Accepting and loving your body will NOT kill you (Jess Weiner article review)

Warning, mild rant. This apparently has been a pretty controversial topic (I understand Ms Weiner is launching a new campaign, so good PR, I suppose...)I was curious to read Jess Weiner's article in Glamour magazine. I had read and recommended, "Life Doesn't Begin Five Pounds From Now," particularly enjoying sections on how to stop the "fat-talk" that we women engage in so freely. Heck, I even "liked" her on face-book.Alas, the title, "Jess Weiner's Weight Struggle: 'Loving My Body Almost Killed Me,'" clued me in to the agenda the piece would be pushing. That is, that loving a larger-than-average body means ignoring health. Only by not loving our bodies, by trying to change them can they be healthy. (Oh, and by "almost killed" she meant some borderline lipid levels and an "almost prediabetes" blood sugar. Not ideal, but not imminently deadly. And-  I wonder if she wrote any articles on, "My eating disorder, it almost killed me," since eating disorders have the highest mortality rate of all mental illness...) I digress...The article totally distorts what I see as the mission of the Health at Every Size model. (Is it just me, or does there seem to be a concerted assault on body-acceptance and HAES these days? I see Dr. Katz all the time on my google-alerts warning about how loving your body can be dangerous...)  Allow me to go through a few  passages, with my own ideas  (as a physician and someone working to help children and adults have a good relationship with food and their bodies) on how the message could have been so much more powerful, and ultimately  more effective in promoting health and body acceptance.1) from her doctor: “your blood sugar numbers show me that you are almost in the prediabetic range. If you don’t lose some weight and watch your sugar intake, you will get diabetes.” It was a harsh truth." Well, not quite, but I don't want this post to be 12 pages long...The better way? Her doctor could have said,: "Jess, I am a little concerned about some of your lab levels, can you tell me what you like to do to get your body moving, and about how often you are able to fit it into your week?" "What do you think might be going on?"and, "You've shared your eating disorder history with me, tell me how things are going with food? I notice on your three-day record of what and when you eat that you seem to go long periods of time without eating and then seem to eat a lot later in the day. Can you tell me about that? How do you feel by 2 pm?  Do you sometimes eat when you are bored, or for other reasons?" ...Ask about behaviors in other words...2) from Jess, "The cold, hard truth was that accepting myself as I was was putting my life in danger."Really? This was perhaps the most aggravating line of all.  Does accepting and loving your body mean necessarily that you accept feeling "weighted down and not as strong and vibrant," as she puts it? That you don't move your body, that you don't eat in a way that is reliable, rewarding and balanced? Isn't that the whole point of loving and accepting your body-that you also HONOR it, and "treat it better" (her words– why she had to want to lose weight to realize she wanted to treat her body better is beyond me) and want it to feel good? Can't you do that at 255 pounds? Am I totally clueless? (I really am asking here...)3) on eating:   she tried to find more whole foods and foods with less than "5 grams of sugar per serving. (I’ve come to appreciate fresh veggies and whole-grain wraps.) It was a blow to realize how many foods I liked had unhealthy chemicals and extra sugar in them."better: Nutrition education can be powerful. Learning to enjoy a variety of rewarding foods from a variety of food groups is great. Again, did she need to embark on a weight loss program to learn to enjoy fresh veggies and whole-grain wraps? Aren't there fat people out there who like those things already? Is recommending calorie or sugar-gram counting, or other eating based on external cues helpful? Isn't it potentially harmful and triggering for a vast number of women who have struggled with eating disorders? Isn't denial of all those foods she likes (chemicals and all) a powerful  trigger for the cravings, guilt and shame? 4) Jess: "I also started seeing a therapist to work on the emotional baggage I carry and how it plays a part in the way I turn to food for solace, not nutrition." To me, body acceptance means you don't have to wait till you're trying to lose weight to address disordered eating patterns, in fact, trying to lose weight almost always sabotages competent eating.5) Uh-oh, there's trouble already. After her repeat labs (all within normal) and 25 pound weight loss, Jess says, "But I was a little pissed off. “I’ve only lost 25 pounds?” I asked. I thought declining desserts and exercising when exhausted would have brought me a more dramatic verdict." Here we see the ugly resentment and bitterness that comes from denying things like desserts. (She'll have to deny herself a whole lot more if she wants to lose the last 30 pounds she says she does.) What if she does maintain all those dessert-free days and exhausting workouts and doesn't lose another pound? How far will she go? What if, she even gains a few pounds before her body finds its new set point? Will she give up? Screw it all! Why bother? This is why weight as a measure of health and success is so damaging- why deprivation doesn't last. When the numbers don't respond the way we want them to we get mad, upset, feel shame, all things that make us less happy and less likely to sustain changes that might otherwise feel pretty good and improve our health. Will she resume her emotional eating to deal with her disappointment?The reality is, humans have the power to change behaviors. As hard as it may be, we can look at our eating if it feels out of control, we can get help, we can find fun ways to move our bodies, we can feed ourselves reliably and well. What the VAST majority of people CAN'T do is have the power to determine their weight. Behavior is modifiable over the long-term, weight is generally not. So some people make healthy changes, see the labs and fitness levels improve,  sense of well-being sky-rocket, while the number on the scale stays stuck. Some will lose weight, some won't. Still worthy changes, no? (More and more research is coming out that supports that healthy behaviors, not weight loss in and of itself, improve health.)Jess has made "healthy" changes, (though I would argue that restriction and sugar-gram counting may not be healthy in the long-run.) Although all her blood markers are healthy, she still has the goal to lose thirty more pounds (what is the magic of that number?) Though she tells a heckler in the beginning of the story, “...don’t assume that just because someone is overweight that he or she is unhealthy." Clearly,  she doesn't believe her own words.What I think is so sad, is that this woman, who helped many  others begin the process of self-acceptance and begin to believe that they deserved to be happy and healthy, blew a golden opportunity. By turning the focus and tying her perceived health to weight loss, she destroys the power of her message. Had she said something like, "I accept my body (I don't have to love it, but I do have to not hate it to treat it well,) but I don't feel very good right now. My eating still isn't where I'd like it to be, my energy is low, I'm not able to do the things I'd like to do, like go for a bike-ride around the local lake. I'm going to make some changes, try to feel better and see if I can improve some of my borderline lab levels." That would have had me cheering. And, if she lost weight? Fine. If not? Fine.Jess has the right to try to lose weight.  She has a right to try to be healthier. What I don't think she has the right to do is claim you can only do one by doing the other. It is that implication that has the potential to do so much damage.Now I just need to figure out how to "unlike" her on facebook, because now, her message is one I can't get behind.Do you think I'm overreacting, or does her focus on weight loss undermine her previous work? What did you think of the article?