I went to a local farmer's market this morning, since the weather was nice.  I was visiting the various booths, sampling things and just seeing what was available.  The farmer's market had more than just produce--there was quite a few stands with gourmet prepared food.  One was sampling roasted coffee, along with applesauces and such. 

As I was standing there, sampling the coffees, she kept saying how her foods were low in sugar and easy on the waistline.  And so on.

My first thought: is it that obvious that I've gained weight?

My second thought: why are you assuming that I'm worried about stuff like that?

I don't blame her, exactly.  She's just trying to sell her stuff.  I know from when I worked craft fairs that a lot of making a sale is trying to figure out what the customer is thinking.  I guess I fit the bill of the food obsessed: young, female, decently dressed.  And part of it was probably a reflection of what the woman herself was thinking, what she thinks when she decides whether to buy food.

But it irritates me that being diet-obsessed is considered the default mindset.  It's sad, really.  That it's safe to assume that the majority of people look for what's not in a food than how it tastes or what is in it (flavor, texture, etc).  I know plenty of people have to read labels, and that reading labels isn't necessarily disordered.  It can be a very normalized thing.  But still...  It's become so not only are people expected to be obsessed with food labels, but it's expected that they should be obsessed.

I know the lady was just trying to make a sale.  She did annoy me, but it was more the assumption that I found irritating rather than the lady herself.  It would be really nice if I could find somewhere where people didn't obsess.

A girl can dream, right?

An email from an ED colleague of mine (who shall remain anonymous) about the anti-obesity campaigns was just so spot-on and brilliant that I had to repost it here:

To me the most critical point is that weight is not a behavior. That's why anti-smoking campaigns are different from anti-obesity campaigns. Smoking is a very easily controlled behavior if you have not taken it up yet. You can most certainly decide not to start smoking but you can not simply decide not to be fat - you can do all the right things and still be fat. I have little nieces and nephews like that. They are active and energetic kids who eat healthy (more so than my kids!) so what else are they supposed to do? How does the message that they have the wrong kind of body that puts them at risk for health problems and earlier death serve them? To elaborate on Jon's point, should I raise my son to know that he is estimated to have a shorter lifespan than his sister? The only thing a kid needs to hear about his or her body is that it is precious and deserves good care.


Another thing that concerns me with our approach to obesity is that instead of normalizing behaviors, like we tend to do with other conditions, we push people into adopting abnormal lifestyles. When we see people with depression or anxiety or EDs, our goal is to normalize behaviors (e.g. that the person with depression be able to get out of bed and go to work, that a person with social phobia be able to go to social gatherings without distress, that a person with an ED be able to eat normally without compensatory behaviors). But in obesity treatment, our goal is to go beyond what we would consider normal. We want people to eat less than what a person who is not obese would eat, we want them to move more than we would expect of a person who is not obese, and we want them to be hypervigilant about their eating and weight - something that would concern us in a person who is not obese. Besides the obvious ethical questions involved in asking something of fat people that we would never ask of a thinner person, how many people are willing or able to go to such extremes?

From what we have seen, not many. The most optimistic reports of "long-term weight loss success" I have seen is around 20% ("long-term" defined as at least 1 y and "successful weight loss" defined as at least 10%). When we look at the behaviors of those successful at losing weight, described in the much-touted National Weight Control Registry, we see patterns resembling the habits of our patients: Low caloric intake, long hours of exercise, frequent weighings, and a constant vigilance - those who are most successful at maintaining their weight loss never stray from the dieting routine, no matter if it's Christmas, birthdays, vacations or what have you. I don't know about you but I wouldn't want my kid to live like that.

I wish more people wrote and thought like this!