You can’t walk past the magazines in the supermarket, go out to dinner with friends or check your Instagram feed or Facebook these days without being bombarded by diets aimed to cure whatever ails you. All these plans—whether they’re gluten-free, Paleo, organic, vegetarian, or vegan—involve eliminating foods purported to cause a host of health problems.
One such popular program goes so far as to promise it will “change your life in 30 days,” offering testimonials (which, I might point out, do not count as scientific evidence) from participants who claim it has cured them of a long list of so-called “lifestyle-related diseases.” These include but are not limited to: high blood pressure and high cholesterol, diabetes (both Type 1 and Type 2), asthma, allergies, infertility, depression, bipolar disorder, arthritis, ADHD, and inflammatory bowel disease. The psychiatric literature, last I heard, doesn’t consider depression, bipolar disorder, or ADHD lifestyle-related diseases. That’s a topic for another post. But for now, I’ll get back to the subject at hand.
Even the widespread trend towards “clean eating”—whose proponents like to think of it not as a diet, but as a lifestyle choice or even a movement—comes with rules. Eat lots of fruits and vegetables. Eat only “whole” meats, preferably organic, whose sources you know. Eat only whole grains. Avoid all processed and refined foods (e.g., sugar, baked goods, white flour, white rice, empty-caloric junk foods). Avoid saturated and trans-fats. Drink at least 8 cups of water a day.
“What’s wrong with trying to follow a healthy eating plan?” you might ask. And my answer would be, “Nothing. Usually.”
But if you tend to become fixated on avoiding specific foods because you’re excessively concerned about controlling your weight or think they might cause cancer or other diseases, be careful. Even a so-called “non-diet” like the clean-eating approach can lead to emotional struggles for perfectionistic people prone to eating disorders or health anxiety.
Any time perfectionists impose all-or-nothing restrictions on themselves, they run the risk of getting upset and ditching the diet altogether if they think they’ve broken the rules. It doesn’t even have to constitute a major transgression, such as picking up a Big Mac, fries, and large Coke from the MacDonald’s drive-through on the way home from work. If you’re evaluating your food choices from the perspective of a black-and-white mentality (and comparing them with the colorful Instagram images of the kale smoothies, grain bowls, and lush farmers market produce others appear to be eating), you could easily beat yourself up for popping a handful of M&Ms at the movies or having white rice with your homemade, clean Pad Thai. Then you might decide you’ve blown it for the day (or week), and let loose with a full-blown binge. You’ll feel guilty, vow to atone and never stray again, and set yourself up for the next self-punishing cycle of deprivation and excess.
Let me make my position clear before the critics jump on me for questioning sound nutritional practices. I’m not suggesting you go overboard with the junk food and the trans-fats. I’m not urging you to forego whole grains in favor of Wonder Bread. I’m not recommending you trade your bottled water for a Big Gulp. I’m not even telling you the clean-eating lifestyle is bad. (Though I might be telling you not to drink the diet Kool-Aid du jour without seriously evaluating its claims from an evidence-based perspective).
But when food—no matter how nutritionally pure, unadulterated, and good for your body it may be—becomes a source of internal conflict, guilt and anxiety, you might want to think about what it’s doing to your mind.
As with most things in life, moderation and flexibility are the keys to emotional wellbeing. Your mindset about eating is just as important for your health as the foods you eat. Sadly, Instagram can’t capture that.
There’s been much buzz recently over an article in the April issue of Vogue, in which writer Dara-Lynn Weiss chronicles her yearlong mission to put her overweight seven-year-old daughter Bea on a diet. At four feet four inches tall and 93 pounds, Bea was in the ninety-ninth percentile for weight and, technically, “obese.”
To her credit, Weiss acknowledges her own problems with food and body image. “Whether I weighed in at 105 pounds or 145 pounds hardly mattered—I hated how my body looked and devoted an inordinate amount of time to trying to change it.” By her own account, even though she’s currently at a healthy weight, she still seesaws between bingeing on “decadent pursuits” (cheeseburgers, cupcakes, and cookies) and purging—if not through vomiting or laxative abuse (although she admits to having used those methods, too), then by going on juice cleanses or rigidly adhering to a restrictive food plan for a week or two.
Clearly, then, Weiss is no role model for either healthy eating or body acceptance. “Who was I to teach a little girl how to maintain a healthy weight and body image?” she says, in her only display of self-awareness in the entire article.
Over the course of the weight loss project she undertakes on behalf of Bea, Weiss earns herself a lifetime membership in the Tiger Mother club. (Ironically, she criticizes the “Tiger Moms who press their kids into private-school test prep at age four, or force them to devote countless hours to piano or dance or sports [yet] find it unthinkable that anyone would coax a child to lose weight.”)
She polices the little girl’s food choices. She berates a Starbuck’s barrista for not knowing the exact calorie count in a kid’s hot chocolate. She withholds dessert, extra portions, and dinner (when she felt her daughter had consumed too many calories at a school French heritage celebration). She alienates friends and family, including her husband, who “soon tired of the food restrictions and the glacial rate of weight loss and stopped actively participating.”
The “Red Light, Green Light, Eat Right” program the family followed, created by Joanna Dolgoff, MD, seems, at least on the surface, to promote sensible eating habits without being overly restrictive. For example, on her website, Dr. Dolgoff distinguishes between “healthy” and “junky” green light (low calorie) choices. But Weiss manages to put her own personalized, eating-disordered spin on the doctor’s recommendations, filling Bea up with diet soda and fat-free, processed snack foods while limiting fruits (which can be eaten freely) because she found Bea’s consumption of them “excessive.”
By demonizing entire categories of foods, making others available solely on the basis of their negligible calorie counts, and subverting Bea’s hunger with low-cal cookie facsimiles devoid of nutritional value, Weiss might as well be giving her daughter a tutorial on how to develop an eating disorder. And instead of seeing Bea’s weight as a behavioral issue involving modifiable eating and exercise habits, she prefers to medicalize it, liking the word “obese” because it “carries a scary, diagnostic tone.” Some sports are added, and Bea even enjoys them, but physical activity doesn’t become a family endeavor because Weiss herself hasn’t been to a gym in over a decade.
By her eighth birthday, Bea had grown two inches, lost sixteen pounds, and acquired, as a reward for her weight loss, a feather hair extension and wardrobe of designer dresses. Weiss hastens to add, “Incredibly, she has not yet exhibited symptoms of intense psychological damage.”
Talk to me in ten years.
When Weiss presses her daughter to take pride in her new appearance, telling her how different she is from “that fat girl [who] is a thing of the past,” Bea responds with a depth of insight that far surpasses her mother’s. “That’s still me,” she replies. “I’m not a different person just because I lost sixteen pounds. Just because it’s in the past doesn’t mean it didn’t happen.”
In the way of many controversial media figures these days, Weiss has gotten herself a book contract. I wonder what she’ll write. . . A parenting book? A diet book? Or a sociopolitical treatise on the childhood obesity epidemic in early 21st century America? I can hardly wait to find out.
This blog is intended solely for the purpose of entertainment and education. All remarks are meant as general information and should not be taken as personal diagnostic or therapeutic advice. If you choose to comment on a post, please do not include any information that could identify you as a patient or potential patient. Also, please refrain from making any testimonials about me or my practice, as my professional code of ethics does not permit me to publish such statements. Comments that I deem inappropriate for this forum will not be published.