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Concern about fat can lead to unhealthy obsession


As a dietitian, I think a lot about calories, fat, vitamins, minerals and proteins. Sometimes that's all I see on my plate. I'd like to wake up just one morning with my nutritional hard drive in "crash, then spend the day eating food instead of nutrients.

So it was easy for me to understand Monica Woolsey's goal for her patients: to be able to eat any food, in any social situation, anywhere in the world, without feeling threatened, ashamed or guilty.

Monica, a registered dietitian working with eating disordered patients at the Remuda Ranch Center for Anorexia and Bulimia, presented her goal-related strategies to 500 dietitians attending a workshop in Baltimore last weekend.

"Disordered Eating: A Reflection of the Times" focused on the classic problems of obesity, anorexia and bulimia, and then shifted gears. Heading into uncomfortable territory, counselors challenged dietitians to face our own fat phobia, fat discrimination and the ineffectiveness of dieting (even the healthy way) for permanent weight loss.

Don't get me wrong. This was no invitation to throw in the towel on nourishing eating and joyful exercise. Instead, we were invited to examine our attitudes about body size and body image. Listen to these unsettling sound bites:

* "I was surprised to find my third-grade daughter and her friends competing around weight and fat grams." Dr. Craig Johnson, Laureat Psychiatric Clinic, Tulsa, Okla.

* "Fruits come in different sizes, shapes and colors. That is an accepted and expected fact. So why can't we accept the fact that it is normal for humans to come in different sizes and shapes? Fatism is the last socially accepted form of prejudice in the United States. 'Lazy, stupid, sloppy, gross, unhealthy, and lacking will power' are just a few of the traits attributed to Americans whose weight, size or shape falls outside the culturally defined norm." Sue Luke, , spokeswoman for the American Dietetic Association.

* "I've been fat all my life. I've dieted most of my life. Now I'm committed to the best possible life. I eat well, stay active and go on with the things I value. I no longer try to help people get thin." Dr. Ellen Parham, presenting "Have Diets Outlived Their Usefulness?"

* "I hear the way men talk about women who are overweight. They don't view you as competent. It's as if they think fat somehow affects your brain." Bulimic-patient presented on videotape by Dr. Alayna Yates.

* "Is your weight the most important thing that happens every day of your life? . . . Our goal should be wellness and wholeness for all people." Licensed nutritionist Frances Berg, presenting "Challenges across the Weight Spectrum: How Can We Reconcile the Tough Issues?"

Finally, these disturbing excerpts from registered dietitian Dale Hayes, author of "Body Trust":

" Thirty million American women wear a size 16. In fact, the average dress size is 14."

"We define insanity as doing the same thing over and over and over again, expecting different results."

"Diets fail 85-95 percent of the time. Quality management in health care looks at efficacy of results. What other treatment do you know of that would continue to be prescribed in the face of such poor outcomes?

"I hate to say it, but I don't think the emperor has any clothes on."

This trip down a rocky road was sponsored by SCAN, the Sports and CArdiovascular Nutrition subgroup of the American Dietetic Association.

Colleen Pierre, a registered dietitian, is the nutrition consultant at the Union Memorial Sports Medicine Center and Vanderhorst & Associates in Baltimore.

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