoes brought from home.
She and the Merricks said in their efforts to be good role models for children and parents, they resist the temptation to overindulge in candy or other goodies.

"You just eat one of something instead of the whole bag," Magnotta said.

Friday, October 10, 2008

Protecting Your Most Valuable Asset

When you think about your "most valuable asset" what comes to mind?

Is it your Job?

Is it your house?

Is it your stock portfolio?

How about the people who love you?

All of those things are valuable (some, more than others - I hope!) but are they the most valuable?

Well, let me put it another way... if you ceased to exist, would any of these assets have any value to you at all?

Think about it - you, are your most valuable asset, because without you none of it matters.

So, how do you protect you, and prevent your most valuable asset from depreciating?
  • Practice stress reduction techniques, and try to tame your anxiety and its effects on you and your body.
  • Make sure you're getting enough rest, and that you're making time for leasure activities with family and friends.
  • Exercise, Exercise, Exercise and make sure that you're feeding your metabolism delicious and nutritious meals full of macro and micro nutrients so that your energized all day long.
Focus on what you can control - YOU! And that way you can really enjoy your other assets.

To read my previous post on dealing with stress -
Go To:motivatedandfit.blogspot.com/2008/03/as-fitness-professional-i-deal-with.html

To learn more about stress, visit: The National Institutes of Health, The Centers for Disease Control and Prevention and The American Institute of Stress

Related Articles:

How to Quell Financial Anxiety

By PHYLLIS KORKKI

Published: October 18, 2008
The New York Times

Q. Day after day of economic turmoil is making it hard for you to concentrate on your work. You can’t stop worrying about your job security, your retirement portfolio and your whole future. Is this normal?

A. It’s only natural to feel anxious during a financial crisis. But understand that anxiety can distort reality, disrupt thinking and erode performance — unless you take steps to manage it.

“Our minds are trying to protect us by bringing up things we should worry about,” said Margaret Wehrenberg, a clinical psychologist in Naperville, Ill., and co-author of “The Anxious Brain.” Too easily, though, these negative thoughts can crowd out all others as they replay in an endless loop inside the brain.

“Right now, the whole United States is a little uptight,” Dr. Wehrenberg said. But the feeling is worse for people “who tend to ruminate a lot anyway and have a hard time turning off those worried thoughts,” she said.

Psychologists distinguish between fear, which has a specific cause, and anxiety, which may not. “One of the things that makes anxiety so debilitating is that you can’t entirely put your finger on it,” said Sigal G. Barsade, associate management professor at the Wharton School of the University of Pennsylvania and an expert on group psychology.

Q. How can anxiety affect people’s work?

A. Anxiety creates cognitive distortion and can make it harder for people to concentrate and to process information, said Myra S. White, a clinical instructor at Harvard Medical School who focuses on workplace performance. Their decision-making is impaired, and they are more likely to make mistakes, she said. Because they can’t listen as well, they may need to have instructions repeated to them several times. They may also have shorter fuses and become more impatient.

“Anxiety is living in the past or the future; it’s not living in the moment,” Dr. Wehrenberg said, so the work in front of you is bound to suffer.

Q. Can your co-workers have an effect on your anxiety level?

A. It is very easy to “catch” anxiety through a process known as emotional contagion, Professor Barsade said. Densely populated workplaces, she said, are particularly vulnerable to this phenomenon.

So if one of your colleagues is moaning that her portfolio has fallen 40 percent and that she will never be able to retire, or another is ranting that your company is sure to go under, be aware that you could “catch” their emotions almost as if they were colds.

“Stay open to both positive and negative emotion,” Professor Barsade said. The key to absorbing negative emotions is “to take them in but not let them take over,” she said.

Professor Barsade said anxiety might be worsening the financial crisis. A kind of collective anxiety — in part emerging in the workplace — could cause people to take overly drastic actions with their money, which could hurt the economy, she said.

Managers need to be aware that their employees are feeling anxious now, Professor Barsade said. They should let employees express their anxiety — and should discuss and clarify the company’s situation honestly.

Q. Are there physical aspects to anxiety?

A. “Anxiety can wreak havoc on the body,” said Dr. White, who has a doctorate in psychology. Physical symptoms, she said, can include a pounding heart, sweaty hands, headaches and indigestion. Anxious people tend to hold their breath and take shallow breaths, she said, so work on taking deep breaths, especially when you exhale.

Yoga, meditation, exercising or simply taking a walk can help dispel symptoms, Dr. White said.

“Any time you’re really stuck in your mind, moving your body helps shift it,” Dr. Wehrenberg said.

Q. What else can you do to tame anxiety?

A. Ms. Wehrenberg recommends this strategy: worry once and do it well.

In other words, if you’re going to fret, be systematic about it and get it over with. If you’re concerned about your finances, for example, meet with a financial planner and decide what steps to take to protect assets as best you can. If you’re worried about losing a job, update your résumé and lay all the other initial groundwork for a job search. Then focus on the job you still have; that is something you can control, as opposed to some horrific future scenario that may never occur.

If you start to feel anxious about your job or your finances, remind yourself that you have a plan and that you have done everything you can do at this time, Dr. Wehrenberg said. Say to yourself, “Stop, I already worried,” then pull yourself back to your work, she said.

“Think about what you’ve got in the now. Today you’re O.K.,” she said. “Focus on what you have instead of what you don’t have.”

She says she has patients who feel that they aren’t allowed to enjoy themselves because of the economy. “It’s not going to ruin your portfolio if you play or go out with friends,” she said.

But if you feel overwhelmed by anxiety to the point that you can’t finish your tasks or are having destructive thoughts or abusing drugs or alcohol, you should seek professional help, she said.

Women's Heart Symptoms Often Blamed on Stress

By Tara Parker-Pope

Published: October 13, 2008
The New York Times

Signs of heart disease are more likely to be blamed on stress when the patient is a woman, new research shows.

In two studies, 230 family doctors and internists were shown sample cases of a 47-year-old man and a 56-year-old woman. The ages of the patients reflect an equal risk for heart disease. Half the vignettes included sentences indicating the patient had recently experienced a stressful life event or appeared anxious. The doctors read the case and offered a diagnosis and treatment recommendations.

When the case study involved standard heart symptoms like chest pain, shortness of breath and irregular heart beat, there was no difference in the doctor’s advice for the man or the woman. However, when stress was included as a symptom, gender differences emerged. The presence of stress changed the way doctors interpreted a woman’s symptoms, prompting them to suggest psychological factors rather than physical causes. But the presence of stress didn’t change the way men were assessed.

When stress was listed as a symptom, only 15 of the doctors diagnosed heart disease in women, compared to 56 percent for men. Only 30 percent of the doctors referred the women to a cardiologist, compared to 62 percent for men, and 13 percent suggested medication for women, compared to 47 percent for men.

The findings, presented at the Transcatheter Cardiovascular Therapeutics scientific symposium, could help explain why there is often a delay in the assessment of women with heart disease, said Dr. Alexandra J. Lansky, a cardiologist at NewYork-Presbyterian Hospital/Columbia University Medical Center.

Upgrading the Stress Levels

By PAUL BURNHAM FINNEY

Published: October 13, 2008
The New York Times

As if the shoes-off routine, charges for checked bags and missed flight connections were not enough, business travelers now have to cope with a global financial crisis that is diverting their attention as well as rattling their contacts here and abroad.

It all adds up to a spike in the unusual stresses that plague business travel, from unfamiliar hotels to sudden switches in travel plans. Experts at the Mayo Clinic and Harvard Medical School along with independent psychologists agree that road life now is more stressful than in the past.

“Back in the 1980s, you could drive to the airport and walk to the gate without thinking of terrorist threats or banks collapsing,” said Rex P. Gatto, a business psychologist based in Pittsburgh. “Now there’s only anxiety.”

In its latest annual “Stress in America” survey, based on 2,507 online interviews in September, the American Psychological Association found that the crisis on Wall Street was the No. 1 cause of anxiety. And participants in the survey said the places where they felt most vulnerable to stress were in the office and on a business trip.

Researchers have uncovered links between the stress experienced by frequent business travelers and dozens of physical ailments, including some cancers and heart disease. A landmark study of some 10,800 employees at the World Bank in 1997 found that those who traveled accounted for 80 percent more medical claims than nontravelers.

In the current economic turmoil, Nancy Molitor, a psychologist in Wilmette, Ill., an affluent Chicago suburb, said that many more of her clients had problems related to stress. “In my 20 years of practice I’ve never seen such anxiety among my banking and business patients,” she said.

The globalization of business had already added to the stresses of business travel.

“When you travel in another country with another culture and try to get multitask projects done to meet deadlines, you can feel overwhelmed,” said Dr. Abinash Virk, director of the Mayo Clinic’s travel program.

Several of the experts said technological advances might be adding to the troubles. “Technology is not the best friend of business travelers,” Mr. Gatto said. “Getting e-mails all day. Doing a deal on your cellphone while trying to beat the long lines at an airport. Frequent fliers just take on too much.”

Dr. Mary FitzPatrick, associate professor at Weill Cornell Medical College in New York, said she believed “the Internet keeps people in touch more than they should,” adding: “And there’s the CNN phenomenon — a constant, 24-hour barrage of disturbing news.”

Of course, stress is not all bad. It can make workers more productive and resourceful. The physiologist Hans Selye, called the father of stress research, identified “good” stress — the adrenaline rush that helps people overcome obstacles — and “chronic” stress, which may easily turn into distress.

Some travelers are better able to deal with the travails of business trips than others. Take a flight delay of several hours, for example.

“When the word comes over the loudspeaker, some passengers take it in stride — watching TV, browsing the shops — while others can’t stop running up to the counter for the latest update,” said Howard Glazer, associate attending psychologist at New York Presbyterian Hospital. “There you have it — two personality types dealing with the same event. One takes it as a small bump in the road while the other considers it exasperating.”

Stress, he added, “clearly is in the eye of the beholder.”

Backstopped by many medical studies, cognitive behavior therapists are generally confident that there are effective ways for business travelers to handle stress.

One of the most popular treatments is the stress management system developed in the 1970s by Dr. Herbert Benson, director emeritus of the Benson-Henry Institute for Mind Body Medicine in Boston. His techniques for easing stress range from “meditation on the go” to deep breathing and massages, all described in the book “The Relaxation Response.”

Dr. Virk, of the Mayo Clinic, said she favored taking time out each day to relax. “Go for a walk,” she said. “Think about something unrelated to what you’re doing on your business trip. Wherever you are — here or in Cambodia — exercise.”

“There are executives who travel a lot and can sleep four hours and still be calm,” she said. “Discipline is the key to coping with stress. Veteran travelers know how to break the daily mental process and look at things with a different perspective.”

Are some business travelers getting better at handling stress?

“You have to be,” Dr. Virk replied. “The world now is not how it was. Everything happens at a faster pace.”


Uncle Sam's Fitness Recommendations for all Americans


The Federal Government, for the first time, has issued Physical Activity Guidelines for all Americans.

No "News" Here: Exercise, Exercise More, Exercise Forever...

I highly recommend these Guidelines because they're full of useful information and practical tips that anyone and everyone can use, and can implement into their daily lives to improve their overall health, and well-being.

So, Download Them Now!

To download your Free copy of the Physical Activity Guidelines for Americans, go to: www.health.gov/paguidelines




Tuesday, October 7, 2008

Feet

"Read 'em Before you Eat 'em"


NYC Health Department Launches Calorie Education Campaign

October 6, 2008 – “Read ’em before you eat ’em,” the Health Department advises in a new campaign launched today to help New Yorkers make the most of the city’s calorie-posting rules. Under the New York City Health Code, chain restaurants are now required to post calorie counts for food items on menus and menu boards. The rule took effect this summer, after a federal court upheld it and an appellate court refused to delay enforcement while the industry tries again to overturn it. The new campaign – five ads appearing in 1,000 New York City Subway cars for the next three months – is designed to help New Yorkers see how quickly fast-food calories add up. Many are unaware that a typical adult needs only 2,000 calories a day to maintain a steady weight. Even fewer know how easy it is to overshoot that goal while eating on the go.

The campaign shows how deceptive appearances can be. One poster shows an apple raisin muffin that looks harmless but carries a stout 470 calories – nearly a quarter of an adult’s daily allowance. “If you’re eating it as a snack,” said Cathy Nonas, director of the Health Department’s Physical Activity and Nutrition program, “you may want to split it with a friend.” Nonas, a registered dietician, will host a blog on calorie counting later this week at nyc.gov/health.

“Many people end up overweight just by going with the flow,” said Nonas. “Now that this information is available in chain restaurants, it’s easy to make healthier choices. Once you set a daily calorie budget, there are lots of ways to live within it.”

As the new ads make clear, you don’t have to give up all indulgences to eat fewer calories. By ordering a diet soda and a small order of fries with your cheeseburger, for example, you can cut the caloric impact by half – from 1,250 to 670.

The Health Impact of Calorie Listing in Chain Restaurants

Obesity is a leading cause of preventable death in NYC. Eating too many calories causes weight gain – which can lead to diabetes, heart disease, and other serious health problems.

New Yorkers eat more than a third of their calories away from home. To help them make healthier choices in restaurants, the New York City Board of Health passed a regulation requiring chains to post calorie information on their menus and menu boards.

When people have access to calorie information, they use it. Health Department surveys have shown that when restaurant patrons use calorie information in deciding what to order, they average nearly 100 fewer calories in each meal purchased. The Health Department estimates that posting calories on menu boards and menus will reduce the number of people who suffer from obesity by 150,000 over the next five years, preventing more than 30,000 cases of diabetes.

nyc.gov/health

Sunday, October 5, 2008

Reading and Weight loss

Researchers at Duke University, working with preteen overweight girls who were enrolled in the Healthy Lifestyles Program at Duke's Children's Hospital, have just completed a study that shows that reading books with likable characters that preteen overweight girls can relate to, and can emulate, may help them lose weight.

The evidence is clear, that young girls who have self-esteem and body image issues, are more vulnerable, and may engage in unhealthy and addictive behavior as adults.

To read the article go to: www.time.com/time/health/article/0,8599,1847340,00.html

To read a more comprehensive piece about this study, go to: www.nytimes.com/2008/10/14/health/14well.html

Related Articles:

Girls' Self-Image May Affect Future Weight

(AP) - Where a teenage girl sees herself on her school's social ladder may sway her future weight, a study of more than 4,000 girls finds.

Those who believed they were unpopular gained more weight over a two-year period than girls who viewed themselves as more popular. Researchers said the study showed how a girl's view of her social status has broader health consequences.

The girls in the study were still growing -- their average age was 15 -- and all of them gained some weight. However, those who rated themselves low in popularity were 69 percent more likely than other girls to increase their body mass index by two units, the equivalent of gaining about 11 excess pounds. (The body mass index, or BMI, is a calculation based on height and weight.)

Girls who put themselves on the higher rungs of popularity also gained some excess weight, but less -- about 6 pounds.

Both groups, on average, fell within ranges considered normal. But a gain of two BMI units over two years is more than the typical weight gain for adolescent girls, the researchers said.

"How girls feel about themselves should be part of all obesity-prevention strategies," said the study's lead author, Adina Lemeshow, who began the study as a Harvard School of Public Health graduate student. She now works at the New York City Department of Health and Mental Hygiene.

The research, appearing in January's Archives of Pediatrics & Adolescent Medicine, used data from an ongoing study used frequently by scientists studying childhood obesity.

Weight and height data were reported by the girls themselves rather than getting weighed and measured by doctors; that's a weakness in the study that the researchers acknowledged.

The researchers took into account the girls' weight and BMI at the start of the study, along with their diet, household income, race/ethnicity and whether they'd reached puberty -- and still found the link.

In the study, perceived popularity was measured in 1999 by how the girls reacted to a question next to a picture of a 10-rung ladder: "At the top of the ladder are the people in your school with the most respect and the highest standing. At the bottom are the people who no one respects and no one wants to hang around with. Where would you place yourself on the ladder?"

The researchers put the girls into two groups: the 4,264 who said they were on rung 5 or above, and the 182 who said they were on rung 4 or below. The weight gain link was based on those two groups.

Clea McNeely of Johns Hopkins Bloomberg School of Public Health called the study strong. She said she wanted to know more about the 4 percent of girls who rated themselves below average in popularity, particularly whether they already were gaining weight faster before they rated themselves as unpopular.

"The reason this paper is so important is it has broader implications beyond weight gain," said McNeely, who was not involved in the research but wrote an accompanying editorial. "Subjective social status is not just an uncomfortable experience you grow out of, but can have important health consequences."

Experts know little about how to intervene in teenagers' peer groups to improve health, McNeely said, but when adults set standards in schools, students treat one another with more respect.

Teenagers may give grown-ups "bored looks," she said, but "adults are still the most important influential figures in their lives."

The study was supported by a grant from the National Institutes of Health.

Starving Themselves, Cocktail in Hand

By SARAH KERSHAW

Published: March 2, 2008
The New York Times

Manorexia, Orthorexia, Diabulimia, Binge Eating Disorder.

All are dangerous variations on the eating disorders anorexia and bulimia, and have become buzzwords that are popping up on Web sites and blogs, on television and in newspaper articles. As celebrity magazines chronicle the glamorous and the suffering, therapists and a growing number of researchers are trying to treat and understand the conditions.

The latest entry in the lexicon of food-related ills is drunkorexia, shorthand for a disturbing blend of behaviors: self-imposed starvation or bingeing and purging, combined with alcohol abuse.

Drunkorexia is not an official medical term. But it hints at a troubling phenomenon in addiction and eating disorders. Among those who are described as drunkorexics are college-age binge drinkers, typically women, who starve all day to offset the calories in the alcohol they consume. The term is also associated with serious eating disorders, particularly bulimia, which often involve behavior like bingeing on food — and alcohol — and then purging.

Anorexics, because they severely restrict their calorie intake, tend to avoid alcohol. But some drink to calm down before eating or to ease the anxiety of having indulged in a meal. Others consume alcohol as their only sustenance. Still others use drugs like cocaine and methamphetamine to suppress their appetites.

“There are women who are afraid to put a grape in their mouth but have no problem drinking a beer,” said Douglas Bunnell, the director of outpatient clinical services for the Renfrew Center, based in Philadelphia.

The center, like a small but growing number of eating-disorder and addiction-treatment facilities, most on the West Coast, offers a dual focus on substance abuse and eating disorders.

Dr. Bunnell, the past president of the National Eating Disorders Association, said the obsession with being skinny and the social acceptance of drinking and using drugs — along with the sense, lately, that among celebrities, checking into rehab is almost a given, if not downright chic — are partly to blame.

“Both disorders are behaviors that are glorified and reinforced,” Dr. Bunnell said. “Binge drinking is almost cool and hip, and losing weight and being thin is a cultural imperative for young women in America. Mixing both is not surprising, and it has reached a tipping point in terms of public awareness.”

Psychologists say that eating disorders, like other addictions, are often rooted in the need to numb emotional pain with substances or the rush provided by bingeing and purging. The disorders are often driven by childhood trauma like sexual abuse, neglect and other sources of mental anguish.

Manorexia is the male version of anorexia. Orthorexia is an obsession with what is perceived as healthy food — eliminating fats and preservatives, for example. But people with this condition can dangerously deprive themselves of needed nutrients.

Diabulimia refers to diabetics who avoid taking insulin, which can cause weight gain, in order to control their weight. Despite the name, the disorder does not typically involve purging.

Binge Eating Disorder refers to obsessive overeating, especially of foods high in salt and sugar, that does not involve excessive exercise or purging to compensate for the high caloric intake.

Judy Van De Veen, 36, who lives in Gillette, N.J., became anorexic at 24. She said she starved herself, meting out small bites of low-calorie food for two months. Then she began bingeing and purging, throwing up entire boxes of cereal, whole pizzas and fast food from drive-throughs that sometimes cost her $80 a day.

She went into treatment, both inpatient and outpatient, for her eating disorder for several years in the late 1990s, with mixed results. In 2001, still struggling with bulimia, she took up drinking. If she ate while drinking, she said, she would purge, but then consume more alcohol to make up for the loss, because she wanted to remain drunk.

Many bulimics who drink use alcohol to vomit, experts on eating disorders say, because liquid is easier to purge. They also tend to vomit because they often drink on empty stomachs.

“In the beginning of my eating disorder I wouldn’t touch alcohol because it is so high in calories,” said Ms. Van De Veen, who later found herself regularly hospitalized for dehydration. “But I have the disease of more: I just want more no matter what it is.”

Two years into her drinking problem, she joined a 12-step program. She spent the next two years in and out of six residential rehab programs, spending about $25,000 of her own money because she didn’t have health insurance. But none of the programs were equipped to address eating disorders, so she binged and purged and her eating disorder raged.

Ms. Van De Veen said she has been sober for three years, but is still struggling with bulimia. She now has a 14-month-old daughter, Cheyenne, and she said that her pregnancy and support groups had helped her make progress on her eating disorder.

“I had an excuse to eat,” she said of being pregnant. “I didn’t care and I loved it.”

But she said the temptation to binge and purge is haunting her again.

Trish, 27, who has had an eating disorder for the last 10 years, recently checked into Renfrew, her fifth stint in a treatment center or hospital.

Like Ms. Van De Veen, Trish, who agreed to be interviewed on the condition that only her first name be used to protect her privacy, struggled with anorexia first and then found alcohol. Before she was admitted to Renfrew, she said she was blacking out from lack of food and suffering from excruciating stomach pain.

Trish, a nurse who lives in Ohio and works with cardiac patients, said she would starve herself through her 8- or 12-hour shifts, staring at the clock and fixating on when she could have her first drink. Drinking, she said, relaxed her when she had to eat in front of other people, a huge source of stress.

“Drinking helped me be less anxious,” she said. “It helped me be more of Trish. The two go together: If I drink more, I’m more into my eating disorder and vice versa.”

Studies show that binge drinking and alcohol abuse are on the rise among women, who are also more prone than men to eating disorders.

About 25 to 33 percent of bulimics also struggle with alcohol or drugs, according to a study published last year in the journal Biological Psychiatry. Between 20 and 25 percent of anorexics have substance abuse problems, the study found.

A growing number of researchers are examining the psychological and neurological links between eating disorders and substance abuse: Does eating a chocolate bar, or bingeing and purging, stimulate the same pleasure centers in the brain as drugs or alcohol?

Suzette M. Evans, a professor of clinical neuroscience at Columbia, recently began a study of the connection between bulimia and substance abuse, a field she said has been neglected.

“People are finally beginning to realize that food can function in the same way as drugs and alcohol,” Dr. Evans said.

As more patients seek treatment for both eating disorders and substance abuse, a complicated set of mixed messages can arise. The response to addiction is abstinence; but quitting food is not an option.

“We’re trying to get our patients to find effective behaviors and life skills,” said Dr. Kevin Wandler, the vice president for medical services at Remuda Ranch, which addresses both eating disorders and addiction at its facilities in Arizona and Virginia.

"Eating normally would be an effective behavior, but it’s easier to give up alcohol and drugs because you never need it again,” Dr. Wandler said. “If your drug is food, that’s a challenge.”

Trish left Renfrew on Feb. 22, after her second time in treatment there. She was determined, she said, to break her obsessions with weight, food and alcohol. Before she checked in, “I didn’t even have the energy to laugh,” she said. But as she prepared to go home, she had more hope than she has had in years.

“I will not live my life like this,” she said. “I’ve learned this time not to be ashamed. I want to love myself and I want to forgive myself.”

www.nationaleatingdisorders.org


The Voices of Eating Disorders

By Tara Parker-Pope

October 15, 2008
The New York Times

INSERT DESCRIPTION

And their faces

In a country where many people struggle with eating too much, it can be hard to understand a disorder in which people basically starve themselves. In the latest Patient Voices, my colleague Karen Barrow explores the daily challenges of men and women battling anorexia, bulimia and other eating disorders.

You’ll meet Gillian Craig, a 17-year-old from Shaker Heights, Ohio, who still struggles with anorexia.

“People so don’t understand this disease,” she said. “As much as it seems like a choice, it’s not conscious. This is not something I’ve chosen. This is something I’ve been dealt.”

Her mother, Lauren Craig, also talks about the challenges of mothering an anorexic.

“It has been totally devastating,” she said. “It’s all consuming. Even when things are going well, you’re really concerned. When things are bad, everything revolves around it.’

Click here to listen to the voices of eight men and women struggling with eating disorders, including Kirsten Haglund, 19, who was named Miss America for 2008 and hopes to use her position to raise awareness of the problem.

Pictures by: Barney Taxel for The New York Times, Darren Hauck/New York Times, Jeremy M. Lange for The New York Times, Ruth Fremson/The New York Times, Stuart Isett for The New York Times, Brendan Smialowski for The New York Times

Wednesday, October 1, 2008

If I Can Do It...


Local Woman Loses Half of Her Body Weight Without Surgery

By Kay Quinn

Weight loss may sometimes seem like an unattainable goal. But a local woman has lost half her body weight!

Here's how she shed the pounds...

When Karen Ebbesmeyer turned 40, she decided to get a check-up that she'd been putting off for years. During that physical, Karen's doctor told her if she didn't lose weight, she wouldn't live to see her youngest daughter graduate from high school.

"The doctor told me that I was basically a walking time bomb," says Ebbesmeyer. "I just went home and cried and cried because I had been on diets, I tried many diets."

She'd tried low-carb and diet meals. Two years ago, Karen weighed 275 pounds. "I've even tried diet pills and knowing the affect that they could have to your heart and nothing worked."

Then, this working mother of four started walking on a treadmill, she immediately felt better and now walks at least three miles a day. She also realized that if she was going to be successful her next step was to start eating healthier.

Her biggest challenge? Giving up soda.

"Yes, it was diet, but I was drinking two to three two liters a day by myself trying to compensate for not eating," says Ebbesmeyer.

Now she drinks only water and eats a lot more vegetables.

"If we opened one can of vegetables a week we were doing good."

In February, she reached her goal weight of 148 pounds. Karen went from a size 24 to a size 6.

"I look at my old clothing, and at old pictures of myself and I think oh my goodness, how did I let myself get to that point. But, it happens it happens to a lot of people."

She also never wants to go back...

But she believes with portion control, losing half your body weight is not an impossible dream. And, she hasn't given up all of her favorite foods. Ebbesmeyer still enjoys pizza and Mexican food. And she still cheats from time to time.

"Nobody's perfect!" says Ebbesmeyer. "We're all going to cheat."

But she sticks to the plan, and to her portion control.

"Now I don't even want to call it a diet," says Ebbesmeyer. "It's just a new lifestyle."

And she hopes to inspire others.

"If I can do it anybody can do it!"

ksdk.com