Is it too early for righteous indignation?

A while ago several of you wrote about a study that detailed the bias towards the obese held by the medical community. The study demonstrated that, among other things, medical professionals were more likely to view the obese as "non-compliant" with medical treatment. This bias even exists amongst bariatric medical professionals. This isn't the article that was passed around previously, but it is another article that references a different study that found similar biases.

I bring the topic up again because I was reading a post yesterday from a blogger who was banded about a month ago. I want to be really vague about the identity of this individual (although they did nothing wrong). Essentially the gist was that this individual was being criticized for choosing one specific food item by their surgeon and staff. Since banding, this person has lost considerably more than the recommended 2 lbs/week. My point was why was this individual being criticized for eating something with sugar in it? Why wasn't the surgeon looking at the results and saying, "Way to go! Keep up the good work!".

See, here's the dirty little secret: naturally thin people eat sugar (shh!). In fact, most of us have had the experience of dining out with our thin friends and watching them eat salad smothered in dressing and croutons, a fat-filled, smothered- in-gravy entree, a glass of wine or three, followed by a luscious dessert. Usually we are picking away at our dry salad while they enjoy their delicious dinner. They don't feel ashamed to have eaten it. They relish it, they enjoy it and they feel satisfied by it! Shocking, right?

Now I do realize that some people may have valid reasons for avoiding sugar. Truth be told, I chose to have sugary desserts only occasionally. But I don't avoid fruits, juices, milk, etc. simply because it has some sugar in it. In fact I like to say that I avoid sugar free foods (and fat free) like the plague. The reason I avoid them is because I am not dieting and those are diet foods.

I'm not dieting because diets don't work. 30 years of dieting is what got me to 280 lbs. (127 kg.). (I've written about some of this before so I apologize if you've heard this from me.) The reason that I believe that diets don't work is because they don't adequately address the problem. The problem is that people who develop weight problems have become alienated from their sense of hunger and satiety. They eat for reasons other than hunger and they don't stop eating when they've had enough. And the thing is that diets actually further alienate you from your sense of hunger and satiety. Diets tell you what to eat and when to eat and when to stop eating, but this information has nothing to do with whether you are actually eating due to hunger or stopping due to being full.

Of course with diets there's also the typical rebound when the diet is over. I think this rebound is what causes people to become so heavy. We think we need a diet so we restrict our eating for awhile. We lose weight. But then we resume our previous eating behaviors and we gain that weight back. And we gain some more. Rinse and repeat. Knowing this, it actually seems pretty crazy that ANYONE would suggest someone go on a diet. It especially is mind-boggling that medical professionals would recommend a diet. This cycle of losing weight and regaining weight and gaining additional weight is what makes us obese!

We all assume that WE are the problem when the diet fails, but I also challenge that idea (shocking, I know). I don't think it is natural for us to radically alter our eating behaviors permanently. We eat the way we eat. It is as natural to us as breathing, just as it is natural to a naturally thin person to eat the way THEY eat. Sure, we can strive to make healthier food choices. Of course we cannot eat crap all the time. Your thin friend doesn't eat that high calorie/high fat restaurant meal EVERY night. The diet fails because it doesn't correct the actual problem which is eating when we are not hungry and not stopping when we are full.

This is where the gastric band comes in for me. It doesn't work because we are on another diet, despite the recommendation of our surgeon's office. It works because it instills very healthy behaviors that are conducive to weight loss and maintenance. We eat small portions, we eat slowly, we are aware as we eat, and we stop when we are full. Many naturally thin people utilize these behaviors themselves. We need to do a few relatively simple things. We need to minimize sliders that thwart the band's effectiveness. We should (generally) eat only when we are hungry. Because we eat relatively small portions, we need to make sure that we are eating as nutritiously as possible (protein first, blah blah blah...). And that's all that is required for success with the gastric band!

Okay, I'm putting my soap box away for now. Thanks for putting up with me!