Monday, January 21, 2013

Ditch the Dieting!

Evelyn Tribole is very enthusiastic about getting the word out that dieting doesn't lead to permanent weight loss.  Here's a clip of Evelyn getting her message out:


We've got very preliminary evidence that supports what Evelyn is saying. Cool, huh?   The message that dieting is associated with weight gain is a great example of why my work here at Otago, looking at weight gain prevention, is so important...we've got a fair amount of women who maintained weight over 3 years without controlling weight through dieting.  How did they do it? We'll see!


Sunday, January 20, 2013

"Why am I 'a beast'?"

Lately, I've been spending a lot of free time reading through parent interviews to look for themes related to their acceptance of the message that their child is overweight (based on body mass index).  I really enjoy reading through the transcripts!  It's been a fantastic learning experience for me to read how parents reacted in so many different ways.

One question every parent was asked is: "Did you share the health check information with your child?"  Then the parent is asked to explain the decision around that (keep in mind the children are between age 4 and 8).

One mother used the information to explain to her child that a healthy lifestyle is important so that the child doesn't get fat like Violet in Charlie and the Chocolate Factory; if that happened, the ooompa loompas would take him away!

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Another mother told the child that the results say she is obese.  The child's response was, "Why am I 'a beast'?"

I think it can be a tough conversation to have with a child - explaining why adults are measuring around their tummy, checking their height and weight, and then trying to explain what those measurements mean so the child understands.  Clearly, some children are too young to understand the body mass index labels.

It appears that there are parents who don't want to share weight-related information with their child because they're concerned that the child will develop weight/body image/self-esteem issues.  Well, we've got inquisitive kids in the study and they want to know what's going on.  So, instead of focusing on body weight, the parents explain that the study is looking at what the family eats and how active the family is and go on to drive the point home that it's important to look at the big picture of what a healthy lifestyle is all about. (Interestingly, some children have been very accepting that they are overweight and it means that the family needs to think about eating less, choosing healthier foods and getting more active.  The key has been including the child in how they'll eat differently or be more active  - they love making decisions for themselves!)

So, I've asked myself, Why is it okay for adults to take the focus off of body weight for children and instead focus on an overall healthy lifestyle, but often adults find it okay to focus on body weight  instead of factors that contribute to a healthy lifestyle?

Why can't we all realize that we should be making choices because we believe we'll be healthier (and, hell, happier?!) as a result, not because we want to control our weight?

I'm very thankful that I've been a part of this portion of the study.  It's made me think long and hard about how I envision our weight gain prevention intervention because I've been concerned that adults won't participate if they aren't losing weight - even if they do end up making healthier lifestyle choices as a result!

For the psychology fans out there... I attended an Acceptance and Commitment Therapy workshop with Steven Hayes before I arrived in New Zealand.  During one session, each of us closed our eyes and envisioned a conversation that we would have with a younger version of ourselves.  Why?  Adults are generally more compassionate towards children.  So, the idea is to think of a situation, say, the time my pediatrician told my mom that I could stand to eat a few more salads.  Then I'd visualize the conversation that I'd have with that 8-year-old Sara: "Yeah, you're overweight and 20 years from now you'll be considered 'overweight' and that's okay.  You'll spend a long, long time being frustrated by your weight, but you'll do your best to make choices that support your health.  You'll finish an IRONMAN!  You'll be healthy and happy because you don't obsess about becoming skinny.  In fact, you'll go on to pursue a PhD because of that conversation between your mom and your doctor - you'll study how to teach women how to listen to their own hunger and satiety cues; how cool is that?!"

My hope is that some day we'll all realize that it's not someone's excessive body weight that's a problem, it's the behaviors that lead to excessive body weight that should be addressed.  (One overweight boy sought approval from his dad by eating five apples in a day because they're 'healthy', but the boy doesn't understand that even too much of a healthy food can have an impact on his health/how he feels-making him aware of that would be important!).

Also, I think reassuring people that it's a process to make healthier choices is super important, too.  There are just too many uncontrollable things in life to expect a huge change that leads to a huge impact overnight...

  Seems like I've got my work cut out for me with my intervention!