What’s Wrong With WW Kurbo’s Approach to Childhood Obesity?

Weight Watchers, who are now rebranded as WW, Wellness that Works have launched a new app under this new branding for children as young as eight… as Young. As. Eight. It’s marketed as a potential solution to the childhood obesity crisis in America. However, a lot, and by a lot I mean, basically everyone who is an eating disorder advocate has lashed out online about the Kurbo App.

America is not the only country where childhood obesity and associated lifestyle diseases are high on the public health agenda. In the UK we have a Childhood Obesity Plan which has been associated with sugar reduction campaigns. With childhood obesity so highly on the public health agenda in the UK and USA. In the last decade, obesity amongst infant school aged children has dropped, whereas for year six children, obesity has risen. There is also a very strong correlation with social deprivation and obesity, which seems like it should be the other way around, that having more would mean you eat more. It isn’t, and so beyond calorie counting, we have to take into account social status and level of deprivation. Childhood obesity is a social class disparity – which will not be addressed solely by calorie counting on apps.

Source: https://digital.nhs.uk/

I would be curious to see if there is a similar chart to represent diagnosed eating disorder prevalence across social deprivation status’. Does it really mean that children are healthier just because they are not obese? Are there more underweight children in either end of the spectrum? Are there more mental health problems and what kind? Are there accessible facilities for exercising in the community? Where I live in SOuth London you pay £5 to access the tennis courts. This seems perfectly reasonable to those who an afford it, but what about all the children living in poverty in the area? Whereas in Surrey where social deprivation is not so much of an issue, the tennis courts in the park are free to use for everyone. As you can see, the picture is not so straight forward as calories alone.

Children being incredibly overweight, to such an extent that their quality of health and life are negatively impacted is a problem. I will not sit here and pretend that it is normal or healthy for a child to be unable to play and run around with their friends. It is not normal or healthy for a child to be limited by their body, or to be in pain when they try to play catch with their mates, and it’s not fair either. By over feeding our children, we are neglecting their holistic needs, and depriving them of a lot of what childhood has to offer for the ease of not managing their diet appropriately. Now I’m no sugar police, have some cake, have an ice lolly, heck, eat ice cream in the rain if you want to – a little bit of sugar here and there, and a child’s natural propensity to be drawn towards super sugary sweet foods is not the issue. It is the abundance in which these foods become a dietary staple, and in depriving children of attention and freedom to be kids in the streets safely (looking at you gang culture!!), we limit their potential coping mechanisms and potential social development. It is much more complex than diet alone. It is much more complex than calories in and calories out – although this is a suitably reductionist prophecy to sell to the general public because in being so reductionist it is also very easy to explain and sell.

As adults we have no right to deny children of the childhood freedoms of running around with their mates playing catch and relevance 40-40 in for days on end. As adults we have no right to either to instill pathological dieting practices into the young and impressionable under the guise of “this is for our health”. It’s not. Let’s not pretend for one moment that WW Kurbo app is for one minute about healthy relationships with food. In the same breath, we need to stop reducing the idea of health down to a BMI chart number, which is incredibly outdated now. Placing utmost importance on the weight of a child will mean that in a child’s mind, the idea of health can be measured easily and singularly in one arbitrary measure, the number on the scales. A very accessible number with which an obsession can easily be built. A very unreliable number with which our sole judgement of health should not be placed upon. What about getting their blood pressure down, and their glucose sensitivity up? What about a way to do this that doesn’t mean scanning every food and counting calories because equating losing weight with success very quickly equates not losing weight with failure. Why would we put such a bullshit task that’s easy to fail at the definition of daily failure for young children.

A child does not need to count calories to be healthy. Kurbo is a reductionist approach to nutrition that undermines the complexity and importance of a varied diet to support the very varied systems inside our bodies upon which our lives rely. Weight is not everything, if it is to be very much at all. A quick anecdote from a children’s weight management programme I worked with: His mum was using it as child care during the easter break and he qualified via BMI. He had an overweight BMI. He played sports, enjoyed sports and was a picture of health for a young boy with a tall athletic build. He was fast and very competent beyond his years in sports, and our nutritionist was quite stunned that he met the admission criteria for the programme. The admission was based solely on BMI and waist measurement. His waist measurement was not “concerning”, just his weight according to our guidelines. Neither his weight nor waist circumference were “concerning” in the slightest. Two words: MUSCLE. MASS. He shouldn’t have been on this particular programme and learning to eat less food, although I can entirely understand why his mum took the opportunity for free childcare during the Easter break.

The solution is not simple or straight forward. An app in principle is perhaps not the worst idea for a health tool, but basing results and goals on weight numbers is plain lazy. Reducing health to calories in vs calories out though, and encouraging children to count calories is dumb at best, and downright fucking dangerous at worst.

 

Beat: The UK’s Charity Antidote to Wellness Wankery and Eating Disorders

If you are worried about your relationship with food, who do you turn to? Your mates? Your GP? Or maybe you might turn to many of the numerous blogs, instagram pages and podcasts out there #wellness? Turning to influencers to make sense, I mean afterall, they’re flawless skin, pert tits, perky bum and six pack is the picture of health, right? Surely they must know what they’re talking about when it comes to wellness, diet, and exercise, or maybe not; influencers and #wellness are in a very committed marriage with diet culture. They’re like the grandparents who have been married  since forever #adorbs. This marriage though is #toxic needs to get a divorce, but there doesn’t seem to be one on the horizon *sad face*. Wellness industries and diet culture are like salt and pepper to your scrambled eggs, left and right to your Sat Nav and milk and sugar to your coffee.

A recent study by Christina Sabbagh looked into the validity, accuracy and evidenced based quality of weight management and nutrition of nine influencers, defined as having in excess of 80,000 followers on at least one social media platform. By assessing each blog against twelve criteria, including evidence based information, the use of reliable sources, and clearly stating the difference between opinion and fact, only one passed each criteria – and they are a UK registered nutritionist who is degree qualified. Nine is a small smaple size, but the strength of the results cannot be ignored: there seems to be a clear trend. Especially with many of the influencers having had no accredited training or education in the advice they are pushing on their sites. [More info here]

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A lot of influencers post before and after wellness photos. Before they were skinny and weak and barely eating coupled with pubishing exercise regimes that proved detrimental to their health. So are the influencers really as #healthy, #wellness, #blessed as they seem? Maybe, but most likely not. Are they really the place to turn to if you have concerns about your own relationship with food? Perhaps you’ve been bingeing in the evening, or skipping breakfast to shed some pounds and the result is that now you are in a somehwat chaotic place with your relationship with food. I don’t have the answers and I’m not going to pretend I do, else I would be falling into the wellness wanker world, no, I’m going to tell you about Beat – a wonderful UK based charity that I have been volunteering for.

Beat is the UK’s leading eating disorder charity. They provide information and services for people experiencing eating disorders, or who may be concerned about their relationship with food – I’m looking at you, the chaotic eaters who feel lost and overwhelmed with food, the fearful who are scared and anxious about eating, and the compulsive overeater who sweats hours in spin class just to try and burn it off. Beat have a lot of helpful information on their website, which can be found here.

What do Beat offer?

  • A phone line that you can call for advice
  • Information
  • Online 1-to-1 chats with a trained advisor (that’s me), like MSN messenger
  • Online group peer support sessions – also facilitated and moderated by trained advisors (Hi again, also me)
  • An email service that people use for seeking help and advice for themselves, loved ones and/or in general. (Me again)(This list is starting to look like it’s all about me, ha!)
  • A service finder application that you can use to find other eating disorder support services in your area using your post code.

So why did I choose to volunteer with Beat? Beat was the first website I was signposted to when I first opened up about my struggles with eating to a teacher way back in 2006. At the time was called EDAUK (Eatign Disorders Association UK): yup, it was that long ago and it was pretty basic. The most useful websites were all American (they get the best of everythign I swear). At the time I was obsessively surfing online between information sites, and other sites where people with eating disorders congregated online at the time (more on that another time). With the majority of sites being USA specific and although they had a lot of information that was useful about eating disorders in general, the support at the time was quite basic and non-interactive.

Sometimes I imagine how useful it would have been to have these online services when I was struggling back then, and as I became increasibly isolated by my bulimia, if I had had somewhere to chat in a safe space about what I was experiencing. Pro-ana sites mainly gave me a space to feel less alone – it would have been nice to have a healthy version as an alternative option; eating disorders are incredibly isolating experiences, particulalry when you have bulimia because a) it takes up a lot of time and b) there is a lot of shame around it when compared to the glorification of anorexia. It is that bit more shameful, that bit infinitely more disgusting and that bit more time consuming, mentally and physically.

So if you’re struggling with any eating difficulties, whether you have an eating disorder diagnosis or not, get in touch with Beat. They offer a good variety of services, and they are all confidential. Finally, if you think you might like to also become a Digital Volunteer, more information can be found here.

Why Loving Your Reflection is Just Another Unrealistic Expectation

At face value the body positivity movement may seem like the perfect antidote to unrealistic body goals, the continuous merry-go-round of dieting and the perpetuation of thin ideals from the fashion, media, fitness, retail, and industry that uses models and their bodies to promote products and ideologies. The incessant nature is that although these images, which are often digitally manipualted, don’t cause eating disorders or disordered eating, they can instill unrealistic ideals upon which to focus on, whether you are male, female, trans, and not even preidpsosed to eating disordered behaviours. The vast majority of us don’t fit the eating disorder category, and I would argue that a lot of dieting practices that are normalised in magazines and on wellness websites are dancing on the very thin line between normal dieting behaviours and disordered eating behaviours.

Body positivity on social media has come in all shapes and sizes. Some people promote the message by getting into their underwear and shaking their bellies in front of the camera, all in a bid to help you feel better about your own belly. Some people spread the message by telling you that you are fabulous and perfect just the way you are. There’s a lot of work going into challenging societally ingrained fat phobia, which is great, however sometimes I can’t help but think that the message gets a little lost and mixed up at times.

There is a common misunderstanding that if you have ever had any body hang ups, which is going to be pretty much all of us, that learning to love yourself and your body is the perfect antidote. A key tool used in hating our bodies, our reflections, is a major focus in learning to love our bodies – or so you could be forgiven for thinking. What if you have spent years and years of your life thinking of yourself as actually abhorrent? What if you have hated yourself to the point where you have hurt yourself in some way to try and fix “it”, whatever “it” might be? This could be in the shape of a number of different ways: binge eating, purging, exercising as a form of punishment, skipping meals, fasting behaviours, self harm. This is by no means an exhaustive list.

The pressure to love your body is a tall order for anyone who has struggled with their body image. How about we turned learning to love yourself on its head? What if learning to love ourselves happened by not focusing on turning the tyranny of your relationship with your own reflection 180 degrees on its heel is not the best focus. Another idea that offers an antidote to body bashing it a hashtag circulating the realms of social media: #BodyNeutrality. Body neutrality removes the pressure of having to love your body to have achieved success in not hating yourself. It means instead that accepting your body and being relatively neutral about your body image instead of trying to love what you previously thought to be unlovable. It is less extreme, less demanding and in being as such, more realistic. The pressure to always be happy and smiley about yourself is removed, but so is the need to berate yourself unfairly. The pretence of loving your belly has been removed, so if you are having an off day you need not feel like a failure for wishing your belly would just shrink. Instead body neutrality means accepting the thought, and not letting yourself be mad enough to diet over it. It offers us a middle path in a world of extremes. I think this is in fact much more empowering and I’ll tell you why.

Illustration by TheNourishmentNinja

Body neutrality means not hating your body or parts of it. It means that off days when you do momentarily hate your self are ok, and instead of havign to U-turn that entirely, into loving yourself, you can instead be neutral. You don’t love your body, but you don’t hate it either. It is very much the mundane and very boring mid-ground of body image, that is in fact potentially much more empowering. You are no longer focusing on your reflaction, or how well you take a photograph from this angle vs that angle. In fact, the mirror plays such a minor role in your day to day value of yourself that you have so much more free headspace for embracing life beyond your body, your image and your looks. Think about it. If you are no longer so hooked up on trying to turn your reflected self hate into self love, the absolute antithesis to what you know, you instead have loads of energy to instead focus on life beyond the skin you’re in, you can hit a middle ground which is in fact much more conducive to living your life away from your looks, and with all of this free energy and head space think of all the burgeoning possibilities that await you: climbing a mountain, planning trips away in nature, learning s new skill or a language, swimming in some wild waters, and baking some beautiful cakes from your grandmother’s recipe and eating them!

Go and laugh until your belly hurts, then roll on the floor clutching your middle and laugh some more. Go and challenge yourself in a way that exercises your mind and character and therefore giving you some brilliant stories to tell for years to come. Laugh at yourself when you fall over, pull a goofy face and let people learn to love you for who you are: your quirks, your mannerisms, your little weirdo ways because really, focusing on our reflections remains a narrow view of the world, of our lives and of our worth, whether we are singing our praises or chastising our very existence.

Be brave. Cover your mirror up and see how you feel only using your reflection to check you’ve not got toothpaste all over your face before leaving the house. Be brave. The greatest empowerment is to free yourself from the suffoctaing restrictions of being hyper-concerned about things you cannot and can change, but maybe your efforts are best placed elsewhere. Of course take pride in your appearance if it makes you happy to wear some make up – but don’t let it define you or how you see yourself. Our bodies are merely a vehicle through which we live, and it is the most dull thing about us as people, and eventually, if you have the privilige of reaching old age, looks fade and bodies change – would you rather be the one who was a stunner when they were younger with nothing more to offer? Or the one with banging stories of adventures, mishaps and hilarity calamity renditions of a life lived beyond the mirror, a life lived not enslaved to learning to love a reflection.

 

RED January: Active Everyday To Beat The Blues Away

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If you’re on Instagram it’s quite likely you will have seen some people going on about RED January. Maybe you think it sounds like another new year resolution fad like: Veganuary (please don’t shoot me, I’m an animal too) or Dry January, for those pretending that quitting alcohol is hard for them after an indulgent Christmas. Dietary cleanses and detoxes are once again circulating although I’m not in on the scoop of which one is most trendy this year. Are we still on the Whole 30, alkaline and keto “lifestyle change” tips? Either way it seems that whatever direction we turn you can’t help but be faced with lifestyle challenges promising to transform you into a new you and make you feel miraculously better about your shitty life. RED January could fall into this trap if you frame it in such a way, but it needn’t do.

Run Every Day January is a campaign to encourage people to be active on a daily basis throughout January in an attempt to buffer against the blues. Unlike the title suggests, you don’t have to run every day, I think RED January is just easier to market and brand than MED (Move Every Day) January. A lot of people do interpret RED January as another punitive challenge and as such, that you have to run every single day. It isn’t and this defeats the purpose of the campaign. Instead you just move, whether that’s a kick about in the park with your kids, walking to the shops instead of driving, running a Park Run or doing some yoga. You’re not supposed to break yourself over it, it is quite the opposite; it is about prioritising and taking the head space to move your body, connect with your body and in the meantime reap the benefits of moving for your mood.

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There are heaps and heaps of evidence for the positive effects of exercise on our mental and emotional well-being. It is now common knowledge that we can’t avoid to the point of GPs prescribing Park Run for mild depression in patients. Don’t be fooled, it isn’t a cure-all but it is a good place to start in terms of looking after yourself. Despite the accessibility of moving, 1 in 3 adults and children in the UK do not get enough physical activity. Let me repeat this. 1 in 3 adults and children in the UK do not get enough physical activity. This is quite shocking and with the benefits of exercising being so vast and varied, it really is an under tapped resource that most of us have.

I don’t mean that in a “no excuses” kind of way. It’s not easy starting to get active from being inactive for a period of time. It’s daunting, it’s hard work and sometimes it hurts but bear with me. Bear with yourself because in the long run you’ll be glad you got up and did it (pun entirely intended).

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There are numerous ideas and theories as to why achieving adequate physical activity is so difficult. Sometimes how we frame the idea of physical activity in our minds can really affect our perception of movement (Mental Health Foundation, 2013). Is it an extra and particularly painful chore to fit into our already busy schedules? Or is it a part of your self-care regime? Admittedly, with January being one of the coldest and darkest months of the year often curling up somewhere cosy with a book or a film feels immediately much more appealing. The greater benefits of movement may not be such an immediate gratification, but doing a steady amount will usually provide some hard-earned gratification immediately after exercise. So perhaps, the delay of immediate gratification by 30 minutes isn’t the worst after all.

The health benefits of movement are numerous, particularly for our mental well-being: from providing a protective factor to developing depression and anxiety (Fox, 1999) to increasing our work productivity and performance (Wiese, Kuykendall and Tay, 2017). The best news? You don’t have to go hard or go home; no matter how small or unimpressive you may perceive the achievement and effort to have been, any activity is better than doing none at all: what have you got to lose other than 30 minutes to try and see? (Mental Health Foundation, 2013).

The results from last year’s RED January participants speak for themselves. Last year in a survey of 3000, 87% of REDers felt significantly better physically and mentally after January 2018 from partaking in the challenge. Aside from the RED January challenge and their partnership with the mental health charity, Mind there’s oodles and oodles of evidence, scientific and anecdotal, about the benefits of moving your body.

This isn’t a weight loss message, but a 100% emotional wellness message. Regardless of your size, you DO NOT NEED TO LOSE WEIGHT before you can get active. There is no prescribed aesthetic or requirement in order to move. If you are concerned about your health impacting your ability to exercise I have added a link to a PAR-Q (Physical Activity Readiness Questionnaire) here.

The important focus is just to get moving, preferably in a way that’s enjoyable to you. Exercise does not have to be punitive, and in fact, to get the most from working out a healthy push of your limits is encouraged but don’t put yourself off forever. Start small and keep it real. Punishing yourself for eating something, or to look a certain way is not going to harvest the positive results that make you feel good, empowered and emotionally sound. It will only serve to do the opposite.

In this respect, the virgin active ad recently is a good message: Enough.


Sources:

Fox, K.R. (1999) The influence of physical activity on mental well-being. Public Health Nutrition. 2(3a) pp.411-418.

Mental Health Foundation (2013) Lets Get Physical. London: Mental Health Foundation.

Wiese, C.W., Kuykendall, L. & Tay, L. (2017) Get active? A meta-analysis of leisure-time physical activity and subjective well-being. The Journal of Positive Psychology. 13(1) pp.57-66.

How Gratitude Can Help Improve Body Dissatisfaction

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The power of practicing gratitude has the potential to be something quite incredible. Culturally in the West we are conditioned almost to always want for more, or with our bodies ironically we want for less. Less waist, less weight, less is more when it comes to beauty and looking good, or so we are told. We are primed to be perpetually discontented, dissatisfied and looking to others who always seem to have more of whatever it is we want: friends, tech, clothing or, ticking more beauty standard ideals with their appearance.

Like any other skill in our tool box of tricks to get us through our days reasonably content and in one piece, it takes a bit of practice in order to change our thinking patterns. The good news is that it can be done and that it can be an effective tool to develop a healthier relationship with your body and body image.

In a study conducted by Armstrong State University, USA, gratitude and cognitive restructuring were compared for effectiveness in reducing body disatisfaction amongst college age females. The group studied had not sought clinical help for body disatisfaction and eating disordered related issues. The importance of body image and dissatisfaction is that the feelings we have towards ourselves often permeate other areas of our lives: body disatisfaction has been associated with depression (Jurasico, Perone & Timnko, 2011) and social anxiety (Cash, 2011) for example.

Cognitive restructuring is a CBT technique. CBT is an established treatment for many mental health and well-being complaints including: bulimia, anxiety, depression. SOURCE THIS. By comparing a gratitude based intervention to an established intervention such as cognitive restructuring, the effectiveness of each intervention on body dissatisfaction can be compared.

The strength of using gratitude based interventions for body dissatisfaction is that it increases appreciation for non-appearence based aspects of one’s self and life: gratitude interventions have been found to be causally related to improvements in intrapersonal and interpersonal aspects of well-being including: increased happiness, decreased depression, improved pro-social behaviour, decreased aggression, improved sleep and concentration (Watkins, 2014).

There does need to be more studies in order to confirm or dispute similar findings. However, with this in mind gratitude is a promising intervention for people experiencing body dissatisfaction without a clinical diagnosis of an eating disorder.

Gratitude works is by changing perspective on what is important in life and how and what we judge ourselves and ourl ives to be worthwile. This study illustrates the potential effectiveness that can be had from introducing and working on gratitude in order to improve well being and happiness.

With this. Line of thought fresh in my mind, and my own practicing of gratitude lately I will be exploring some personal experiences of gratitude and how practicing gratitude has helped me alter my automatic thought patterns over time. As a disclaimer I am not suggesting gratitude is a cure-all, but more of a handy tool to help contribute to a changing way of relating to the world around us.


References:

Cash, T. F. (2011). Cognitive behavioural perspectives on body image. In T. F. Cash, & L. Smolak (Eds.), Body Image, A Handbook of science, practice and prevention (2nd ed., pp. 39-47). New York, NY: Guilford Press

Juarasico, A. S., Perone, J., & Timko, C. A. (2011) Moderators of the relationship between body image dissatisfaction and disordered eating. Eating Disorders, 19, 346-354. doi: 10.1080/10640266.2011.584811

Watkins, P. C. (2014). Gratitude and the good life: Toward a psychology of appreciation. New York, NY: Springer Science

Wendy, L. Wolfe & Kaitlyn Patterson (2017) Cpmparison of a gratitude-based and cognitive restructuring intervention for body disatissfaction and dysfunctional eating behaviour in college women, Eating Disorders, 25:4, 330-334, DOI: https://doi.org/10.1080.10640266.2017.1279908

What Is ‘Health’? And How Do We Define It?

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What is health and how do we define it? It’s a pretty complex topic and our interpretations will vary as much as our personalities. In 1946 the World Health Organisation defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (1) at the International Health Conference. This definition was put in place as of 1948. I don’t know about you but aiming for complete health in each of these areas feels like quite the daunting task, much like asking your crush out face to face in year 8 it isn’t going to happen.

“It is health that is real wealth and not pieces of gold and silver”
– Mahatma Gandhi (2)

Well-being focus and all the buzz around it is booming. Gone are the days when it’s a popular idea to starve yourself to nothingness in order to achieve a fashionable “look”. The greater the engagement from each of us with our health can only be a good thing. With all this focus on healthy living, healthy eating and “living my best life” what happens when the foundations of understanding what health is and is not are poorly understood? In this sense, striving for health can be like navigating the maze in a Triwizard tournament with an extra catch, you’re blindfolded and there is no cup to be found. Bah ha! You’ve been Tango’d. Except when health is concerned, the consequences can be a bit more dire than a double happy slap. 

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Being aware of and taking responsibility for our health can help us in many ways, whether it’s feeling able and capable, happy and content, experiencing sadness in proportionate bouts and even saving us money on health visits and prescription charges. With the age of the internet however, the health messages we receive can be combobulated and skewed – identifying fact from fiction is a bit of a tough cookie to crack.

So how does the evidence for what is and isn’t healthy translate into simpler ideas? Is it being a certain “ideal” weight? Having the “right” body fat percentages? Is it healthy to living in one emotional state? Is avoiding the GP unless you think you might be legitimately dying mean you’re healthier than everyone sat in the waiting room for said GP? The waters become murky very quickly and it’s easy to lose sight elusive Goblet of Health whilst sashaying amongst the currents and tides of fads, shock factor headlines and public health campaigns that are somewhat not accurate anyway – think Weight Watchers in American schools and the Ob_s__y campaign by Cancer Research UK earlier this year. 

The crux in relation to nutrition and our relationship status with food doesn’t boil down to one measurement, or one aspect of health. What we eat and how we do or don’t eat affects countless aspects of our bodies and functioning. Some very real questions in relation to health and nutrition is currently in an antler head bashing contest amongst those in the field, whether accredited and qualified or not. Is it healthy to marginalise a population group because of a pattern of association without identifying causation? Is it healthy to drill diet culture into young minds, and thus setting them up for a lifetime of living “healthily” on diet culture? Is that even possible? I’m not convinced. I’m also not convinced that everything stocked in Whole Foods is automatically healthy – sorry not sorry. I’m also not convinced about the healthiness of many modern day normalities, such as our phones becoming an extra part of the human anatomy, using social media to gain self worth and validation, or extreme approaches to anything much at all. 

With health food shops donning more supplements than we can possibly afford or swallow, and health influencers donning skimpy clothing to show off abs, glutes that can crush walnuts and who can do more chin ups than an excitable dog can tail wags, does being healthy have to be so extreme? I’m going to go out on a whim here and speculate that there’s no extremes in being healthy. It’s actually more about a balance and happy medium as boring and unexciting as that may sound.

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A little secret not pushed by those cashing in on the trend, you don’t need an extreme diet to eat healthily. You don’t need an extreme exercise regimen to be healthy. You don’t need to always be happy and content to be healthy. Nor do you need to spend crazy dollar on fancy ingredients and farfetched meal plans. Health isn’t even a number on a scale. The BMI is a tool for guidance and definitely not definitive – many athletes have a BMI considered obese and I’ve never seen someone typically considered to be ‘obese’ competing at the Olympics.

Each of us will define health differently drawn from our lived experiences. The most important point to be made though is that health is not a destination but a tool for living. It isn’t the be all and end all, merely a snazzy individualised car for scooting through your days with. Yeah, you want to keep the gear box in check but you don’t want to be obsessing over whether your gears are always sliding perfectly. You also need to keep your oil and waters tanks topped up, but you don’t want to be watching them furtively whilst missing out on the enjoyment of your drive. It would be a shame to not enjoy and take in the views.

Sources:
1. http://www.who.int/about/mission/en/
2. 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705649/

To The Bone Behind The Mask: Inside Anorexia

*Trigger Warning* – If you are experiencing or have experienced an eating disorder this post may be triggering for you.

The song of the morning birds has just begun, she can see through the crack in the curtain that the morning dawn is about to break. Her partner remains still as the night, unaware of the creeping day ahead. Pushing and kicking the duvet between her legs she rolls over to try and grasp at another few moments of peaceful slumber, “why is it that she can’t stay awake during the day and can’t sleep at night?” Tucking her extra pillow between her jarring knees for padding she twists her body so the least of her jutting angles are bruised from the mattress.

The tranquillity of peace is unbeknownst to her. Her only peace is found when calorie limits are adhered to, when pounds drop or measurements shrink; and despite the constant battle with herself and others, these moments are few. The human body can only lose at such a rate, she can only muster the strength to push herself to such a limit, and below nothing, there is no less to eat. Of course, she does eat, just not every day, but what more can she do to please this need?

The ruminations never desist, they merely quieten in a moment of victory, a moment when she has “done well”; she has adhered to the strict regime set by her demon of X calories, less calories, less calories. The congratulatory prize is small, a minor victory – and after a while does not extend to the praise of those around her as it had done when she began losing weight. No longer is she cooed with, “oh you look so beautiful”, “oh don’t you look marvelous, look at her cheek bones and toned stomach” or, “I’m so jealous, how do you do it?” There is a fundamental issue with society here; she was never overweight in the first place and she was never fat despite repetitious hollers. Her stomach isn’t toned, it’s bordering concave; her legs aren’t sculpted; they’re weak, aching and bruised; her arms possess no strength, they’re minute and painfully angular; her face isn’t chiselled like a catwalk model, but gaunt, lifeless and exhausted.

Her complexion pales whilst she walks through town smelling the foods she can’t have, staring in the windows of restaurant chains and eyeing up menus that she can’t even dream of ordering from. The thought fills her with a fantastical excitement at how good it must taste, but the engulfing fear and dread of actually eating it is too much. She had once felt empowered by her ability to say ‘no’, to deny herself and to not need but now she needed, and she wanted so desperately to say ‘yes’. She had become powerless to her disorder.

Wandering into the supermarket she’d stalk the aisles. Picking up foods she felt intrigued by and looking at it closely through the packaging. Turning it over and looking at the calories and fat grams, 90% of what she picked up had been a far cry from what she was now “allowed”, but with each package the fascination grew: if only she could taste, feel and enjoy food: longing to let herself need, to find true enjoyment and to just eat. Each packet was sat back on the shelf for someone else, someone less greedy, and someone who deserved to eat it. Aisle after aisle: dairy, confectionery, foreign food, it all amazed her. To just read the labels and ingredients engaged every morsel of her obsession until the anxiety and pressure to actually buy something began to creep in and ruin her fun. Leaving with nothing, she tried to sneak out without raising suspicion with security. She hadn’t stolen anything, but didn’t want to be pulled over because who spends two hours in a supermarket looking at food to walk out seemingly empty handed? She was painfully aware that her behaviour would be deemed as unusual.

When she got home, her cupboards were filled with foods she could eat. Feigning enjoyment of these choices to herself she was convinced that water on cereal was delicious and how could anyone not like a bowl of lettuce and mustard? Her demon had tricked her, fooled her into thinking in new ways and instilling relentless rules of survival: cutting up food into the smallest pieces possible, chewing x amount of times each time, no eating after 7pm but no eating before 5pm either, always eat alone, measure everything, weigh ten times daily. It went on. It went on and on. She was governed by barking orders from this voice within.

She had to keep it a secret. She had to lie. She had to remember everything she ate for the last fortnight. She had to count how many items she had consumed. She had to count calories or every bite, medications and vitamins included. She had to walk here, there and everywhere that she could. She had to exercise. She had to listen, she had to comply, because if she didn’t she would be berated to a withering heap. “You’re a fat bitch!”, “You greedy cow”, “You’re a failure and disappointment.”

Once immersed within the health services she has only more people to hide from, to lie to, to fight against. She is a slave to her own game. It’s not working out so well now; she has lost her autonomy, her independence, and her freedom. Caged in a cell of constant torture she is a shell of who she used to be: no longer laughing, no longer energetic, sociable, fun or fulfilling her potential.

What started as a diet to save her from “fat” hollers, what had started as a method of ‘self-improvement’ is gradually destroying everything she was. What started as a means to control her inner turmoil and world has grasped at her every molecule and refuses to let go. Entrenched, she is obsessed and caught up in the relentless need to abscond from greed, to not need and to be less. The “oh you look so beautiful”, has turned into, ‘Is she OK?”, “She looks so unwell.”, “I don’t know why anyone would want to be that thin. It looks disgusting” but the truth is, in her eyes for as long as she is alive, she will always be fat. She will never be thin and never has been thin and that really, ‘thin’ has become irrelevant. All she ever wanted was a bit of control, and to feel a bit better.

– If you want more information or are affected by this story, something-fishy.org and B-eat are good organisations for help, support and more information.