Better Watch Out for Those Hot Dogs, says Dr Hu

Does anyone remember the professor/researcher at Harvard Medical School, Dr Frank Hu, who came up with the conclusion that if a person was overweight, exercise did not help them at all?

In 2005, Frank Hu and JoAnn Manson (Harvard) published a study in the JAMA "proving" that an overweight person cannot be physically fit even if they regularly exercise.

This was an epidemiological study (notoriously inaccurate) but it hit the news in a big way. Not surprising since the news thrives on this sort of headline.

Dr Hu and associates have again hit the news with a study which will be published in the "American Journal of Clinical Nutrition".

This study concludes that if you eat red meat at all and especially hot dogs, you have a significantly higher risk of developing diabetes. (the risk factors quoted in the news range from 21% greater risk to 50 percent greater risk).

If we get picky about things, there is a big difference between lean steak and a hot dog but no real proof that either, eaten in moderation will be our demise.

As is with all epidemiological studies, the numbers of the cohort are impressive but we must remember that not enough information was collected specifically for this study. That is, you can prove pretty much anything with an epidemiological study done with an existing cohort - even likely prove that as much as eating a hot dog can raise the risk for diabetes so can that risk be increased by riding a bicycle (assuredly most in the cohort have done both!) :)

But making headlines is what researchers want to do because it assures them of continued funding and the news doesn't want to see what science really comes up with i.e. possibilities that this or that might be true but rather foregone conclusions.

"Scientists", reminds Dr Roy Spencer, PhD and author of "CLIMATE CONFUSION", "are human too", doing what is necessary to obtain funding. Coming up with an attention getting headline is a good way of assuring continued financing for other studies.

The problem is, that some folks perhaps, take studies like this seriously, which isn't a good idea. Rather, it's best to smile and move on and eat our hot dogs and red meat with no worries. Dr Hu's study proves nothing except he likes to get paid, and coming up with a sensational news story is a good way to do that.

New push for gastric bypass for diabetes

I have noticed a new media campaign hawking gastric bypass for diabetes. And not only that but also they are suggesting this surgery (which Rudy Leibel called "draconian") for those folks who are not especially overweight.

The articles are misleading like this one on MSNBC. For example this article states that:

Scientists in recent years have discovered that diabetes all but disappears in some obese patients soon after the operation.

No scientist ever wrote that "diabetes disappears". No scientist ever used the word "CURE" either. What they stated was that after any weight loss surgery including the less invasive gastric band, the sugar levels seem to go down in 72 percent of diabetics at the two year post op point.

(And some of the surgeons admitted that they didn't know if the after surgery fasting caused the sugar levels to go down or the surgery itself!)

Additionally, the one study which did a follow up at the 10 year point after surgery found that only 36 percent of the diabetics still had sugar levels in the so called "normal" range.[New England Journal of Medicine: Volume 351:2683-2693 December 23, 2004 Number 26 Lifestyle, Diabetes, and Cardiovascular Risk Factors 10 Years after Bariatric Surgery Lars Sjostrom, M.D., Ph.D et al]

What continues to amaze me is that they are still doing a surgery, which is a more invasive version of one invented in 1888 (for the treatment of duodenal ulcers) and about which the inventer, Dr Edward Mason, stated in 1980, after extensive patient follow up, that it was too risky even for those patients who were clinically obese. Mason wrote:

"For the vast majority of patients today, there is no operation that will control weight to a "normal" level without introducing risks and side effects that over a lifetime may raise questions about its use for surgical treatment of obesity."

Dr Mason advocated a less invasive surgery which did not interfere with the digestion of vitamins.

The gastric bypass, says Kaiser Permanante's release form, causes vitamin deficiencies in nearly 100 percent of patients.

Gastric surgery for weight loss causes nutritional deficiency in nearly 100% of individuals who have it done. The most common deficiencies are Vitamin B12, Iron, Calcium, Magnesium, Carotene (beta-carotene and other carotene vitamins) and potassium.

Some of these vitamins and nutrients can only be supplemented intravenously. Others cannot be supplemented and the deficiencies can be either disabling or life threatening in the long run.

The surgeons I have asked about lifespan after a gastric bypass have been evasive, implying that a gastric bypass patient might live longer than a clinically obese person but again, science has not proven this at all.

Dr Mason, in 1965, thought this surgery would work for the clinically obese because his normal weight patients who had this surgery, had a difficult time keeping their weight at a normal level.

However, followup suggested it was too riddled with complications and even as late as 2006, Dr Mason wrote that since the mid 1990s scientists have learned a great deal about "the biochemical mechanisms that influence food intake and weight".

" I would like to see greater use of simple restriction procedures that do not rearrange these finely balanced mechanisms," Mason added in an article he wrote for the U of I healthletter.

And in July 2010, 30 years after Dr Mason first advocated not doing the gastric bypass even for clinically obese people, the media is campaigning for diabetics to have this surgery?

The worst thing is that

1. Blood sugar levels can be controlled in diabetics through lifestyle changes - often without medication for several years after diagnosis (my hubby kept his sugar levels at normal without meds for the first 15 years after diagnosis


2. Medication works well without invasive surgery especially if combined with a few lifestyle changes


3. As stated before, the few long term studies we have, suggest that the gastric bypass isn't very effective in the long run for many patients, at either keeping weight off or controlling diabetes

Not only does the recommendation of gastric bypass to control diabetes make no sense to me - it seems, more than somewhat ethically challenged.

New study obese children more likely to die earlier

An article in the news recently, shouted that being obese as a child doubled the risk of premature death (i.e. death before the age of 55).

This was based on a study appearing in the New England Journal of Medicine in the Feb 10, 2010 issue and is online as the full text version, accessible without a subscription.

The news reporting on this study ranged from total misreporting -one source gave the deaths which "counted" as 559 deaths - cohort was 4857 people born from 1945 to 1984 - other sources were more accurate about the 166 deaths in the cohort which "counted". The cohort came from the Gila River Reservation in Arizona.

However, for some reason, (I could speculate on this but I won't) the researchers included deaths from alcholism/drug use and infectious disease in the deaths from which they figured that those who were obese as kids were two times likely to die prematurely of.

The breakdown on the causes of death in the 166 who died prematurely, (which is still a low number) out of the 4857 member cohort was as follows - according to the study article:

A total of 166 deaths were from endogenous causes: 59 were attributed to alcoholic liver disease, 22 to cardiovascular disease, 21 to infections, 12 to cancer, 10 to diabetes or diabetic nephropathy, 9 to acute alcoholic poisoning or drug overdose, and 33 to other causes

Several things should be taken in consideration here. The deaths from those causes which may have an obesity factor in them is only 44 individuals out of the 4857 member cohort i.e. diabetes, cancer and cardiovascular disease. Infections, alcholism, drug poisoning and "other" have no established relationship to obesity at all.

So as you can see, two times as many in a small group like 44 is not very many. And in fact, had they considered, for example, which of the 44 rode bicycles as kids, they might have found a highly significant relationship between early bicycle riding and premature death!

I am always reminded of something Science News editor Stephen Milloy quipped some time ago:

"But who needs data when you can spoon-feed junk science to a gullible media?"

Postscript: 166 premature deaths out of 4857 individuals may be a lower figure than in those who do not live on the (Native American) reservation which might suggest that reservation living might be less stressful than living elsewhere (something I've long suspected since working in a Pima Indian mission several years ago).

Also, anecdotally, I've known several who died premature deaths but none of these were obese - several were smokers however (including my own slim father who died several years before my obese mother and mother's death was a suicide). My husband's cousin was married to a person who had no risk factors at all not even smoking i.e. he ate healthy, exercised daily and was very lean. 15 years younger than she is, he died several years ago, a premature death (heart attack). She who has a high BMI, just celebrated her 74th birthday.

Gastric bypass in teens - why not?

A recent article in the LA Times quoted a Dr Brandt as saying, about overweight teens that:

"But these kids are dying! We’ve created something in our society we have to undo."

Dr Brandt believes in doing the gastric bypass on young kids (even as young as 14 years old) despite the fact that this surgery (based on a procedure for ulcers invented in 1888 by Theodore Billroth and no longer done for ulcers) bypasses not only most of the stomach but also the first segment of small bowel where most vitamins are digested.

Brandt expressed "doubt" about the much safer adjustable lap band because:

"The band is a human-made device that could be in place for a lifetime, and as such carries a risk of scarring and malfunction"

I wonder why Dr Brandt thinks it's better to cut the stomach into two pieces and the small bowel into 3 pieces and reconnect in such a way which is causing 3 world vitamin deficiency diseases in 1st world kids. (ref: Bariatric Beriberi by Charlotte Gollobin1 and William Y Marcus, Obesity Surgery, Volume 12, Number 3 / June, 2002, Pages 309-311)

Not withstanding placing 300-400 staples into the digestive tract which is what happens in the gastric bypass - the staples, unlike the lap band, are not removable!

According to the Fresno Bee expose in 2001, patients do die from gastric bypass and not only the 2 percent who die within a month of surgery(REF: Dr David Flum - death rate 2 percent within 30 days of surgery from 62,000 patients: report delivered to the College of surgeons in Oct 21, 2003.[Study title: The Impact of Bariatric Surgery on Patient Survival: A Population-Based Study])

According to some, many more patients die than admitted by either providers or the media. The Fresno Bee wrote:

"the deaths, by and large, do not occur in the operating room, or in the hours immediately following surgery. They happen in the days, weeks and months after surgery, when patients return home and find themselves coming apart from the inside -- sometimes leaking from the abdomen."

And this is better than the lap band which calls for no cutting up of the stomach or cutting up and bypassing of the small bowel and is fully reversible? Which delivers a similar weight loss to the bypass at the 3 year post op point also?

It should be noted that the gastric bypass, in patients with a BMI of over 50, has a 34% failure rate (i.e. 34 percent of these regain all or most of the weight... see: Annals of Surgery. 244(5):734-740, November 2006. Christou, Nicolas V. MD, PhD; Look, Didier MD; MacLean, Lloyd D. MD, PhD )

I am thinking of the lady who was down to 85 lbs and got her gastric bypass undone. A year later, she is still slim but has color back in her face, is healthy and like so many others who got their surgery undone, she feels her life began the day she woke up from reversal surgery.

Frankly, I sometimes wonder if the average WLS provider's $250,000 - $500,000 a year salary has anything to do with the zeal of some to rush children into surgery modifying the digestive system for life or perhaps the fact that gastric bypass surgeons don't generally, have to do the follow up on gastric bypass like they do on the lap band - gastric bypass follow-up is typically, done by the emergency rooms and gastro-enterologists, many of the latter who are very against these procedures.

One local hospital told me they have an entire floor set up for sick gastric bypass patients! And most ER nurses I've talked to, say a goodly percentage of their nightly visitors are gastric bypass patients with repercussions. Most of the nurses I've talked to, are against that procedure also.

And these surgeons are saying we should allow this on 14 year old kids?

I keep remembering the 22 year old young man who was featured in a news article a few years ago - he'd had bypass surgery at the age of 18. At the age of 22, he was at his ideal weight and was pictured smiling, sitting on a tractor. The article also said that his bones were as porous as an 80 year old's... at the age of 22!

Calcium is one of the nutrients which gastric bypass patients can no longer digest - the calcium which is typically building up the bones of young folks will now be leeched from their bones after their WLS. They can take calcium supplements but we only digest about 2 percent of these and the rest is excreted and can cause kidney stones among other things.

That's the side you don't read in the news or hear about in seminars.

Hopefully parents will put a stop to this because kids only think about one thing and that is "fitting in", but teens I've seen post op with the gastric bypass, sit in the TV studio unsmiling because I'm sure no one told them about the spontaneous vomiting perhaps sitting in a restaurant with their friends (I'm sure this is less socially acceptable than being fat) or the myriad of foods they no longer can tolerate, nor being knocked on their butt after doing something so innocent as eating a piece of their birthday cake.

A recent photo of a "gastric bypass birthday cake" I saw, had the writing on the cake "sorry you cannot have any of this".

And I'm sure no one ever told them about the fact that they might get seizures from the vitamin deficiencies caused by the surgery (seizures are definitely not socially acceptable among teens) or have to sit for hours in the oncology section of the hospital getting infused iron peridically or having irratic blood sugar levels from reactive hypoglycemia (unlike diabetes, there is no medication for that condition).

A clinical study of 63 gastric bypass patients by Mitchell Roslin and associates, found that 80 percent of the patients also had undiagnosed "glucose abnormalities" including "high blood sugar" or "low blood sugar" or both. Roslin M, et al "Abnormal glucose tolerance testing following gastric bypass" Surg Obesity Related Dis 2009; 5(3 Suppl): Abstract PL-205.

I wonder if anyone warned these teens that when they dare to eat something like a breast of chicken and don't take an hour to eat it slowly, it might get stuck in the stoma (opening of the pouch stomach into the small bowel) and hurt like heck for the next two hours until it either passes or they have to be scoped to make it pass.

Maybe that's why at least some of them are depressed after surgery. Suddenly a young healthy teen enjoying life, has a serious disability to contend with. Isn't this a bit much to burden anyone with, let alone a person who is supposed to be in the "carefree years"?

"You don't really know what the outcome is," said Dr. Edward Livingston, chairman of gastrointestinal and endocrine surgery at the University of Texas Southwestern Medical Center at Dallas. "You talk about the benefit being that it prevents kids from terrible chronic disease later in life. But some of them are going to regain weight. Some of them are going to have long-term complications and we won’t find out until later."

Dr Livingston has been one of the bariatric surgeons who speaks out about the drawbacks of the gastric bypass even for adults.

His study of 800 gastric bypass patients a few years ago, found a high percentage of repercussions and he wrote for Self Magazine in 2001:

"By doing this surgery, you're creating a medical disease in the body. Before you expose someone to that risk, you have to be absolutely sure that you are treating an illness which is equal to or greater than the one you are creating."
(Dr Edward Livingston, bariatric surgeon in Self Magazine, 4-2001)

Brittany Caesar, who had a gastric bypass 6 years ago and now weighs 170 lbs, described sitting down at her favorite lunch of two cheeseburgers, two orders of fries and a Coke and hearing a friend say to her "Why do you eat so much? It's not normal". Caesar fled to the washroom determined to lose weight, feeling very wounded by this comment. "Food was my best friend," she told reporters, adding that her whole family was fat. Caesar was over 400 lbs on the day she had her weight loss surgery. Now she is 20 years old and 175 lbs, but the article did not say whether she had had repercussions or has osteoporosis or osteopenia.

Are the possible repercussions worth the lower weight?

The RNY trades one disease for another: it trades obesity for malabsorption. By re-arranging your guts you sometimes have severe side effects, and can have long-term problems such as iron deficiency anemia, calcium deficiency leading to osteoporosis. (Dr Terry Simpson, MD, WLS surgeon)

Especially as in Dr Simpson's almost 30 years of doing these WLS procedures, he found that it was true of all of his patients, regardless of which procedure that:

"Success with Weight Loss surgery is 10 percent the surgery and 90 percent the patient".

Dr Kaplan, was more blunt about weight loss surgery:

"Because it's risky, it's only appropriate for a tiny fraction of people with obesity—the sickest 1 to 2 percent. The idea that all obese people should get [WLS] surgery is insane." Lee Kaplan, M.D., director of the Massachusetts General Hospital Weight Center in Boston in "Self MAGAZINE: 'The Miracle Weight Loss that isn't' AUG 2008

The article in "Self" detailed some long term patients, many of whom were not happy campers several years after surgery.

If we are really, worried about getting our children healthier, Dr Pattie Thomas, PhD, a scientist, suggests some good ways of doing so in her article, "7 Better Ways to Help America's children than Making Fat Kids Skinnier"

answering rebuttal to gastric bypass post

The following is to answer a comment - this was in two parts and had a lot of quotes in it so would be hard to read and brings up some points which I have answered (and so has Junkfoodscience blog answered) in other blogs but should be answered again to clarify things :

Mikalra who wrote the comment states he/she has no interest in the bariatric industry but since he/she does not identify him/herself I have no way of verifying this. Mikalra (M:) writes:

A study of 10 year post op gastric bypass patients found that 34 percent of those who started with BMI 50 or over, had regained all or most of their weight.
The abstract is here: "The failure rate when all patients are followed for at least 10 years was 20.4% for morbidly obese patients and 34.9% for super obese patients" -- which means, of course, that ~80% of morbidly obese and ~65% of superobese patients were successful.

No that doesn't mean this at all. And they do not define "success". FYI, success with bariatric surgery means keeping off 50 percent of the originally lost weight which still leaves many patients severely or morbidly obese (this is 50 lbs kept off for most patients), but as the Swedish Obesity Study found at the 10 year post op point, patients only tended to keep off an average of 16 percent of the original bodyweight and were, in fact, still High BMI. SOURCE: New England Journal of Medicine: Volume 351:2683-2693 December 23, 2004 Number 26 Lifestyle, Diabetes, and Cardiovascular Risk Factors 10 Years after Bariatric Surgery Lars Sjostrom, M.D., Ph.D et al


Secondly, the 35 percent was for BMI 50 which is the average BMI at which folks get a gastric bypass. Exactly why this study concerned the ASBS and they approved some revision procedures (which later turned out to be unsuccessful and temporary and painful i.e. the -through the mouth- stomaphyx and rose procedures)

Third, success is also staying healthy and estimates of acquired co-morbidities from gastric bypass have ranged from 20 percent in the 5 year duration Mayo Clinic study in 2003 to 40 percent in Dr Livingston's study of 800 of his own patients over a 10 year period post op, and can include epilepsy, reactive hyperglycemia and islet cell death, gastroparesis, osteoporosis and auto immune disorder.

As Dr Terry Simpson has stated:

***The RNY trades one disease for another: it trades obesity for malabsorption. By re-arranging your guts you sometimes have severe side effects, and can have long-term problems such as iron deficiency anemia, calcium deficiency leading to osteoporosis. (Dr Terry Simpson, MD, WLS surgeon)

The other study you quoted "long term mortality after gastric bypass" is not an accurate one for many reasons (epidemiological, not randomized etc) and also compared gastric bypass patients against fat people as obtained from driver's license weights only most fat people very much under state their weight on the drivers license so matching weights this way, one is going to be comparing the patients actual start weight with much HIGHER BMI people. Finally, if I remember correctly, the study mostly just followed for 7 years and did NOT take in consideration the 5-9 percent who die within a year of surgery (started following 1-2 years after surgery). I have written about this study in another blog - you may want to look that up.

And no we do NOT have "several" longevity studies on gastric bypass - we only have a couple which you have mostly managed to obtain and those are not real accurate.

Mikalra further wrote:

So yes, there were certainly some risks from gastric bypass, as with any medical procedure -- but overall, it's clear, the health benefits to these very obese patients outweighed the risk.

This is NOT clear at all and why many surgeons are advocating the lap band now which is a much less risky procedure which delivers the same weight loss retention benefits.

Mikalra further wrote:

Moreover, this study included people who had undergone surgery as much as 25 years ago, when the technique was much more experimental; it's reasonable to think that both the techniques, and any counseling or warning signs that need to be followed for optimal patient safety, will have improved by now.

The gastric bypass has not basically changed at all except now they are cutting the stomach into two pieces so it's much harder to reverse than the ones done 25 years ago were. Also 25 years ago, less of the stomach was bypassed which made it a bit safer than now. As Dr Ernsberger has pointed out:

"All of the operations, old and new, are based on an incorrect assumption: that the stomach is no more than a passive sac for receiving food. In fact, it is a critical digestive organ and cannot be cut away or bypassed without compromising the digestive process."

Paul Ernsberger, PhD, Department of Nutrition,
Case Western Reserve School of Medicine, 10900 Euclid Ave., Cleveland, OH 44106-4906

Mikalra concluded:

I am personally very concerned about the obesity epidemic. I would like to see a lot more of this epidemic controlled through support for healthy lifestyles in children, but for patients who have already become obese, this is clearly an option that should be seriously considered, based on personal values and risk factor profile, as it provides very substantial health benefits for most very obese patients.

First of all, news flash, "controlling children's diet" doesn't work. No matter HOW you do it. We know that putting kids on a regular diet does nothing more than injure their metabolism, making them more likely to get fatter when adults. It also injures their self images. But even a less invasive approach such as a friend of mine used... not having things like candy, potato chips et al around, building exercise in their son's daily life and limiting high fat foods does not work. In the case I am thinking of, this individual who kept reasonably slim during his childhood years, as soon as he left home, starting eating all the foods his family never had around and has been clinically obese for the last 20 years or more (he's 40 now).

Secondly, if the gastric bypass introduces NEW comorbidities, what good is it? Are those comorbidities lesser than what they experienced as being fat? In the opinion of several patients I know, they felt healthier BEFORE their gastric bypass than now.

And if the suicide rate among gastric bypass patients is 58 percent greater than among fat people, we must question whether the after surgery quality of life is all that good.

You watch the ads. I see the other side. Countless people who write to me, alone and isolated in their homes, underweight, living in fear or many more, very overweight but also very ill. You cannot make a judgment however well meaning you are, about this surgery until you have seen the entire story.

One super sized friend of mine (over 500 lbs) who is in her 50's (and her slim husband is the one who has had heart problems by the way- not her) has told me that she has OUTLIVED 48 of her fat friends who had weight loss surgery.

Here is just one poem which expresses the pain that some long term patients feel, the pain which never gets to TV or the ads:

(reprinted with permission of the patient)

Sent: Wednesday, August 21, 2002 3:13 PM
Subject: if only...


> oh, sue, I just found your site re: RNY GBP
> if only...
> if only the tears would stop
> if only I knew then half of what i know now
> if only I knew how to turn back the clock
> if only I had not trusted so blindly
> if only I had my life and my love of life back
> if only doctors understood and respected the value of living vs. the lack of value in existing
> if only the effects of malnutrition and slowly starving to death were not so bizarre that people assume and treat me as if I were terrifyingly contagious
> if only I knew someone who could/would reverse, not merely modify, this hell in which I exist
> if only I could hide from that emaciated creature who peeks at me in such a terrified manner when I glance at her reflection
> if only I had not learned so much about medical "error" and the resulting retaliation from the medical world if you dare to whisper those words
> if only I didn't have to hide from the world out of shame and fear
> if only I didn't know so much about PTSD as I do now
> if only I could ever trust another medical care provider
> if only I didn't spend every moment wishing I could die or regretting I did not
> if only I knew how to protect others from the incompetent/unethical animal who did this to me
> if only
> if only
> if only

Fatter babies caused by estrogens in the air?

A recent Newsweek article opines that the chemicals in the air, namely the so called "phytoestrogens" may be causing today's babies to be more overweight than before.

They quote an impressive sounding statistic:

In 2006 scientists at the Harvard School of Public Health reported that the prevalence of obesity in infants under 6 months had risen 73 percent since 1980.

Pointing out that if more fast food and less exercise could explain the higher prevalence of adult obesity, it was more difficult to explain an increased incidence of obesity in a population (like babies) who don't attend movies, and don't eat fast food and were always "couch potatoes". Must be the chemicals in the air, concludes Newsweek...

I looked up the study - apparently the researcher, Matthew Gillman, MD, is also a pediatrician.

He never even mentioned chemicals in the air as a possible reason for fatter babies but rather concluded after studying "120,000 children younger than 6 years old at 14 Harvard Vanguard Medical Associates practices in eastern Massachusetts from 1980 through 2001" that solving the problem of increased baby weight might lie in:

"Avoiding smoking and excessive weight gain during pregnancy, preventing gestational diabetes, and promoting breastfeeding, all of which researchers have shown to be associated with reductions in childhood overweight."

(remember how a recent article blamed breastfeeding for _increased_ size in infants?)

While I understand that Newsweek must come up with eye catching stories almost on a daily basis which must be difficult, I think the public should realize that stories like this one are just that - eye catching - and not necessarily based on any good science.

One thing which struck me is the entire article is based on the "73 percent increase" in "infant obesity" however, is that really as impressive (or alarming) as it sounds? Probably not. For example, the study found that the incidence of overweight children had "jumped 59 percent" but then the actual numbers on overweight kids, were in 1980: 6.3 percent and in 2001: 10 percent. And this means that in 2001, 90 percent of the children were not overweight, even according to our inflated weight charts which have set the line for "overweight" to much less than it was in 1980.

Less than 3 percent more kids were found to be "overweight" in 2001, not exactly anywhere close to a significantly higher figure even with much more fast food and much less activity!

We should always be on the lookout for statistics which may sound alarming but in reality, are not.

Unfortunately I could not find the actual percentages of overweight babies but I suspect it's not that significantly higher either...

The Newsweek article goes on to cite a string of mouse and rat studies which seem to prove their "chemicals in the air = obesity" theory.

And all to the conclusion that we just might be innocent victims of weight gain, like the caged rats and mice (which also were very "under-exercised" and had a much greater exposure to food than their cousins in natural surroundings), and the fact that we burn 800 calories a day less than did our grandparents and that most of us are consuming high calorie fast foods several times a week, has nothing to do with our being somewhat larger than our grandparents. Nope, it's all the chemicals in the air!

(Forgetting of course, that the phyto-estrogens in the air have not particularly increased since the 1980's - on the contrary, with all the "green" hysteria, there are actually less pollutants like this in the air. I know, details, details... :)

While articles like this are entertaining reading (Americans love to be alarmed), we should not take them too seriously. All news media should carry a warning "for entertainment only - any resemblance to facts is purely coincidental"!

Review- Stress Eater Diet book

I have been asked to take part in a "blog tour" reviewing the book, the Stress Eater Diet by Robert Posner, MD and Linda Hlivka, MBA, C.N. Since I tend to be a stress puppy myself, I was intrigued when approached to review this book.

Robert Posner, co author of the book, is an internist who has apparently run a Weight Loss Clinic in the Washington D.C. area for the last 20 years. Having a theory that weight gain in some people could be caused by an imbalance of serotonin in the brain, he and Linda Hlivka, a nutritionist-chemist, developed a Supplement called Serotonin-Plus. This supplement's ingredients read like a multivitamin but it does have "green tea extract" in it which has been touted in some circles to raise metabolism, and also contains 50 mg of caffeine in each pill (and that has been proven to 'raise metabolism' but is not necessarily a healthy way of doing it). Dr Posner wrote a book published in 2002, advocating this supplement but since then, some groups have de-bunked the green tea theory including consumer group, Center for Science in the public Interest (CSPI). A government document detailing a suit questioning weight loss claims about a drink called Enviga containing green tea extract and caffeine, includes the following:

CSPI's scientists have concluded that "Enviga is just a highly caffeinated and overpriced diet soda, and is exactly the kind of faddy, phony diet aid it claims not to be." [Watchdog group sues Coke, Nestlé for bogus "Enviga claims." CSPI news release, Feb 2007] http://www.cspinet.org/new/200702011.html Meanwhile, Connecticut Attorney General Richard Blumenthal has asked the marketers for copies of all scientific studies, clinical trials, tests, and/or papers that support the calorie-burning claims-and information about any group that may have sponsored the studies. [Attorney General demands that Coca-Cola, Nestle prove claims of 'calorie-burning' beverage. Connecticut Attorney General press release, Feb 5, 2007]

To Dr Posner's credit, he does not include a plug for this supplement in "THE STRESS EATER DIET". In fact, it's not mentioned at all except in the bio of Linda Hlivka which names her as the chemist involved in developing "Serotonin-Plus".

One of my personal frustrations with the book which, by the way, IS a good read with plenty of worthwhile information in it which can help us all to be less stressed, was that for some reason, Dr Posner and Ms Hlivka chose to not include their cites and sources as footnotes in the traditional manner, so although many studies were mentioned, one has no way of knowing when, where or how these studies were done. In the section called "References" at the end of the book, it mentions that cites and references can be found at http://www.stresseaterdiet.com/references.html however that page returns a "not found" error. The few studies listed in the references section are ones we all know about and not the studies supporting the book's theories about Serotonin and weight control.

So I had my work cut out for me. The book is a collection of tips about weight loss i.e. log your food, exercise, reduce stress using yoga and deep breathing etc, eat slowly and more - things which will cause weight loss on any program, but I wanted to check out some of the claims new to me which were as follows:

1. That eating foods high in tryptophan would cause the brain to produce more serotonin and that this is a good thing and one which would aid in weight control

2. That tryptophan is the precursor to serotonin

3. That although carbs are high in tryptophan, they only produce a momentary relief and thus are not as effective as foods like turkey etc i.e. low carb foods.

With reference to number 1, I did find a few articles (not any studies though) that suggest that eating tryptophan rich foods would cause the brain to produce more serotonin and some opinions that this does aid in weight control. Of most interest in that area was an article sent down a listserve for medical providers by a P.A. The article was not from a medical journal but still is interesting because it opined by mixing substances rich in tryptophan and taking anti depressant drugs which are serotonin re-uptake inhibitors (SSRI's) could cause a syndrome called "serotonin syndrome" which according to the article could result in:

• Cognitive-behavioral symptoms like confusion, disorientation, agitation, irritability, unresponsiveness and anxiety.


• Neuromuscular symptoms like muscle spasms, exaggerated reflexes, muscular rigidity, tremors, loss of coordination and shivering.


• Autonomic nervous system symptoms like fever, profuse sweating, rapid heart rate, raised blood pressure and dilated pupils.

Source:February 27, 2007 - PERSONAL HEALTH - A Mix of Medicines That Can Be Lethal
By JANE E. BRODY

While this is obviously extreme and not necessarily a risk with eating a lot of turkey, the article did contain the statement that:

"Although serotonin poisoning can be caused by an antidepressant overdose, it more often results from a combination of an S.S.R.I. or MAOI with another serotonin-raising substance."

And this causes one to wonder whether it's a good idea to fool around with Mother Nature when it comes to brain chemicals at all... even with food sources, a question asked in the book, "PROZAC BACKLASH" by Joseph Glenmullen, MD. Glenmullen opined from his research and working with many patients over a long time span that messing with the serotonin balance in the brain could cause problems such as Parkinsonism.

As for my question of whether Tryptophan IS really the precursor of serotonin, my research suggested that it is generally theorized that, yes, it is at least ONE of the precursors. Again I didn't find any studies but many educated opinions on this.

And finally with reference to question 3, eschewing carbs in favor of low carb meats, I found that the jury is still out on this with at least one very respected researcher at MIT disagreeing with the authors' low carb suggestions.

Dr Judith Wurtman has apparently done a lot of research on carbs and serotonin and in an article carried on the MIT site, Wurtman stated that carbs were essential for good health and that a low carb diet could result in some serious cravings (due to the body's need for carbs). Wurtman feels that stopping carbohydrates could not only affect the brain's serotonin levels but also affect your mood: (Note apparently Wurtman's remarks are based on her years of studies which are available in peer reviewed journals.)

"Wurtman, director of the Program in Women's Health at the MIT Clinical Research Center, and colleagues have found that when you stop eating carbohydrates, your brain stops regulating serotonin, a chemical that elevates mood and suppresses appetite. And only carbohydrate consumption naturally stimulates production of serotonin.

In "The Stress Eater Diet" Dr Posner and Ms Hlivka are not clear as to whether one should go low carb for life because they say you slowly add carbs back after the first week of "induction" (of a 4 week program). However, comments like the following suggest to the reader that carbs in general are not well thought of by the authors:

"pasta has little nutritional value" (page 122)

However, this conflicts with what I have often read and that is that Pasta is rich in B complex vitamins for one, a vitamin which Dr Posner stated he feels is a direct stress reducer, a statement accepted by mainstream medicine.

(And it's well known that one gets much more of the vitamin out of food than out of supplements).

Dr Posner and Ms Hlivka are also very much opposed to eating sugar which is OK but as substitute, they recommend, by brand name, sweeteners like aspartame and splenda which is somewhat controversial now that many studies have shed suspicion on the safety of these chemicals. Even the CSPI, once on the "no sugar" bandwagon i.e. do aspartame instead of sugar, has recanted on this position after the well respected Ramazzini Institute studies which found a link between leukemia and aspartame consumption.

The program in "THE STRESS EATER DIET" recommends cardio exercise which, as folks know, I greatly agree with, and the chapter on exercise is excellent, as is the chapter on stress. Perhaps we have heard some of the suggestions given before but somehow having it all in one place, reminds us that we need to do some of these things to reduce stress in our lives.

I hope that in a future edition of the book, the authors _do_ consider including the cites in a footnoted manner because I think today, most of us being bombarded on a daily basis with all kinds of claims, do question uncited material.

For example, one of the statements I would like to see cited is the authors' claim that 90 percent of those diagnosed with type II diabetes are overweight. The percentages I have read have been that 33 percent of type II diabetics have never been overweight and this has been my own observation also.

All in all, I liked the book - it is readable, well written and interesting, and provides a lot of useful suggestions and some things I did not know even with my having read so many diet books.

And most of all, it is one of the only books which gives us real world practical suggestions on reducing stress which I, in agreeing with the authors, feel is a major factor in many of the ailments we suffer.

As a weight loss program, well, if you do the things they suggest such as, log your food daily, count your calories, measure your portions, substitute low cal food for fast food etc and exercise at least 20 minutes - 30 minutes a day, yes you will lose weight whether you eat foods high in trypophan or not. Unfortunately, studies have suggested only about 5 percent of the public are able to be this vigilant on a long term basis. But even if you don't use "The Stress Eater Diet" as a diet book, I feel reading it can be helpful in getting more healthy and reducing stress.

Would this book make a good addition to your library? I would say, probably so. I know I found it rather enlightening.

Where you get it: The Stress Eater Diet Website

Other blogs participating in the "blog tour" can be found here!

Teens, weight loss and obesity surgery

Clyde was an ordinary teen. When he was in 7th grade, he was intelligent, talented and liked video games far more than exercise. He lived the American lifestyle. In his family, there aren't many veggies available and a lot of fast food and pizza. He tried the swim team but it didn't appeal and he felt a bit odd in a bathing suit because he was about 15 lbs overweight. And back then, the obesity hype for kids had just started.

When reflecting on High School at the end of his 8th grade year, he told me, "The kids in school are MEAN!" I didn't ask details but assumed that, like all kids who are not the "ideal" size, he had taken his share of teasing and nasty comments. He had, already at that young age, learned to dress in cover up clothing.

Today Clyde is a senior in High School and he is relatively slim.

Is this a success story? I wonder. Because how he did it was NOT through eating 5-9 portions of veggies a day, avoiding fast food and junk food, and trying to do 60-90 minutes of cardio daily. He, instead, continued to live the American lifestyle with some modifications.

He drinks a lot of tea (caffeine speeds up the heart and makes it easier to lose weight and by cutting the calories - it may also, in the long run, be a factor in Parkinson's disease as are all stimulants - see the book, PROZAC BACKLASH for one).

And he smokes cigarettes.

If he went to the doctor, the doctor would probably be pleased at his BMI but at what cost did he attain his "ideal weight"?

Does he know the proven dangers of smoking i.e. hardens the arteries, strains the heart, and shortens lifespan as much as 15 years? Yes he does. "I know it's dangerous," he told me a bit sadly, "but it's hard to stop."

He does not receive any support from his parents. They want him to stop smoking but do not help him to accept himself at his natural size. And they don't understand that when you are a teen in school, the pressure is 1000 times what it is in life and right now, there is a lot of pressure and heat given to all of those who are overweight regardless of age.

The sad thing is most kids will keep within the "normal zone" if they eat healthy, avoid foods like potato chips and fast food which are extremely calorically dense and not particularly nourishing and if they exercise 1-2 hours a day. However, most kids are not really enthusiastic about this type of program and do not often get a good example of a healthy lifestyle at home.

Clyde is not alone. Statistics tell us that more teens are starting to smoke now, than in the 1960's before the dangers of smoking were known.

In considering kids like Clyde, is it really hard to understand that teens simply do not care if they are doing something unhealthy to keep thin because that is most important in the narrow minded society of High School?

Starting with Junior High School, "bulimia clubs" are flourishing, use of "uppers" are common and an alarming percentage of kids are already dieting or more extremely cutting calories. Very often it's the models in the magazines who are blamed, totally ignoring the heat overweight kids get from parents, teachers and the medical profession.

And now, with the encouragement of our wonderful news media and the surgeons who stand to profit, teens who are very overweight, have discovered Weight Loss Surgery.

As recent as a decade ago, the thought of doing something like a gastric bypass on anyone under 18 was considered unethical - inducing vitamin deficiencies in a body which has not yet matured, partially disabling a healthy digestive tract was considered bad medicine but now it's considered good medicine, the surgeons reciting the song of how the teen "was in danger" of a variety of ailments, many of which are non issues or not caused by obesity.

The "Today Show" recently, featured a teen, around 256 lbs who got a gastric bypass. In her before photos she was shown running around a field playing with a dog and smiling. A year later, she had lost 100 lbs and was of "socially acceptable size". But now she was not smiling. Even when the doctor told her she was a success, one saw only a hint of a smile on her face.

"I have to eat very differently now" she told the Today Show, "there are many foods which no longer go down right." She concluded, "It's not an easy road."

The rationale for giving this 17 year old a surgery which cut her stomach into two pieces and her bowel into 3 pieces, rearranging them in a very unnatural manner, a surgery which some studies show to pose a risk of serious complications in 40 percent of patients, by the 8 year point, complications like bowel obstruction, ulcer, pancreatitis and more... the rationale for doing this on the young lady was she had "sleep apnea", "high blood pressure" and "was in danger of going blind" (they never told us what endangered her).

Sleep apnea is a fairly new diagnosis. I don't doubt that some extremely large folks may have breathing problems, but I think the diagnosis of "sleep apnea" in everyone with a BMI over 35, may be way exaggerated.

I had an overweight friend diagnosed of that. She was given a C-PAP machine and found it way too noisy so she gave it back and went on and she was just fine without intervention. I think we CAN stop breathing for a few seconds without a problem and probably many people who are not fat might be doing that also.

So that left the "high blood pressure" (which can be easily regulated by medication) as their sole rationale for ruining this young lady's digestive tract for life, giving her lifetime problems which may really be biting her at the age of 30 when she would be in the prime of life had she not had the surgery, even if she was very overweight.

Sober faced, the young girl told the Today Show that it was "so nice to not worry about future health problems." How ironic that the procedure she had is, indeed, going to give her a new set of health problems which she might have never had to worry about.

It's time that the media and also adults stop pressuring our children. If they want to help them, they should encourage exercise (to be healthy) and eating veggies and healthy foods and most important, help them to understand that health and beauty is not about size. But when even our medical profession starts condoning unhealthy ways of getting thinner, things are out of control in my opinion.

On the Today Show, the resident doctor obviously approved of this young girl's gastric bypass. "Today's obese children are in the unique position of really having a shortened lifespan," she told the viewers.

With all due respect, the only reason that might be true is because society is pressuring teens to the extent that they are doing unhealthy things to lose weight, like smoking or gastric bypasses. That's a no brainer, isn't it? Apparently not to many folks.

V-Bloc - new hope or old spin?

Several years ago, they did a study on a device developed, I believe, in Switzerland called the "gastric pacer". Several US Weight loss surgery surgeons jumped on the bandwagon. What this device (implanted in the back - and similar in function to a heart pacemaker) did was send electrical impulses to the vagus nerve of the stomach. No intestines were rearranged, the stomach was not otherwise disturbed and it seemed a really great idea. One surgeon wrote to a listserve "I am testing a device now which will outdate all weight loss surgery in five years!"

I followed the studies on gastric pacing and even interviewed some patients. Unfortunately the results, weightloss-wise, were extremely poor. One patient out of the three studies in one area, lost 70 lbs. One patient lost 100 lbs but became very ill from several things including cancer, partially from the side effects of the device and had to have it removed. The rest in the three studies, either lost very little weight or no weight at all. All of the patients except the two previously mentioned, ended up getting other procedures, either gastric bypass or lap band which they all, down to the man, found not only far more effective with weight loss but also, far more comfortable than the gastric pacer.

But worse yet, this "totally non invasive device" (as it was _heavily_ advertised) had a set of co morbidities of its own, some of which I understand are also true of the heart pacemaker but to a lesser degree.

First, it could travel around in the body causing problems getting where it didn't belong (like heavily inflaming surrounding tissue). The one patient who had to have it removed in an emergency situation, had it travel halfway down her back.

Secondly, the amount of current required to block the vagus nerve turned out to be about 10 times the amount of current required in a heart pacemaker. When the device was working, many patients complained of tingling uncomfortable feelings in their arms.

Third, patients were told it stopped the appetite. But the way it stopped the appetite was to keep the stomach from emptying into the small intestine, a condition well known to GERD patients. What they didn't tell the patients was that if the food just sits in the stomach, it starts to rot and can cause a horrendous case of upset stomach (and burping up, rotten food - I know because I have GERD myself). It can also cause too much stomach acid which splashes into the esophagus and can cause not only heartburn but also a condition of ulcers and sores in the esophagus called "Barrett's Esophagus" which can lead to esophageal cancer - a rather distressing type of cancer.

Fourth, patients were told the battery on the gastric pacer would require changing every 2-9 years which are the statistics on heart pacemakers. But what patients found out was that, because the amount of electrical current required for blocking the vagus nerve, was about 10 times what a heart requires, gastric pacer batteries generally had to be changed every 9 months to a year and that required a small surgery.

And finally, for many patients, disturbing the emptying of the stomach did not cause a great deal of weight loss just like the discomfort (and even stricture) associated with GERD doesn't necessarily cause weight loss either. (Again I can attest to that one - I easily managed a BMI of 44 for years until I found Weight Watchers, even with GERD, and a stricture of the esophagus).

Needless to say, the gastric pacing listserve was closed, the studies of this "utterly hopeful" device having been ended but not without a few lawsuits from sick or upset patients.

But ........

As they say in "infomercials"... but wait! Because the gastric pacer came back in 2005, with a new name, new studies and more heavy advertising! That's right.

In 2005, a small company named EnteroMedics in Minnesota announced that they were working on a type of gastric pacer. The press release included the following:

The company says cutting off the nerve supply may slow down digestion because the stomach doesn't register the food and start the digestive process.

Well, apparently they had begun trials of this device in several cities and like the gastric pacer, they claimed it's totally non invasive. Interestingly enough, the TV blurb on it used a gastric bypass patient to show how great losing weight is and claimed the new gastric pacer (the V-Bloc) "may" work just as well as the gastric bypass.  (Which they soon found out to be not as true - in some studies the weight loss in the controls equaled or exceeded that of the people using the v-Bloc.

So you'd think the second time around, they would have gotten the message.  But apparently they didn't because in Jan 2015, guess what's back!

None other but the V-bloc dolled up with a new name but it's the same old, same old.  They opened a new website for it at: http://www.enteromedics.com/vbloc/

Look quickly because after two or three go-arounds with this device, I suspect the website will be as long lived as the last websites were.  But not until they've sold patients with huge promises of its success.  People cannot remember as far back as 2005, I guess they are reasoning (or hoping?)

The following is from my research in 2005 - I'm quite certain this device has the same issues despite the new name! :)

It was difficult to research the V-bloc. Both the EnteroMedics website and the research study website were very vague about how the device works.

So I called a phone number which stated: "For more information about VBLOC Therapy and the EMPOWER clinical research study, please call the nurse-staffed information line at ......"

I spoke to 2 nurses, one of whom got short with me when I was apparently asking too many questions. She said "really this phone number is merely to identify and qualify patients for the study". To which I answered "well that's NOT what you stated on the website" and I quoted the above. Then I reminded her that as soon as they have advertised the device on TV, then the public has a right to know the details. By the time I spoke to the second nurse (a different lady from the first nurse so they apparently are paying no small fee for having nurses to answer phones!), I had a specific question and was prepared with an answer when she told me the line was just to qualify patients.

I did find out that the chest belt part of V-bloc is the battery pack so apparently one improvement V-Bloc has over the gastric pacer is that to change the battery you don't need the small surgery.

But something else on the EnteroMedics website about what the V-Bloc really does (and this website is not given on the Empower study website either - I had to google it) is a bit unsettling. They admitted that they don't really know how the Vagus nerve interfaces with the appetite but listed the functions of the vagus nerve and it's more than just stopping the peristalsis (the muscular action of the stomach to digest the food and send it to the small bowel). Here is the list of vagus nerve functions which the V-Bloc supposedly stops (from their website) :

The mechanisms responsible for obesity and the role played by the vagal nerves are not yet fully understood. Vagus nerve function appears to play a significant role in enabling multiple mechanisms including:

• Expansion of the stomach as food enters.
• Stomach contractions that break food into smaller particles.
• Release of gastric acid to continue food processing.
• Emptying of the stomach contents into the small intestine.
• Secretion of digestive pancreatic enzymes that enable absorption of calories.
• Sensations of hunger, satisfaction or fullness

In plain terms, the V-bloc not only gives you a horrendous case of indigestion but also can induce a  simulation of "gastroparesis" (stomach not emptying due to partial paralysis), and can interfere with the pancreatic enzymes as well as with stomach acid which will not only affect fat digestion but also protein digestion and vitamin digestion!

In another place on the same website, it stated that the idea for the V-bloc (and probably the gastric pacer also) was that before they had the medication to stop the stomach acid for ulcers, the so called PPIs, they would go in and cut the vagus nerve to help ulcers.

Before the availability of proton pump inhibitors (drugs that reduce the amount of gastric acid released into the stomach for persons with ulcers), surgeons routinely cut the vagus nerves near the stomach to treat ulcers. This procedure is called a "vagotomy." For a period of time following surgery, many of the people who underwent this procedure absorbed fewer calories from fat, lost weight and had decreased appetite.

Notice for a "period of time after surgery". That is, it did not work indefinitely to stop the appetite.

Other than the battery pack (it's carried on a case the size of a compact disc, one nurse told me) worn around the chest (which I suspect might be inconvenient at times) which is an improvement over surgery every nine months to change the battery, it seems the V-bloc is pretty much the "same dog, different fleas" as the devastatingly unsuccessful and risky in its own way, gastric pacer. And something which the TV said has been added i.e. wires in the esophagus (I don't know how accurate the TV report is but since the Enteromedics folks are not giving much information, it's all we have).

The new device might have a smaller battery....

"He who does not study history, is doomed to repeat it" and "doing the same thing repeatedly hoping for a different result is insanity" (said Albert Einstein) so take a tip from those who struggled and suffered with the gastric pacer a few years ago, and consider waiting on the V-Bloc! Its predecessors interfered with digestion as much as the gastric bypass but did not even produce good weight loss results for most people.

At best scenario, the weight loss promised is 15-20 percent of the bodyweight in the first year. Doing the math, 15 percent of 300 lbs is 45 lbs. And likely the real results will be more like 10 percent or less. (as they were with all trials on the gastric pacer).

Surely a horrendous case of indigestion, food rotting in the stomach, heartburn and nausea may slow the appetite but at what price? You can do that without expensive electrical devices and multiple wires implanted in your body.

If you did not come here from the new blog - it's been re-introduced in 2015 ... click here to see the new blog on it...

Can you be fat and fit? Latest spin says "No"

Based on a "data dredge" study (meaning they took existent data which was not designed for THAT study so is outdated and also doesn't usually have the right information), some of those in the diet industry are now telling us that we cannot be fat and fit.

The study, like other epidemiological studies boasted big numbers, 39,000 women classified as normal weight, overweight or obese (BMI 30 or over). It was published in the Archives of Internal Medicine, April 28, 2008 issue.

I looked up the article, because the news service headlines read "Fitness does not reduce risk if you are fat". The media told us that people who were obese had a 50 percent greater rate of heart attack even if they exercised than people who were not obese.

If the study had really suggested this, it would be very questionable ... the exercise habits were self reported and people often exaggerated their level of fitness (mostly exaggerate it!). Also overweight and obese women are often weight cycling (popularly called "yo yo dieting") because the body produces all kinds of hormones to force weight gain if it thinks your weight is too low (and too low varies for every different body). And of course, several CLINICAL studies have suggested that any kind of dieting increases heart disease risk by 50 percent.

However, in looking up the abstract, the study did NOT suggest that there was no benefit for an obese person to be fit. On the contrary, the last line of the abstract reads:

The risk of CHD associated with elevated body mass index is considerably reduced by increased physical activity levels.

The media ignored this statement and picked up the next line in the conclusion:

However, the risk is not completely eliminated, reinforcing the importance of being lean and physically active.

Ok, that's fine except it is a meaningless statement because a reduction in risk doesn't mean no risk... regardless of weight. However, it made a great statement for the media to base yet another article of misinformation on.

Now if we look at the study further, we find that although researchers wanted the expenditure of 1000 calories in exercise a week (which isn't very much... about 3 x a week, 40-60 minutes each time), the average expenditure in calories in exercise for those considered "active" (remember this is self reported) was 550 calories a week which isn't for most people, even twice a week. And even that small amount, said the researchers, reduced the risk of CHD significantly regardless of weight (34 percent, they stated).

It should be remembered that many people feel NON cardio is exercise to be counted like gardening and likely reported that as "activity" even if it didn't fit in the categories which were basically cardio exercise (I guess gardening could be reported in the "walking" category if you stretched it).

So although this wasn't the best designed study (to put it mildly) the results were not what the news media reported them to be. Exercise does significantly reduce the heart disease risk... regardless of weight.

Rudy Leibel, obesity researcher said "there probably is a benefit to being of 'normal weight' but there is no proof that people forcing their weight down below their set point enjoy that advantage". This is kind of a no brainer and I have no problems with it. Although right now, according to CDC statistics, people in the BMI category of 25-35 are living longer than those in the so called "normal weight" category.

Another strange thing in our society is that although most of us have had friends who exercise a lot of cardio, are lean but smoke cigarettes, drop dead rather early in life, I have not noticed any studies suggesting what we already know to be true - that smoking may cancel out the good effects of exercise in some individuals (regardless of weight or fitness level).

And in fact, many people who smoke, are doing so to keep their weight down because they are under the false conclusion that doing anything unhealthy is better than being fat. And of course, where do they learn that but from our media.

The Cooper Institute studies of 50,000 people over the last 30 years or so, suggested that people who were obese and fit had only a 00.08 greater risk of heart disease than those who were normal weight and fit. And those studies also suggested that being lean (under normal weight) was at the highest risk even if fit. But of course you will never see that in the media which is, bottom line, hard selling a diet.

One more comment about this study. Most people do not keep up a fitness program more than a year or two but in a self reported study, those people may not have reflected the change (stopping exercising) in their surveys.

Exercise greatly cuts risk of illness regardless of what people weigh but cutting risks doesn't mean no risk, of course. And to enjoy that reduction of risk, people must make cardio at least 3 times a week (and 5 times a week is way better) a part of their lives FOR life.

And it seems the greatest risk to our health may be believing the media which when not lying, is incorrectly reporting health topics.

What are we doing to our teens?

Most teens I talk to, feel they are fat, even though they are not.

Several teens I know personally, started smoking to control their weight.

Somehow we are _not_ getting across the message that smoking has been _proven_ health threatening and are concentrating on giving folks the message that obesity is _extremely_ health threatening even though there is virtually NO scientific evidence that obesity alone is health threatening at all.

How much of a problem are eating disorders among teens and pre-teens? If you look at youtube.com, there are huge numbers of videos which advertise themselves as "thinspiration". These videos either show slim young women squeezing what small amount of fat they have on their bodies in disgust or else, are slide shows of super slim fashion models and actresses. Often the songs which accompany the videos give mixed messages. One song begs "SOS me - rescue me" while another song states that no one notices that her body is falling apart.

One young woman who is 21 years old, and said her latest dieting effort began with her wanting to "get her body back" after having her son, started uploading videos in August 2007. Her first video made while she was smoking a cigarette, had her talking a lot about how she cared for her skin. But in the end of the video, she admitted that she had a problem with eating and also showed us a piece of tape covering a scar she made on herself when she was 16 ("S" for sinner, she said) and how she covered it all the time now. "Smoking is bad" she admitted but then added that she smoked a lot during her 'fasts'.

Another video made in early late 2007 by the same woman, was all text. It told how she had been in a mental hospital because of a suicide attempt. How from the age of 16 and on, she had tried all kinds of drugs in a desperate attempt to lose weight. And how she was going to rehab and get well now (but not take any prescription drugs). "I want to get my son back" she wrote, "he's 3 years old!". Another video showed a visit with a bright eyed 3 year old boy, her son. The video was entitled "I miss my son".

Sadly her rehab didn't work- a recent video talked about her 40 day fast which would end April 11, 2008. Two body shots showed that she had lost quite a bit of weight since she uploaded her first video - she looks like the typical anorexic in those shots. But this fast is not about her eating disorder, she tells us - it's to "gain control". She is allowing herself 1 glass of juice a day and the rest, non calorie drinks like coffee, tea and water. She is continuing this for 40 days, during which she will exercise and get control and save up the money (if she can get a job) to get a pole and start pole dancing. "Weight doesn't matter" she keeps saying adding how she discarded her scale.

One of the comments to this video states:

binges are bad! i was doing well, eating at the most, 300 calories a day, but, then i tried to fast and the binge monster came to me and i ate until i exploded although some people say it wasn't that much food. but all you have to do when you want to binge, is look in the mirror and tell yourself how it will ruin this progress! and then eat an apple or whatever and then wait. tell yourself if you're still hungry in 10 min that you will eat. chances are, you can control your binge better. but you are lucky if you can purge after. it doesn't work for me :(

NOTE: what she suggests in the above quote is a version of what Weight Watchers calls "the 20 minute rule". How much of this comes from our general obsession with dieting and a diet industry which makes a larger profit than even the pharmaceutical companies?

Several feel that anorexia and bulimia are more widespread than we'd like to think. It is usually blamed on fashion models and slim actresses however, most people who are dieting or restricting calories mention health as their first concern. An article in a London newspaper, suggests that there are many internet sites which encourage young women to starve themselves to be very slim:

The UK article suggested that 1 percent of teens have an eating disorder but an estimate from an Australian newspaper stated that 1 in 8 teens has some kind of disordered eating.

What is confusing is that most teens who are restricting (and often over exercising, will not admit it. On the contrary, they say they "eat a lot" while getting slimmer and slimmer. And instead of a cause for concern, slimmer teens are often rewarded with getting more clothing and perks from their family, as well as compliments from their classmates and often, a lack of concern from their medical providers while the fat teen is teased, often not rewarded by the parents and constantly battered by the media as well as medical providers to "lose weight or die". And we wonder why these teens start smoking to "control their weight"? They are following what _we_ are telling them... that _anything_ is more healthy than being overweight!

Ironically, it's the fat teen who is often much more well nourished than those trying to keep what is considered an "ideal weight" (which the CDC has said may be underweight for most people).

And again I ask - will the insanity ever end?

Spinning a Good Story on Tragedy

Years ago, I photographed a wedding - a lovely young couple. And two weeks after the wedding, the groom died - fell to his death while hiking the Grand Canyon. That hardly rated an obituary, let alone a news story.

Truth is, of course most deaths never make it beyond the obituary - there are just too many of them. For example, there is at least one death at every marathon and sometimes more when it's a large marathon.

When I was working as a computer software developer, there was a 36 year old who dropped dead on the basketball court. He was in "perfect shape" and his death confused everyone. But even that didn't rate a story in the news.

But there is ONE type of death which DOES rate a news story and that's any death that they can even -remotely- link to "obesity".

Often, regretably they play upon the tragedy of someone's life to sell a diet or surgery or perpetuate a scare about obesity.

For example, one news story this weekend, carried the headline "Grieving mum 'ate herself to death'!" The story goes on to tell us that this lady binge-d food after her 22 year old son died from suicide. "She tried every diet," continues the article saying that finally she had a gastric bypass and died from complications.

Wait a minute. If she died from complications of a gastric bypass how on -earth- did she eat herself to death? Well you see, labors the story, she was fat and so that's why she died from a gastric bypass or that's why she had a gastric bypass? If you start to process the story, it doesn't make sense - she died from the gastric bypass and if she had just stayed fat, she would still be living. That is, had they treated her for the binge eating instead of surgically destroying her digestive tract, she would have lived to possibly have gotten over the tragedy in her life. Instead, the providers used the excuse of her fatness to compound tragedy upon tragedy as she died from the invasive surgery which has been known to be somewhat ineffective in individuals with binge eating disorder.

What the news pundits are hoping is that you won't notice the small mention of the gastric bypass since most of the article is about how she was constantly stuffing her face. And they are right, most folks won't notice it!

The second story was even more sneaky about being fat-a-phobic.

The headline in most news media (and this story went out over the associated press, nationwide) read "Diabetic complains of light-headedness before dying from heart disease"

Just reading the headline, what comes to your mind? I asked my 10 year old granddaughter about this and she basically said that must be diabetes type II or the type often erroneously linked to being fat and that the lady must have been fat.

Now it's a well known fact that most folks in reading the news, do not read much more than the first paragraph. So in this story, the clincher sentence stood by itself about 6 lines into the story.

"At 36, the bride was dead from heart disease."

Only a couple of lines before the end of the article (which most people won't read) we find this:

"She had a previous cardiac episode in her 20s and was a poster child — literally — for juvenile diabetes, relatives and friends said... recalled seeing the poster featuring her on New York subways."

Juvenile diabetes doesn't mean now what it used to - because we are told daily that this obese generation of kids is coming down with diabetes in their childhood.

So the only clue that we have in the whole article is that she was a poster child- literally- for juvenile diabetes i.e. that her posters were in the NY subways.

In other words, she didn't have diabetes type II at all - she had type I which is a totally different disease and not linked to fatness or lifestyle at all (usually the death of the pancreas in type I is caused by a virus or something like that).

Additionally what they don't bother telling us is whether she had a heart condition or not because if she did have a "cardiac episode" (do they mean a heart attack here?) in her 20's, she likely had a heart condition unrelated to the type I diabetes. Her picture was only carried in the NY Daily News which apparently originated the story. And predictably, she was not fat.

But fact remains, most people who read the story will walk away being more scared about diabetes and a willing audience for another series of articles which appeared this weekend telling the public how gastric bypass cures diabetes (it doesn't really - although the sugar levels drop during the fasting phase, the Swedish Obesity study observed at the 10 year post op point that only "35 percent of diabetics were still disease free").

What strikes me is the ruthlessness of the whole thing. How far will people go to sell a product? Advocating gastric bypass i.e. a partial destruction of the digestive tract, for normal weight or fat diabetics, misrepresenting this invasive surgery as a cure for anything and capitalizing on the tragic death of a newly wed to misreport her illness in order to promote a scare tactic to fat diabetics is more than ethically-challenged.

We've gone far beyond the old "first, do no harm" which doctors used to recite in the Hippocratic Oath. Now, it's more like do anything to sell the product and who cares about how many people are hurt in the process.

Pizza, Fat and Genetics

My 12 year old granddaughter is as slim as a rail. Not "skinny" but just perfect... looks great in pants etc. Like I never did, never was. And she basically eats what she wants too. Fast food, pizza, whatever. Even according to the fat-a-phobes, she is apparently like 90 percent of the other kids because the so called "obesity epidemic" only affects 10 percent of kids!

And I was in the "lucky" 10 percent!

I remember those darned kids who lived on pizza and coke when we were in High School and never had a weight problem. I had to starve, literally, to get down to 135-140 and then the minute I stopped starving I gained right up to 170. (And I'm 5'5" so I'm somewhat altitudinally challenged). Unlike these modern kids, pizza and coke was basically never in the house for us - neither candy except at Christmastime and Easter. We had apples and oranges for snacks.

Pretty much through elementary school, I did 2 hours daily of bicycle riding or skating or playing ball (after school that is, and during school, we had P.E. daily and also active recesses - something kids do not have now).

In High School, I was in intramurals twice a week (played volleyball or tennis or badminton or had trampoline), I swam during my study halls and I walked home from school, 3 miles every day with books and a violin. I also walked to stores and/or my violin students homes (what I did to make a few bucks in High School) That kept me at a weight of 170 lbs, unless I starved (ate about 500-800 calories a day) so I DID starve to stay within a somewhat normal size in High School. No breakfast, no lunch and then, a small supper... can we say "eating disorder" sports fans? Of course no pizza and very little coke. My High School social life was spent in watching others stuff their faces with goodies with apparently no worries about "getting fat".

So, my 12 year old granddaughter told me that they had pizza the other night. Now she's somewhat active but not near as active as I was, riding my bicycle for hours etc - Just out of curiosity, I asked her if pizza filled her up. She answered "Oh yes!" and I said "how much pizza do you have to eat because you are full" and she answered "about 1 and 1/2 pieces!"

I remember distinctly, not only did pizza NOT fill me up but left me with hidden hunger and a sick stomach if I ate more than a bite. And that to fill me up, took at least 3 or 4 pieces of pizza. And at 400 calories a slice, that's a bunch of calories to consume at one time.

Maybe there is something to this satiety disorder thing.

So now I eat mostly veggies, still no pizza, fast food, candy or junk food. And I exercise at least 40 minutes of cardio a day and often more. That to keep at a svelte (not) 250 lbs. (I'm not counting the half hour of yoga I do daily because that's not "fat burning" - actually seems nothing is fat burning for me!)

I talk about this because I see in the papers daily and on TV, slim people expounding about how ALL fat people eat too much and move too little. The latest study (maybe I should put that in quotes!) tells us that you should diet when you are pregnant because if you have a big baby, you are "dooming" your child to a "miserable" lifetime of obesity.

Well, ironically enough, I -ate- during my pregnancy (gained 40 lbs), was clinically obese when I delivered by natural childbirth - I also exercised daily during my pregnancy so was a fit fat mom. I had a normal sized baby who was an Apgar 10 (that's a scoring system from 1 to 10, 10 being the highest score a baby can get meaning no birth defects and perfect healthwise).

So much for the "diet during pregnancy - deliver a small baby" myth. Add that to the numerous myths we hear daily about obesity - like the one which states that -all- fat people eat too much and move too little.

And my 12 year old granddaughter, you know the one with the ideal figure? She weighed 9 lbs at birth and now can eat anything she wants and still is slim without being overly active (like I was).

The name of the game here is -genetics! As geneticist Rudy Leibel states "Size is 40-80 percent genetically controlled".

Genetics, the big "G" word that no one wants to put in the media because we people of size are not only a great target for derision and bad examples, we also are a great market for the diet industry which has now "ballooned" to 55 billion bucks a year just in the USA.

That's a twofer - two for the price of one. Verbally abuse fat people then sell them a diet, over and over again. No wonder the 90 percenters who do not have to deal with clinical obesity are not wild about stopping -that- gravy train!

Queen Size movie was a Queen size diet ad

Recently Lifetime aired a movie called "Queen Sized" about a very fat High School lady who was nominated for Homecoming queen as a joke and then, decides to run. A good summation of the plot of the movie, stars, movie trailer and short analysis can be found here.

About the only positive thing I found in the movie was the main character played by Nikki Blonsky, was really fat and actually wore somewhat youngish clothing.

But the movie was actually anti fat and perpetuating the same tired old myths about fatness over and over.

Based on a real incident which happened in 2004 in Detroit to Allie Burris, various facts about Burris were changed in order to push the anti fat agenda. Whereas Burris' Dad died of asthma, a non fat related disorder, Maggie's dad died of diabetes which is said to be fat related (it is genetically related rather than fat related but it's one of the sound bites they use to scare people into dieting). Throughout the movie, although we are reminded that it - isn't nice - to make fun of fat people, we are also reminded that Maggie should lose weight to save herself from the deadly diabetes which killed her Dad.

In the real incident, Burris got the support of the other High Schoolers and got elected to Homecoming Princess (she was supposedly elected so they could jeer while she was riding in the parade but her ride was without incident). In the movie Maggie got the support of a lot of her contemporaries who were tired of the lady who usually won, but when Maggie stood up to accept the honor, she was almost unanimously booed.

Supposedly, the audience was told she brought that upon herself when she took a TV interview and acted fat and proud. "We want the old Maggie back" said several kids to her. That is, the Maggie who hated herself and thought she was a failure and buried her sorrows in food -that's the one the High Schoolers liked, NOT the new Maggie who actually thought she could do something. Ostensibly some kids who worked in her campaign got angry at her because she didn't mention them as having a part, on TV but they helped, the movie gave us the impression, because they "felt sorry for her" and not because she had any attributes worth anything.

Everyone else in Maggie's family was Hollywood slim and the movie clearly suggested that Maggie was fat because she was out of shape (they showed her running and puffing, walking and not being able to keep up with the other kids and so forth, implying the only exercise she did was opening the fridge plus the arm exercise of putting the food in her mouth). Maggie was also fat, the film showed us, because everytime something went wrong, she ate - all of the wrong things of course. Never did so much as a veggie pass over her lips.

The usual stereotypes we all are familiar with. People are fat because they eat too much and move too little. Only like other stereotypes, these are equally erroneous. There are plenty of slim High Schoolers with binge eating disorder and plenty of fat High Schoolers who are like I was - exercising MORE than the average person (I walked EVERYWHERE I went, I swam during my study halls, I ran from class to class) and STILL only achieving a somewhat large-normal size by starvation. Society doesn't want to admit fatness is mostly genetic because then they couldn't have their fat-a-phobia in comfort. But science says that size IS genetic. The "Queen Sized" movie did not teach people that however. On the contrary.

Interestingly enough, all the high schoolers were shown as slim and perfect looking. I guess the makers of that movie hoped we wouldn't ask difficult questions like "where are all these fat kids that the obesity epidemic mongers are telling us about?" Two fat kids in a large school? Where is the epidemic and why do we have to be "worried" if only 2 out of 1000 kids is fat? Guys, you cannot have it both ways!

"Queen Sized" wasn't even that interesting to watch. It dragged in several places. I fast forwarded through the commercials but I'm told the diet industry was advertising a lot.

The end of the movie was like the rest of it. Maggie goes back to being humble and carefully finds all the candy she has hidden in her room and throws it in the garbage so the audience is consoled with the fact that she has finally decided to get with the crowd and lose weight.

If you haven't seen this movie, I don't think you've missed anything but more of the same dose of fat-a-phobia we get on a daily basis. It was just cleverly (or not so cleverly) cloaked in a different wrapper.