Calorie Counts on Restaurant Menus Don’t Change Behavior

 Email This Post

When I was on a working trip to New York City, some of my staff and I popped into a very lovely open-air sort of restaurant for lunch.  The menu was huge in size (I always wonder how they have all that food on hand), and I noticed something I had never, ever seen before:  calorie counts between the description of the food and the price!

I read each and every calorie count and was shocked at how unbelievably caloric many of the foods were that I had thought were healthy.  An appetizer of fried calamari had more calories than one should have in a whole day!  Even the veggie meals were stuffed with extra calories from oil, cheese and sauces.  Oh my!

Talk about being “scared straight,” like those kids in front of convicts who warn them to clean up their acts.  I immediately selected the healthiest thing I could find (boring, but healthy), ending up with a turkey sandwich on rye with lettuce and tomato - no mayo and no dressing, but with some salt, because I normally have low blood pressure.  I give callers high blood pressure, but mine is usually low. 

New York City was the first place in the country, I believe, to require calorie posting.  What have we learned from this experiment?

Researchers at New York University and Yale discovered that, although 9 out of 10 people who saw the calorie counts claimed they “made healthier choices as a result,” when the researchers checked the receipts afterward, they found that people, had, in fact, ordered slightly more calories than the typical customer had before the labeling law went into effect in July, 2008.

The lead research scientist said, “I think it does show us that labels are not enough.”  What?  What else do you want to do?  Send in the calorie police?  On cityfile.com, someone made a suggestion that restaurants could have scales for people to weigh themselves before sitting down to dinner (ohhhh, what  rude reminder!) or they should post pictures of what you’re going to look like if you have that lasagna in addition to  bread, butter or olive oil, a big salad with a cup of dressing and then cheesecake to wrap it up!

So, if calorie postings have no impact, except for the people who already are careful and appropriate in their healthy food choices, then what is the point of continuing them?  I still think it’s a good idea to continue.  Perhaps with patience, we will see people care about their bodies and their health as much as their family, friends and relatives do, and as much as the taxpayers who are not overweight and are forced to be burdened by the rising health costs brought on by illnesses associated with obesity.

Russell Crowe is Not A Role Model for Healthy Living

 Email This Post

An Australian newspaper columnist mocked actor Russell Crowe for smoking and chowing down on three tacos and a soft drink during a recent bike ride.  Specifically, her piece was entitled:  “Smokes and Fatty Foods – The Fitness Regime for Rusty.”

No, he didn’t throw a bike at her (like he threw a phone at a hotel employee several years ago).  Instead, he challenged her to a bike ride.  She went on the 12 mile ride through the city, struggling to keep up, and then she fell off her bike.  She persevered and finished the ride, and had compliments for “Rusty.”  Instead of gloating (she revealed), the actor was gracious and concerned about her:  “…the perfect gentleman as he rolled up my trousers to check on my knee.”

Well, the actor has trimmed down of late, and bike riding is probably a part of his new health regimen, but, c’mon, biking with your trainer and scarfing down tacos, sugary sodas and dragging on a cigarette earned him that headline.  That he could outride a non-rider doesn’t change the truth:  what he did was very unhealthy.  And considering that two thirds of Americans (Crowe is Australian) are fat or obese because they move less and eat more, it would have been better if he had owned up to the error of his gastronomical ways.

Overdosing on Antidepressants

 Email This Post

Antidepressant drug use in the United States doubled between 1998 and 2005, according to a report in The Archives of General Psychiatry.  But I’m telling you that there is no way in the world that the incidence of profound depression doubled in that same period.  No way.

About 13 million people (or 6% of the population) were prescribed an antidepressant in 1996.  By 2006, that number rose to more than 27 million people.  Again, there’s no way that the incidence of profound depression increased that much. 

Try this number on for size:  more than 164 million prescriptions were written in 2008, totaling almost $10 BILLION  in US sales.  Unlike the incidence of profound depression, I believe that the incidence of making money off prescriptions for depression did indeed double between 1996 and 2005.

As a licensed psychotherapist, I can tell you with great candor that the psychological and pharmaceutical communities have a huge investment in income - plain and simple.  It’s been amazing to me (and I have commented on this publicly for thirty years) how there are trends in diagnoses and grandiose treatments.  For a while, everyone was agoraphobic; then every adult claimed to have some level of ADD; then there was a trend toward multiple personality disorder.  Now, being bi-polar is the illness of choice, or so it seems.

I’m going to state the obvious:  yes, there are people clinically depressed to such a severe level that medicine might be the difference between life and suicide.  I have recommended interim treatment for people who seem to be suffering profoundly.

However, this “doubling” issue is occurring for a number of reasons:  1) trends in the psych industry; 2) money-making efforts by pharmaceutical companies (notice all the TV commercials); 3) the growing weakness of the American public to deal with frustrations and setbacks; 4) the social acceptance of copping to a mental illness to explain various personality/behavioral issues; 5) insurance companies not paying for psychotherapy (requiring high out-of-pocket expenses for treatment).  The bottom line?  Numerous studies show that therapy is as effective (if not more effective) than drug use alone.

I’ve become more and more concerned about people trying to “cure” what is normal.  I’ve said this on my program many times:  being sad and deflated over job or love losses is normal; having childhood disruptions in one’s life is normal; hanging on to them as an identity, attempt at attention, and as a cop-out for responsibilities is not accepting (and not enduring) what is normal. 

A sixteen year old male called my radio program the other day.  He was sad that “the love of his life” dumped him, and he didn’t see any future for himself.  I told him that what he was calling the “love of his life” at 16 was not what he would choose as the love of his life at 26.  I also told him that this adolescent “drama” was normal, and that he would go through it a number of times, before he truly recognized who would ultimately be the “love of his life.”  His attitude lightened up as he began to understand what normal meant.  I told him to distract himself with sports (releasing powerful endorphins) and friends, without harping on his situation, and it would pass…until the next time.  That is just simply what life is like.

We have people who can’t take a joke, can’t tolerate a difference of opinion (after George W. Bush was re-elected, a psychologist in my area published an article talking about the massive depression in his patients who were Democrats - I was stunned and horrified that people would seek therapy for an election disappointment), who call everything “harassment,” who go through difficulties and say that the rest of their lives are “ruined” because of that event, who say they can’t function anymore in life because somebody pushed them too close to their actual potential, and so on. 

Frankly, I worry that Americans are getting spiritually and psychologically weaker - voluntarily - because victimhood is attractive, and because there is a group for every type of victim that will help them to prolong the suffering.

“Dance Your Ass Off” is Right On!

 Email This Post

Last Monday, I stayed up late to watch “Dance Your Ass Off,” a new reality series on Oxygen.  I’ve said many times (and I stand by it), I loathe even the concept of what has been called “reality TV.”  I find it generally exploitive, humiliating, demeaning, mean, stupid and guilty of lowering the American consciousness to sub-basement levels.  People are embarrassed, made fun of, attacked, and dismissed with a cavalier attitude of so-called judges or peered out.  These shows make it to air, because they’re cheap to produce and because there seems to be no end to the appetite of some of the American public to lick their lips when others are behaving badly or grossly, or when people are being “thrown to the lions.”

When I heard there was a new TV show in which overweight people would compete in dancing, I thought this would be seriously sickening.  What a scenario for making fun of people!  “Dance Your Ass Off ” has some of the elements of the typically disgusting reality format:  judges who have “not too judicious” comments, and someone who gets thrown out after some weeks.  But there is much more to this show in particular (in spite of the spicy title). 

The scores are not only for their dancing (they’re trained and choreographed by a professional dancer), but for how much weight they lose.  They all have access to a nutritionist who guides them in cooking and food choices and portion sizes.  So at the end of the Olympics-like scoring from 1 to 10 for the quality of their dancing that week, the percentage of weight lost that week is added to their individual score.  Therefore, a person could have been graded poorly for their dance program, but if they lost 5% of their body weight, they potentially could win the whole night!

I like that this is just not a typical exploitation of people small or too big.  It’s a real challenge for these people to get fit, lose weight, practice dancing, and perform.  The most significant part of the entire program that I appreciated was that there was no competition between these folks.  They all support each other in losing weight and doing their best.  There are no mean manipulations in order to throw somebody off the island or forced fights just for entertainment’s sake.  These people work hard, and become quite committed to being fit.

It’s funny.  I thought this would be an utterly disgusting display, and it turns out it’s one which is quite benevolent and fun to watch.  Seeing these folks working very hard in spite of their extra weight and lack of fitness is admirable and not something to giggle about.  Most of the time, the contestants behave quite respectfully when the judges are not that complimentary (and I think the judges are often out of order making demands of non-dancers who are overweight).  Nonetheless, overall, this show is quite supportive of the right behaviors.

An Obese Woman Responds

 Email This Post

My recent comments about obesity as both a health issue and an overall economic issue generated quite a number of responses.  Some people wrote, detailing medical histories that made it impossible for them to get down to a normal weight.  While there are always exceptions, I wanted to share with you a seemingly “impossible” situation faced by a woman who weighed over 400 pounds.  She knew that losing weight was going to be very difficult, but she made the changes in her life that kept her on the path to good health, and she’s a real inspiration to us all (I’ve not included her name, for reasons of privacy):

Dear Dr. Laura:

I am an obese person.  Two years ago, my sister asked me to have surgery.  I did not want to have it, because I was afraid of the risk.  I did not know how heavy I was, because my doctor’s scale limit is 400 pounds.  I promised my sister I would change my behavior, but not go on a diet.

I went to the doctor and got some information and a health exam.  Then I began to make plans on changing my behavior.  [In the past], I was not eating breakfast or lunch.  I was so hungry when I got home, I would eat easy fast food instead of taking the time to prepare food.  I would also binge late at night.  The doctor suggested I no longer skip meals.

First change:  I eat breakfast and lunch.

Second change:  Drink before eating.  I drink water, and, for flavor, sometimes Crystal Light.  I learned that when the body needs something, it is not specific.  It just says “I need,” and “stomach feels empty.”

Third change:  Choose better foods.  If heart tells brain “I need nutrients,” and stomach tells brain “I am full of garbage,” the brain sends the message “empty stomach.”

Fourth change: Thinking of food in a different way.  It’s neither my entertainment nor my entitlement.  Better food will get me up the stairs at work.  At 200+ pounds overweight, life becomes stationary.  Nutrition can replace that.

Fifth change:  Reduce the amount of food.  The doctor suggested that I keep a log of my food and drink.  I wrote down everything for two weeks.  I was eating more than I thought.  Over time, I reduced my starch in half and then in half again.  Today…I do not plan food or write it down.  For me, I would be thinking of food too much.  I eat set breakfast and lunch meals.  Dinner is now something that can be made in 30 minutes.

Sixth change:  Move more.  Your nagging worked.  The doctor suggested low impact exercise over a long period of time.  No jack rabbit starts and stops.  I can’t sustain walking out of water, so I walk 1 hour in water and backstroke 1 hour, six times a week.  I get stares.  I stare back.  I am not ashamed.  I have changed.

There is no diet for me to break from.  The only thing left is to feel the frustration.  It renews my dedication to my life change.  The first two years, I lost 70 pounds.  It’s the first time in 15 years I have not gained weight.  I have been exercising for a month.

Thank you, Dr. Laura, for all your nagging.  I wish I would have started earlier.  The last two years made it possible.  It gave me a foundation of nutrition that sustains me while I move.  I now move more and eat less.  I can hardly wait until next year.

Thanks again for the kick in the butt.

The High Cost of Obesity

 Email This Post

It seems that it’s very much in the nature of human nature to expect more without having more expected of us.  Because so much energy is being focused on the cost of health care and the proposed programs for universal health insurance, the flip side of the equation is starting to get attention.

The Centers for Disease Control and Prevention unveiled a free website application last week called LEANWorks, designed to motivate employers to start “healthy living” and weight loss programs for their employees, because being overweight is a major cause of certain illnesses, and also contributes to missed work days and higher insurance costs.  Of course, representatives of organizations like the National Association to Advance Fat Acceptance are up in arms over this.

A keystone to the LEANWorks program is the “obesity cost calculator” for companies to estimate how much their obese and overweight employees are costing them in higher insurance rates and missed work days each year.  The ultimate point is to get preventive programs in place.

Of course, the “fat advocates” don’t want responsibility - just perks.  They are claiming everything from prejudice to discrimination.  In their view, facts are irrelevant.  It’s just their “feelings” that count. 

It’s no secret that obesity is a big risk factor for chronic diseases.  Obesity has accounted for over 25% of the rise in medical costs between 1987 and 2001, according to Dr. Bill Dietz, Director of the Division of Nutrition, Physical Activity and Obesity at the CDC.  While it is also true that people of normal weight have medical issues which result in work day losses and higher insurance costs, most of their conditions are not as controllable as excess body fat.

It is the moral responsibility of those who are overweight and obese, of those who smoke, of those who abuse alcohol and various drugs to correct their activities for the greater good of the community which has to take on responsibility for the negative consequences of their behavior, and their lack of self-discipline and commitment to health.

If the greater “we” is responsible for taking financial hits in order to cater to the predictable consequences of your actions, then you become accountable to the greater “we,” and we cut out the nonsense about discrimination and prejudice against fat.  It isn’t healthy, plain and simple.  And now that you think about it, it isn’t fair, either.

Calorie Police or Helpful Nutrition Information?

 Email This Post

Beware “The Calorie Police!”  At least, that’s how some look at the newly proposed Federal legislation which would require chain restaurants with 20 or more establishments to post the calories of everything they serve, right on the menu.  The National Restaurant Association, which originally fought calorie posting, now says it supports it.

Dr. Lynn Silver, Assistant Commissioner, Bureau of Chronic Disease Prevention & Control at New York City’s Department of Health and Mental Hygiene says “We hope this law will have a significant impact on both the frequency of obesity and diabetes in our city [which already has the law, by the way].  We estimate that in our city there will be 150,000 fewer people obese because of this.”

Well, I don’t know if that’s true, since every time I go out to eat, I see relatively fit people eating fish and vegetables and fat people eating lasagna with extra cheese.

I’ve only encountered the calorie menu one time so far, and it was in New York.  There were dishes I thought were healthy, but I was totally wrong about them.  I definitely ordered my meals completely based on calorie content, leaving out foods I knew were yummy but which were calorie-laden.  Nonetheless, I was shocked to see how many relatively innocent-looking dishes had enough calories for the entire day and the next morning too.

I know people who have worked in a number of restaurants, and they tell me that to make food “delicious,” extra sugar, fat and salt are added by the bucketful.  Butter, butter, and more butter; sugar to make the food sweeter, and salt to give more flavor.  This is especially true when the meat, poultry or fish is not of the highest quality or if it’s a bit old.

I’ve gotten to the point that no matter what I order (even fish), I ask for whatever sauce they are serving to be put on the side.  I never have salad with dressing - again, I order any dressing on the side.  If I use any sauce or dressing at all, it’s a micro drizzle for a little taste. 

Do I think this will diminish obesity?  No.  I do think, however, that it will help people with self discipline as well as the motivation to be healthy to make the right choices and not be undermined right under their noses.  I think that, generally, folks with limited motivation and self-discipline will ignore or rationalize the calorie facts and add unwanted pressure to our health system, where the health-conscious have to financially support the health-unconscious behavior of others. 

I do believe that the calorie count posting laws might serve to have restaurants cut fewer corners when it comes to the quality of their cooking and their menu planning.  And that I am looking forward to!

Knowing is Better Than Not Knowing, or Why I “Push” Some Callers to Discomfort

 Email This Post

Researchers at the University of British Columbia studied people who had undergone genetic testing to determine their risk for developing the neurodegenerative terminal disorder known as Huntington’s disease.  Did you know (and can you believe) that those subjects who learned that they had a very high likelihood of developing this horrendous and ultimately fatal disease were “happier a year after testing than those who did not learn what their risk was.”

Many of you probably think that not knowing would result in more happiness, but you’d be wrong.  According to Dr. Daniel Gilbert of Harvard University, “…when we get bad news, we weep for a while, and then get busy making the best of it.  We change our behavior; we change our attitudes.  We raise our consciousness and lower our standards.  We find our bootstraps and tug.  But we can’t come to terms with circumstances whose terms we don’t yet know.”

Even those of you who listen to my program regularly may be shocked when I tell somebody their mother or father or spouse or even their child is a bum.  You may wince when I have them scream out how righteously angry they are at parents who didn’t protect them.   You may also sometimes recoil from your radio when you hear me push and push and push a caller until they reveal their innermost horrible truth.  Perhaps you’ve seen me as cruel…or hawking for ratings stemming from the drama.

The fact is, that as a professional psychotherapist I have long realized the value of dealing with the truth - as ugly as it might be.  I’ve seen and heard people fighting to keep ugly truths submerged as though it protected them.  In fact, the energy that goes into burying reality is huge, and not available for healthy living.

Not everyone who calls is willing or ready for this evolutionary leap in their lives.  Sometimes, they have to think about it more and come back later.  That’s fine.  The seed is planted.  I don’t see my job as making every caller feel happy at the end of our brief conversation.  I see my job as one of freeing them from their own personal jail of denial and avoidance, all of which lead to depression, anxiety, and poor (very poor) choices in life.

Knowing is always better than not knowing.  Several recent callers have demanded that I give them some magic to get their loved one to stop smoking or stop being obese.  I tell them to give up that ongoing, unpleasant battle, and simply enjoy the time they do have with that person.  Accepting what is out of your control opens you up to more happiness, because you are left with dealing with “what is,” instead of fighting to have it be something else. 

You can wrap your arms and joys around what is.  You can’t do the same thing with what you wish was the truth.