Nicole says she wants to lose weight but says her “fitness freak” husband, George, has no compassion or empathy for her struggles, and his intense, drill-sergeant ways aren’t helping. George says Nicole is her own biggest obstacle to losing weight — he says she’s lazy, makes excuses and gives up too easily — and all his efforts to help her have only strained their relationship. How can he motivate his wife?
And, Dominique says she knows she needs to lose weight but says her mom, JoAnn, won’t stop nagging her about it. Could JoAnn be sabotaging her daughter with her constant comments?
Then, Charles says ever since his identical twin brother, Adam, lost 90 pounds, he has become an arrogant jerk who loves to embarrass Charles about his body. Adam says his brother resents him for getting healthier and needs a serious wake-up call about his weight. Can these brothers heal their relationship while getting to a healthier place?
Husband and Wife “When we got married, Nicole was really fit. She was really hot, hot, hot,” George says of his wife of two years. “Helping Nicole try to lose weight is really tough," he says. "Nicole is her own biggest obstacle. Nicole is lazy." George says he tries to help his wife with her workouts, but his motivating tactics aren’t working. “I tell her, 'Quit crying. Let’s just get it done,'” he says.
Nicole says working out with her husband isn’t working for her. “He’s rough, and he’s strict. I always tell him, ‘I’m not one of your workout friends. I can’t bench press 150,’” Nicole says. “He’ll tell me, ‘Quit being a baby. Suck it up and do it.’ I feel like a failure as a wife and a mother. I don’t feel that my body type matches my husband’s body type because he’s so fit and athletic. When I look in the mirror, I don’t really like what I see anymore. I feel like I’ve become somebody who is not even me. I just don’t know what to do.”
Dr. Phil explains how George can properly support his wife.
Mother and Daughter
“I weigh 229 pounds,” says 21-year-old Dominique. She says her weight isn’t her only obstacle in life. “My mother is always mean to me and constantly making comments about my weight. She’s always telling me I’m gaining weight, and I shouldn’t be doing that. She’s always picking at me.”
“I’m always on Dominique’s back to lose weight because I’m afraid she’s going to lose control,” says her mother, JoAnn. “She needs that little push. I feel like I have to keep on her.”
Dominique admits she sneaks food into her bedroom so her mother won’t see her, and she can avoid another confrontation. She says a fight they had a year ago turned ugly when her mother called her a “fatass.” “I never thought my mother would say something like that to me, and she did. I’ll never be able to forgive her,” she says.
Why does Dominique blame her mother for her weight?
In a powerful experiment, Dr. Phil shows JoAnn how her comments affect her daughter.
Twin Brothers
“My twin brother, Adam, and I have always struggled with our weight,” Charles says. “Right now, I’m 605 pounds. In the last year or so, Adam has started to lose weight, and he’s really becoming an arrogant ass----. Since he’s lost the weight, he’s started taking more jabs at me about my weight. He’s become one of those kids who made fun of us growing up.”
“I’m pissed off my brother doesn’t do anything about his weight,” Adam says. “He doesn’t work out. He doesn’t try to eat right. It’s like he’s just given up. He just sits around and constantly overeats.”
Adam says he’s concerned for his brother’s health and is upset that Charles turns down his offers to go to the gym together. Adam says his life has improved a lot since he lost weight, and he wants his brother to experience the same thing. “He’s just lazy. He needs to get up off his ass before he dies,” he says.
Losing weight for healthy living is difficult, but that's not new. What's interesting is the role our brain plays in regulating our weight—any weight—and why that makes it so difficult to lose weight when we want to. Neuroscientist Sandra Aamodt explains in this TED talk, and discusses how eating mindfully can help.
The talk is a little long, about 12 minutes, but it really is worth a watch if you're struggling with your own diet or weight loss goals. Ultimately, she describes the intersection of human nature and our modern, drive-through world—where the brain is hard-wired to accept food and build energy reserves when food is available, but resist efforts to burn those reserve, largely because food scarcity has been a problem for much longer in human history than food abundance. She goes on to explain how the brain will, usually after a short period, determine what the body's "set point" weight is, kind of an unconscious "ideal weight" that has nothing to do with our health, but everything to do with food availability and lifestyle. She even explains how thinner people will burn fewer calories, thanks to the brain's interference, which makes it even harder to shed pounds.
All of those factors combined add up to why it's so difficult to lose weight when we want to, and why diets are so dysfunctional—our brain is now wired to send us powerful signals to keep us at the weight that it has deemed appropriate, even if our conscious mind wants something completely different. Instead, we get hungry, we overeat, we make poor dietary choices, and we're back to square one, feeling miserable about the whole endeavor. That's why "just put down the fork" is never a real path to weight loss.
Instead, the key is focusing on a healthy lifestyle instead—exercise, activity, healthy habits—and mindful eating (eating when you're hungry and stopping when you're full, strictly), as in eating when you're hungry or when you need to, and being aware of what you're eating and how long you're eating while you dine. She gets into the importance of healthy habits at about 7:40, and what she means by "mindful eating" at 9:28. Skip there to go to the punchline, but the rest of the talk is interesting—and informative, if you've struggled with healthy eating (or know someone who's trying to losing weight) as well.
Do all these new diets ever bug the crap out of you? It seems like there’s a new diet every week (I think statistically speaking there’s a new one every few weeks.)
Just last week I was in Barnes and Noble and saw half a dozen new diets on the shelf — most were some kind of re-purposed Atkins, Paleo, or Gluten-free diet, but some were new.
But to me it’s not really surprising that modern consumers have no clue who to trust in the health & wellness space. A new diet every month. A new guru every month. Sites like Bodybuilding.com geared towards bodybuilders but actually in the business of pushing supplements (that often do nothing) on customers.
And these are all marketed towards people that have the same hope: the belief in quick fixes. New guide? Maybe it’ll have something the others don’t. New supplement? Maybe it’s a revolutionary new uber-antioxidant from a pillaged rain forest in South America.
So who do you trust? The story almost always ends up the same when I hear it from people:
“I have no idea who to trust anymore, so I give up, I’m just going to eat what I like, enjoy my life, and stop stressing over it.”
If you need to be reading this, you know exactly what I mean when I say the words "normal" eater. If you're a "weirdo" about food -- a calorie-counting, binge-eating, chronic-dieting weirdo -- you've all probably seen "normal" eaters in action, and thought to yourself, "How the hell does that woman just eat a single bite of a cupcake and leave the rest on her plate?!" Or, "Why does she get to eat whatever she wants and not care, while I have to count every calorie and sit on my hands trying not to eat the whole bread basket when I go out to dinner?"
I get it. Been there! And after years of studying, I've discovered the fundamental mentalities of "normal" eaters that are keeping you from freedom with food. Buckle up.
1. Normal eaters generally don't plan their food in advance. They eat when they're hungry, or when dinner time rolls around, and they don't think about food in between those times. They don't worry about what they're going to eat for dinner for hours before they get home from work, and they don't spend time creating elaborate meal plans (e.g., "For the next three months, I'm eating 3 oz. of lean protein and 1 cup of vegetables for every meal, with two fruit snacks at 10 a.m. and 3 p.m. every day"). Lame.
2. Normal eaters have a life in between meals. That is, in addition to not planning, they don't fantasize about food, dieting and weight loss all day long. They think about what they should get their boyfriend for his birthday or how they're going to celebrate that new promotion -- not whether or not they should try to sneak a stale cookie from the corporate kitchen, because God knows when they'll ever be able to eat cookies again.
3. Normal eaters don't think they're doing anything "wrong" when they eat something that might not be the best for them. What I mean is, normal eaters don't attach moral judgement to what they're eating. They don't think the whole world is going to judge them for eating a doughnut in public, and don't "sneak eat" cookies in the middle of the night. While they generally make healthful choices because that's what feels best to their bodies (and thus that's what they legitimately want) they're not sent into a frenzy when they do eventually have a bite of dessert or the occasional side order of fries. It's no biggie.
4. Normal eaters eat when they're hungry and stop when they're full, and usually eat what sounds good to them in the moment. Are you having a "duh" moment? The number one objection I get from women when I tell them the benefits of a "non-diet" approach to eating is, "If I wasn't constantly on a diet, I'd gain a bajillion pounds." Not so. Eating like a "normal" person means making decisions about food based on your body's natural biological wisdom, rather than external cues that make you feel like you're in prison. Your body knows exactly how much food you need to maintain a weight that's healthful for you. That is the biological function of hunger -- to remind animals to eat (because otherwise "normies" might forget... for serious).
5. Normal eaters practice a variety of coping mechanisms and don't turn to food to get them through the day's discomforts. This is the single most important thing to understand about normal eaters, and probably the thing most of you are scared you can't do. Normal eaters trust that if they let themselves eat what they wanted, they wouldn't fall into a bread basket that they weren't able to swim out of. They're able to do this because they've been practicing coping with life's "triggers" using non-food-related comforts. I promise this can be learned.
by John Richardson – Behavioural Weight-Loss Consultant / NBW-LP
This book is 'The Answer' to the world’s steadily increasing obesity epidemic.
Talk Yourself Slim with the Self-Chatter Diet was written from John Richardson’s childhood observations of his grandfather and mother. His grandfather was slim, and a naturally healthy weight, whereas his mother was not, and this was the true cause of her early disablement.
Diets don’t work, do they? Not conventional, out-of-date, orthodox, restrictive diets – these are one of the fundamental instigators of obesity in the world today, fueled by the same diet industry that masquerades as a 'solution provider'. It is not food that makes people overweight, but the behavioural manner in which food is eaten, and until obesity is addressed and treated behaviourally, no solution will ever be found.
In this book you will discover the true cause of obesity: beliefs, habits and associations. Richardson first provides a way in which these rogue behaviors can be identified. He then questions them and challenges them, allowing readers to form a general understanding of a method through which they can be changed.
Talk Yourself Slim was written to facilitate permanent weight-loss success, and nothing more. This simple yet highly effective method is uniquely innovative in its approach, ideal for anyone fed up of diets that don’t work, who wants to lose weight and keep it off! Source:- http://www.troubador.co.uk/book_info.asp?bookid=2604 talk yourself slim
One morning at a local gym, anxious whispering could be heard between trainers and clients. The peddling gossip was about two women who spent the previous night in a hospital after experiencing seizures and heart palpitations. Rumor had it that controlled substances, like steroids, were found in their bloodstream, and the gym was reported to be the source of the problem.
Allegedly, these women were taking supplements handed out by their trainer, who had since been dismissed from the gym for distributing these products. The supplements promised to give them more energy, increase their metabolism and help them lose weight, fast. But these supplements, the trainer explained, were different. Better. They were “self-made” by his own hands. His clients fell for the weight-loss promise as quickly as the weight promised to disappear. No questions asked.
Plainly speaking, people are desperately trying to find the quickest and easiest way to lose weight. So desperate, in fact, that these women continued taking the harmful pills even after the trainer was fired for distributing his supplements.
Before writing these women off as drug abusers, consider that they were acting as many would from the desperation of wanting the miracle weight-loss drug. In 2007, 70 percent of the United States population was taking dietary supplements, and the weight-loss supplement industry was worth $1.67 billion. Mr. Jeff Burbank, Rph, a pharmacist for over 20 years at Dear Drugs Pharmacy, attests to the fact that weight-loss supplements are increasingly prevalent in community members’ diets. “Unfortunately, weight-loss supplements are a major component in someone’s diet and are bogus. People are looking for the miracle drug, like snake oil from the 1800’s where one sip cures your ailments, but it doesn’t work like that. Nothing can replace a good diet and exercise for weight-loss.”
Unsupervised and Unrestricted
Rule of thumb: if it sounds too good to be true, then it is – especially when a product promises to cause weight-loss of over two pounds per week without diet and exercise.
Consumer Reports noted that the consequences of these supplements can be far worse than just false advertising, and can include: heart attack, heart palpitations, high blood pressure, rapid or irregular heartbeat, seizures, stroke and possible death. Currently, the Food and Drug Administration (FDA) has limited authorization over dietary supplements, since they are not considered drugs. Manufacturers do not need to register their products or get approval from the FDA before placing it on the market. Mr.
Burbank explains, “The lack of FDA approval means that 9 out of 10 times weight-loss supplements do not do a thing.”
Because of the lack of FDA oversight, consumers can easily be taking supplements containing controlled substances. Manufacturers may either omit harmful chemicals on their ingredient list or accidentally contaminate the pill during production. As of 2007, if a supplement is later found to contain illegal substances or have serious side effects, the FDA can pull it off the shelves, as in the case of ephedra, an ingredient in herbal weight-loss treatments. Ephedra was removed from the U.S. market in 2004 after it was found to cause strokes and heart problems. But the FDA’s interference is too little, too late.
Added Ingredients May Pose Danger
There is growing controversy over whether other ingredients in supplements, including vitamins, have beneficial or harmful effects on one’s health. Certain herbal and weight-loss supplement ingredients, including comfrey, chaparral and kava, were shown to be linked to 9 percent of 300 cases of drug-induced liver problems in a study published in the Journal of Gastroenterology. Dr. Steven Clarke, a laboratory leader in pharmaceutical research and professor in the Brooklyn College nutrition program, explains, “Because a supplement claims to be botanically derived, once purified, it can be harmful. Botanically derived does not make it more safe, just botanically derived.” Furthermore, if a person has preexisting health conditions, extra precaution is needed. Mr. Burbank says, “People need to watch out for ephedra or caffeine, the active ingredients behind many weight-loss supplements, especially if they have high blood pressure, coronary heart failure or an erratic heartbeat.”
Educate Yourself
Since 2004, with the enactment of Dietary Supplement Health and Education Act (DSHEA), the manufacturer is responsible to ensure a dietary supplement’s safety before marketing it to the consumer. The reality is that the supplement industry is too large and growing at exponential rates, making it difficult for the FDA to keep up. Therefore, it is incumbent upon consumers to educate themselves from reliable sources, such as a registered dietician, before taking a supplement, and not from other sources, like health food store personnel. As Mr. Burbank explains, “Employees at health food stores may have some knowledge, but are not a replacement for a doctor or pharmacist. They are there to sell products, not care about your health.” And it seems like the community is taking a step in the right direction. Mr. Burbank finds that “In the past 4 to 5 years, people have become exceptionally educated before purchasing supplements. That is mainly due to the internet. What used to be available to only doctors and pharmacists is now available to the general public.”
Dangerous Combinations
Education does not end with each supplement’s effect on the body; it also includes its combination with other vitamins, minerals or prescription drugs. If a supplement contains an active ingredient at a healthy and effective level, once it is combined with other sources, it can become toxic, lose its effect, or increase its absorption. For example, combining iron with vitamin C can help increase the absorption of iron in the body, while large amounts of zinc in the diet for extended periods of time can inhibit the body’s ability to absorb iron, copper and vitamin C, which could cause anemia. But knowledge on these effects is lacking among community members. Mr. Burbank explains, “The first question I still have to ask is, ‘What medications are you currently on?’ Everything depends on that.” He cites some examples of interactions between vitamin E, vitamin K and fish oil supplements and the drug Coumadin, a blood thinning agent. These supplements, among other things, have blood thinning characteristics, and when combined with Coumadin, can be life-threatening.
Double Check the Dose
If there is a benefit in taking a supplement, it occurs from taking the recommended amounts. Therefore, it is important to read and understand what is being consumed. Dr. Clarke finds that “sometimes supplements contain just a sprinkle of an active ingredient and is having no effect.”
Having no effect is argued to be the ideal consequence when looking at the other side of the spectrum. Taking vitamins in excess can have dire health consequences and is becoming more common than taking too little. Some vitamins, like vitamin C, are water soluble, and so if there are taken in excess, they are simply excreted through the urine. However, fat soluble vitamins, like vitamin A, are absorbed by the body, and the line between safe and harmful levels of vitamin A is quite thin. Consuming a multivitamin, eating fortified cereal and drinking fortified milk bring a person close to toxic levels of vitamin A, which can lead to osteoporosis.
After establishing that a supplement is safe and beneficial, it is important to stay attune to signs or symptoms experienced after taking the pill, such as nausea, weakness or fatigue, fever, abdominal pain, chest pain, shortness of breath, yellow corneas and skin, and discolored urine. These are all warning signs reported by the FDA in products that may contain steroids and can cause liver or heart problems.
Do We Need a Multivitamin?
Potential dangers aside, the value of multivitamins and other supplements for generally healthy individuals is questionable. But some, like Mr. Burbank, feel that certain vitamins are beneficial regardless of health status, “The most common supplements taken, like calcium, iron and vitamin D, are proven effective for preventing health conditions like osteoporosis.” Fish oil supplements have also gained increasing popularity for the benefits of eicosapentaenoic (EPA) and docosahexaenoic acids (DHA), which have been shown to lower cardiovascular disease risk and triglyceride levels.
However, there is rarely enough reason to introduce weight-loss supplements, with all its risks, whether over or behind the counter. Even if weight-loss can be achieved, the effect will be short lived once the body becomes accustomed to the supplement. Or, as Mr. Burbank explains, “A weight loss supplement can be placebo and have no chemical effect other than making a person believe they are losing weight from the supplement. It’s all in a person’s mind.”
Before one develops a fear of vitamin supplements, know that some can have their place in one’s diet. But it is important to take caution when ingesting any vitamins. As long as consumers become proactive in educating themselves on the safety and benefit of a supplement for their individual health status, dietary supplements can potentially have their place in the diet.
Office of Dietary Supplements, National Institute of Health provides information on research about safety and efficacy of supplements at http://dietary-supplements.info.nih.gov.
National Center for Complementary and Alternative Medicine has information on possible interactions between dietary supplements and drugs at http://www.nccam.nih.gov or the Center for Education and Research on Therapeutics at www.QTdrugs.org
I had gone to a lot of trouble to land myself in the hospital. At 15, I had embarked on a diet and had shed 50 pounds in six months. My body had started out slightly padded, clad in baggy painter's pants to conceal my thighs. As I shrank, I wore tighter pants to flaunt my success, until those too began to hang on my diminishing frame.
- from Evelyn Strauss's, "Facing the Plate" (Salon 9/13/00), a personal account of the author's experience with an eating disorder.
This is a horrifying but typical picture of a young woman suffering from an eating disorder — something that, according to the National Institute of Mental Health, affects more than five million Americans today. Aside from cases where depression or other mental illness leads to suicide, it is hard to think of a psychological problem that poses a greater threat to a person's physical health. Those afflicted with eating disorders try to lose weight by dieting, purging or other means until they make themselves sick. Though some get treatment and recover, others literally starve themselves to death.
As Ms. Strauss's story illustrates, a particularly troublesome aspect of this illness is that while its victims may appear not to understand that they are making themselves sick, most of the time they know exactly what they are doing to their bodies. In cases like these, friends and family members can beg, plead and try all they want to convince victims that they are too thin or that they are ruining their health but they continue to do it anyway.
What can you do if you or someone you care about is suffering from an eating disorder? The good news is that there are treatments. The first step, however, is to become informed about what eating disorders are, the different kinds and how they affect the body.
There are two main types of eating disorders. Their technical names are anorexia nervosa and bulimia nervosa. The table below shows the main ways in which they differ.
Eating disorders are a uniquely dangerous form of mental illness.
Table 1.
Eating Disorders
(Based on the American Psychiatric Association's Diagnostic and Statistic Manual, IV)
Anorexia Nervosa
Refusal to maintain body weight at or above a minimally normal weight for age
Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight
In postmenarcheal females, amenorrhea, i.e., for at least three consecutive menstrual cycles.
Restricting Type:
person not regularly engaged in binge-eating or purging behaviors
Binge-Eating/Purging Type:
In addition to symptoms of anorexia nervosa, the person regularly engages in binge-eating or purging behaviors.
Bulimia Nervosa
Recurrent episodes of binge eating characterized by 1) eating in a discrete amount of time a large amount of food and 2) a sense of lack of control over eating during the episode
Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, enemas, and other medications; fasting or excessive exercise
The binge-eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for three months
Self-evaluation is unduly influenced by body shape and weight
The disturbance does not occur exclusively during episodes of anorexia nervosa.
Purging Type:
During episodes of bulimia nervosa, the person regularly engages in self-induced vomiting, misuse of laxatives, diuretics, or enemas.
Nonpurging Type:
During the episodes of bulimia nervosa, the person has used other inappropriate compensatory behavior such as fasting or excessive exercise but has not regularly engaged in the purgative methods listed above.
What Are the Warning Signs?
Some of the common early warning signs of bulimia are extreme weight fluctuations, preoccupation with diet and really bad breath. Typically, a victim's family or doctor might notice that the victim's weight is going up and down over a period of months or years. The victim may begin to abuse diuretic drugs or laxatives, begin to exercise obsessively or make themselves vomit after meals. Repeated self-induced vomiting leads in the short term to bad breath and in the long run to dental and other physical problems. When confronted, however, the typical bulimic will deny everything.
When asked to explain their behavior, both anorexia and bulimia victims will insist, no matter how objectively thin they may be, that they "feel fat." These feelings can be so extreme and unreasonable that doctors often conclude that victims are mentally ill and have lost contact with reality.3 Deep down, however, this is not the case. In fact, those with eating disorders understand how they really look and what they are doing to themselves. The problem is not that they are irrational or out of contact with reality, but rather that they cannot control their behavior.
Another warning sign of an eating disorder is excessive concern with a particular part of the body. Victims may turn to plastic surgery or liposuction to fix a supposed physical flaw or just to "stay thin."
Certain psychiatric problems often accompany eating disorders. These include depression, anxiety disorders (especially obsessive-compulsive disorder), borderline personality disorder and substance abuse.
Who Are the Victims?
Traditionally, most victims of eating disorders have been thought to be White, economically well-off girls or young women. This remains largely true, although the picture does seems to be changing. Recent studies have shown that growing numbers of African-Americans and other minorities are becoming afflicted with eating disorders, especially bulimia.
Boys and men are also at increasing risk for eating disorder. Although studies show that nine out of ten victims are female, males who participate in certain sports (e.g., wrestling, gymnastics, running), are homosexual, or who suffer from addiction or personal disorders are at greater risk of developing an eating disorder. Anorexic males can be just as preoccupied with body image as females, but tend to want to have a slender waist and muscular, athletic shoulders and chest. This is sometimes called "reverse anorexia".
Eating disorders are appearing among all socioeconomic groups. They are crossing age barriers, showing up in younger and younger children. More and more preschool and grade schoolers are developing eating problems, showing preoccupation with weight and size, and going on diets.
What Is the Cause?
No one has found an exact cause of eating disorders. There are, however, circumstances and influences that make some people more vulnerable. Among preschool children, studies have found a strong association between eating problems and extreme parental attitudes about food and weight, particularly for children of a mother with an eating disorder. Ironically, being overweight is also a contributing factor. And childhood obesity is definitely on the rise.
Today, as many as 50% of grade school children are overweight. This has caused an increase in diseases in children that were once seen almost exclusively in adults, such as Type 2 diabetes. Studies indicate that youngsters who are teased or feel ashamed about their weight are much more likely to develop an eating disorder when they are older. (Parents should be aware that in some cases, children who show symptoms of anorexia may in fact have a pediatric autoimmune neuropsychiatric disorder (known as PANDAS) that is associated with streptococcus infection. This can be cured with antibiotics.
Some people also seem to carry a gene that makes them more likely to develop anorexia nervosa or bulimia nervosa.
Finally, a startlingly high percentage — in the range of 30% to 60% — of those with eating disorders are victims of past childhood physical or sexual abuse, or of a more recent adult trauma such as rape. This could explain why post-traumatic stress disorder is more common in those with eating disorders. Read the rest of this article here:- http://www.thedoctorwillseeyounow.com/content/behavior/art1960.html?getPage=1
In An Endless Quest to Slim Down, Image-Obsessed Americans Try Surgery, Pills and Starvation—Sometimes with Fatal Results
In his sprawling La Habra, Calif., home Ruben Fernandez is surrounded by reminders of his late wife, Judy, especially the furnishings she traveled widely to buy—Spanish statues, a grand piano, crystal chandeliers, Oriental rugs. "Everywhere you look, you'll see detail," says Fernandez. "She wanted everything to be right." That included her figure. At 47, the mother of three decided it was time for lipoplasty, commonly called liposuction, a procedure that siphons fat from strategic areas. "She had gained a few pounds," recalls Fernandez, now also 47. "She was just looking, let's say, for maintenance."
Instead, on March 17, 1997, Judy Fernandez died following extensive cosmetic surgery, a casualty of the all-too-common pursuit of the perfect body. "The premium for women on physical beauty over intelligence is on the order of 100 to 1," psychologist Dr. Rex Beaber says bluntly. "A woman with an IQ of 180 who is not lovely is likely to marry ugly, be paid modestly well and secretly despise herself until the day she dies. A woman with an IQ of 100 and beauty in the 99th percentile is likely to marry a physician or an investment banker, have a maid and be admired by all her neighbors." Strong words—however, according to the American Society of Plastic Surgeons, their board-certified members treated more than 1 million Americans last year. Liposuction was by far the most popular surgery: More than 230,000 procedures were performed, almost 30,000 of them on men, a 350 percent rise since 1992.
And therein lies a cautionary tale, for Judy Fernandez was no fluke. A 1998 study showed that over the previous four years the fatality rate for liposuctions was one in 5,000. "To put it in perspective, the incidence of death from liposuction is two to three times higher than that of dying from a normal pregnancy," says Dr. Robert del Junco, former president of the California State Medical Board. "Liposuction is the only cosmetic surgery with this level of risk." Most fatalities occur in doctors' offices or unaccredited outpatient clinics, which are not held to the same standards as hospitals, and are generally caused by blood-clotting, complications from anesthesia or errors by practitioners who may be doing cosmetic surgery only as a lucrative sideline.
Indeed, in many states a medical license entitles a doctor to practice any kind of medicine. "Can a psychiatrist take a weekend course and on Monday start doing cosmetic surgery?" asks del Junco, who helped spearhead efforts in California to tighten regulations on outpatient procedures. "The answer is yes."
Of course liposuction is but one potentially fatal manifestation of the cult of thin. According to the National Association of Anorexia Nervosa and Associated Disorders, roughly 7 million American girls and women and 1 million boys and men struggle with eating disorders. The mortality rate from anorexia—estimated between 10 and 20 percent—is the highest of any mental disorder. Plus, there are diet pills that offer another supposedly quick and easy way to lose weight. In August a federal judge approved a $3.75 billion settlement of claims stemming from 9,000 lawsuits against American Home Products, the maker of fenfluramine, part of the diet drug fen-phen, which was pulled from the market in 1997 after a study linked it to heart-valve damage.
In addition, the U.S. Food and Drug Administration is studying the herbal supplement ephedra, a stimulant used for weight loss that some studies have tied to strokes and heart attacks. (In 1994 Congress rendered the FDA essentially powerless to regulate herbal supplements unless the agency conclusively proves them dangerous.)
Horror stories notwithstanding, it is unlikely that Americans will renounce their desire to look good in a bathing suit. "Whenever human beings weigh the risks of something that might give them happiness," says Beaber, "they tend to ignore the risk." On the following pages are the stories of six people who, like so many, were consumed by the battle to lose weight. Three sought help from liposuction, two took pills, one starved herself—and all paid with their lives.
JUDY FERNANDEZ 'The easy way' proved to be deadly
When Cuban émigré Ruben Fernandez met Judy Blum in 1981, he fell fast and hard. "If you look at any of the pictures, it's the smile," he says. "She was just a very bubbly, lighthearted personality. She looked at life through undamaged eyes." Both divorced, with five children between them, the couple lived together for three years, then married in 1984 and built a thriving business refurbishing and reselling electric forklifts. Life was good. Still, at 47, Judy didn't like the signs of age she was seeing in herself. There were more and more new wrinkles, and at just 5'3", she weighed 147 lbs., about 30 more than when she'd met Ruben.
Then she saw a magazine ad for board-certified Irvine, Calif., plastic surgeon Dr. William Earle Matory Jr. "She liked the ad and then the people in his office, who were very friendly," recalls her husband. Judy put down $20,000 and signed up for a face-lift, brow lift and liposuction to her stomach, back, arms and legs.
"Why don't you just go to the gym?" Ruben asked. But Judy was comfortable with cosmetic surgery, having had her breasts enlarged years before. "This is the easy way," she replied. And so at 5:45 a.m. on March 17, 1997, they arrived at Matory's office. Ruben was concerned about the extent of the surgery but says that anesthesiologist Dr. Robert Hoo assured him, "Don't worry, it's within the ballpark." Just before 7, Ruben kissed his wife and left for work. "Honey," she said, "next time you'll see the new me."
As the day wore on, Ruben called several times to check on Judy, and each time, he says, he was told everything was going well. Only later would he learn through medical records that as early as 9 a.m. her blood pressure had dropped sharply. By afternoon her kidneys had shut down. At 5:30 Ruben, having been told Judy was in recovery, arrived to pick her up. An hour later Matory came out. "He looked at me very calmly, very peacefully and said, 'Ruben, the operation was a success. I just have a little concern about volume.' " Judy's blood had been dangerously diluted with several kinds of fluids.
At 8 that evening, Matory said they needed to take her to a hospital, at which point Ruben burst into the operating room and received a horrific shock. "She was dripping fluids from various parts of her body," he says. "She was swollen to about twice her normal size. She was a see-through color, the color of death."
At 10:20 p.m., Matory walked out of the ER at Irvine Medical Center, hands over his face. "Sorry," he told Ruben, "but we lost her." Judy's cardiovascular system had shut down—a consequence, according to medical records, of massive blood loss. Immediately Ruben filed a complaint with the state medical board, which investigated the case and in November 1997 revoked Matory's and Hoo's licenses. Ruben also settled a civil suit with the two doctors for an undisclosed sum. Matory's attorney Lloyd Charton calls his client "a victim," noting that Matory was not the one responsible for monitoring Judy's vital signs. "Should Hoo have spoken up? Absolutely," says Deputy Attorney General Steven Zeigen, who helped prosecute the doctors for the medical board. "But should Matory have said, 'By the way, how much fluid have you put in? We've been doing this for 12 hours'? Damn right."
Today, Ruben Fernandez keeps a gold-framed photo of Judy on his bedroom wall, a constant reminder of the brilliant smile that he will cherish for the rest of his life. "I don't know about that word a lot of people use, 'closure,' " he says. "If someone was part of your life, how do you close it? She'll still be part of me. It's just that I'll carry her in a different spot." Read the rest of this article at:- http://www.people.com/people/archive/article/0,,20132771,00.html
Suzie had seen her weight soar to around 22st before taking the drastic action of asking for a gastric band operation.
She confesses she and her mum Julie used to binge-eat together, adding: “We were both very fat.
"I would scoff a sausage roll, a cheese and ham bake and a pizza slice for lunch, followed by a chicken korma, naan bread, chips and rice with a side portion.
“We’d tried diets, slimming clubs and pills. We might lose a stone, but we’d put it on again, and then some.”
But things changed four years ago when Julie had a gastric band fitted. “As I saw all the weight dropping off Mum I knew that it was what I wanted to do too,” said Suzie.
“She went from 24st to 11st and she looked amazing. It was such a difference. She had energy, she could wear great clothes, she’d never been so happy.”
The transformation encouraged Suzie to follow her mother into theatre.
She said: “I was excited. I couldn’t wait to wake up and begin my new life.”
But when Suzie came round after the operation, she found she had a breathing tube down her throat – and saw that Julie and her dad Ian were both in tears.
“Mum told me I’d died for 45 minutes,” Suzie said.
“It turns out I was allergic to the muscle relaxants used in the anaesthetic. That caused me to flat-line on the operating table and go into anaphylactic shock.
“It took the crash team 45 minutes to revive me and the last attempt to get my heart working properly was going to be the final one.
"If I’d flat-lined again, they would have given up. My body was so traumatised I had to be put into a coma to recover.”
But far from being glad to be alive, Suzie was so disappointed the operation hadn’t gone ahead she ripped the medical tubes from her body and burst into tears.
And she even asked the doctors: “Why did you wake me up? I might as well as be dead.”
She said: “I know that sounds ungrateful, but I saw the operation as my one and only chance to be thin.
“Five days later when I was discharged from hospital I sank into a depression. I didn’t care what had happened. I didn’t want to be fat, that was all that mattered.”
Doctors at first told Suzie, of Keighley, West Yorkshire, that she couldn’t have the operation again. Without muscle relaxants, she could flinch while they worked on her, which could be fatal.
But she begged them to rethink and, after various tests, they agreed to try if Suzie signed a disclaimer.
In May 2012, she went back into the operating room at Bradford Royal Infirmary – and in a world first, doctors did the operation without muscle relaxants.
This time, the procedure was a success and Suzie awoke to find a smiling Julie at her side who told her: “They’ve done it, baby girl.”
Suzie says: “I started to cry too. I was going to be slim for the first time in my life.”
The weight began to fall off. In seven months Suzie lost eight stone, and continued to slim.
Now she weighs just 11st 7lb, wears Size 12 to 14 clothes and has a boyfriend Jay, 30.
She said: “I wasted too much of my life saying yes to food and no to life – now it’s time to start living the life I almost lost.”
Julia Kozerski lost half her weight in a year, but coming to terms with her new body was the real battle, as her self-portraits reveal
Julia Kozerski: ‘I hate the skin. I don’t want to fill it back up.' Photograph: Julia Kozerski
The opening photo in Half, Julia Kozerski's series of naked self-portraits, is actually the bookend to a sequence of earlier photos. In those, she appeared unhappily in her wedding dress in a changing room cubicle, more than 300lb (21 stone) and mortified. Here, she appears in the dress again, standing sideways on to the camera, to show how much of the dress is unoccupied. Over the course of a year, Kozerski lost half her body weight, and you might expect the resulting photos to conform to the glib narrative of before and after. Instead, the 28-year-old took pains to show "what real is, what raw is" – in this case stretchmarks, skin folds, contours like sand dunes. Raw is Kozerski naked, and frequently crying.
Nudity is an overused gesture in photography, particularly when it purports to "celebrate" the "ordinary". You can't turn on the TV (Lena Dunham), go to a gallery (Spencer Tunick) or, if you're in San Francisco, enter a civic building these days without tripping over someone getting their kit off in the name of corporeal democracy. That Kozerski still manages to be shocking and interesting is testament to her ideas and her courage. The question most people ask on seeing the photos – after "Why don't you get surgery to remove the extra skin?" – is "How did you get the weight off?" which she thinks misses the point. Losing the weight was tough, she says: "I had no idea who I was, and while I went through all that I was lost." But what came after was tougher. Contrary to media everywhere, being thin isn't enough of an identity to go on. "This is it!" she thought, when she finally got her weight down, and then: "Now what do I do?"
We are in a coffee shop in Milwaukee, where Kozerski grew up and where, after finishing her degree in fine arts, she works in marketing. The photos, taken when she was at her most vulnerable, don't prepare one for how she is now. Kozerski could advertise the midwest: she is fresh-faced, ruddy-cheeked, brimming with enthusiasm. "Nothing fancy, I'm from Milwaukee!" she says cheerfully. She is a regular weight, she points out. Not model-thin, but the size that, after a lot of trial and error, she worked out she needed to be. When she decided to lose weight, she signed on instantly to the cult of perfectionism. She thought, "I'm going to be this amazing person, I'm going to be a model! And that's not what happened. It was a transition into something new; into learning to love myself as I turned out, as I was and as I am now."
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"Loving who she was" sounds like a dictum from therapy, which Kozerski didn't have. She didn't hire a personal trainer, or join a gym. The most remarkable thing about her year-long journey is that it wasn't assisted by exorbitant lifestyle aids. When I ask to whom did she outsource her motivation, she laughs and says, "No, no, no, no one." At least, no one beyond her husband, Tim, a mechanic who cheerled his wife from day one and was hugely understanding, even though "he can eat whatever he wants and nothing ever happens to his tiny little body".
Instead of paying someone to shout at her in her lunch hour, Kozerski walked the dogs. She exercised "portion control". She cut back on fizzy drinks. "I feel like it's a disappointment to people, they want some magic remedy and I don't have one." When things got really tough, she looked at those photos of herself trying on her wedding dress at the one shop in Milwaukee that carried her size. "It's humongous," she says. "And I still put it on. But these days my husband can fit into it with me."
Growing up, no one in Kozerski's household was thin. She is one of three girls and their parents worked hard, her father in sales, her mother as a librarian and teacher in the public school system. "There was a lot of frozen food after work, real quick. We drank a lot of soda. We didn't have specific meal times, so I'd be eating throughout the day. It catches up with you."
There is almost no period in her memory when Kozerski can't recall being sensitive about size. When she was in junior school, she avoided the girls and hung out with the boys. "The boys would accept me for who I was. I'd play sports with them, they didn't care what I looked like. But the girls were always into fashion, and I knew I couldn't do that."
Things got worse as she got older. Shopping was a nightmare, particularly for big events. For her prom, as for her wedding, she shopped alone, as quickly as possible, and bought the first thing that fitted. "I got the bare essentials and got out."
Kozerski's mother died in 2011 of diabetes. Her father has had a triple bypass. There are long-standing weight-related health issues in her family. Before her mother's death, Kozerski asked her why, when she saw her three daughters getting unhealthily large, she didn't say anything. "And she said, 'I never wanted you to be unhappy; I never wanted you to think that you had to be thin.' And I said, 'You know, I was unhealthy, I could have died, you should have said something.' And she said, 'I would rather us have a good relationship than have it strained by me telling you to diet.'"
Kozerski sighs. "It's not their fault; they didn't do it out of ill will. They were unhealthy, we were unhealthy, it was just our lifestyle."
It wasn't the wedding that triggered Kozerski's desire to change, although she anticipated the day with a certain amount of grim humour. She and Tim met when they were 15, in high school, and although the actual day of the wedding was wonderful, "I knew I was going to be the big girl bride with the skinny groom. And I knew what the pictures were going to look like. Reliving that is tough."
It was six months later, as she and Tim sat idly on the sofa eating cookies, that Kozerski suddenly had the urge to weigh herself. She got up and went to the bathroom. "And I saw 338lb. And I thought, 'Oh my gosh; if you think that a model is 100lb, all of a sudden I'm three people!' So I started freaking out. I thought I could die. I thought, 'What does it mean if I have children?' So I said, 'OK, I'm going to carry on eating cookies tonight and then tomorrow, I'll start.'"
‘I felt safe, with a little community of artists, that they would see it isn’t pornography.' Photograph: Julia Kozerski
A thousand resolutions like this are made every day, but Kozerski meant it. So alien was the concept of nutrition that the next day she sat at her computer and typed, "How to eat healthily" into Google. She devised methods of incentivisation, cleverly realising that small goals would be more effective than huge, unattainable ones. Instead of focusing on an end weight, she worked in increments of 10lb and no more. With each 10lb she knocked off, she gave herself tiny rewards; a CD she wanted, a movie.
The only weight-loss gadget she bought was an armband that measures how many calories you're burning against what you're eating. She rolls up her sleeve and shows me; Kozerski has burned 1,300 calories today. "I don't think you need this," she says, guiltily. "You can work it out for free on the internet. But I love it."
Having, for most of her life, treated her body as an enemy and tried to ignore it, she started to be sensitive to small fluctuations. "Like when it gets cold out, I don't lose weight as quickly. There are hormonal fluctuations. I just became very attuned to how I functioned. There were weeks when I gained, then lost, then stayed the same. I was beginning to understand my body."
She was also beginning, slowly, to understand that losing weight wouldn't automatically fix all her problems. Kozerski had always taken photos; her degree at the Milwaukee Institute of Art & Design had a photography component. As she documented her weight loss, starting with that horrifying moment on the scales, she realised that as her size went down, she still looked unhappy.
There was a lot of shame in her system. Part of the reason she wouldn't go to exercise classes or ask for help was that she didn't want to involve other people: "Because I felt like it was such a burden. And I also felt I did this to myself." She didn't want to be complimented either because, at that stage, she didn't feel she deserved it. "So people are saying, 'You look great!' And you don't feel great. You are in transition. You think, 'No, no, not yet.' It was never good enough."
At one stage, she went into overdrive and began over-exercising.
"There were times when I walked 20 miles a day and I would come back and say, 'OK, I just spent six hours walking. That's too much.' When you start counting calories, you want to push yourself, just 20,000 more steps, and it becomes addictive. And I stopped when I realised that. There was a picture I took in the changing room in a store and I look very unhappy. I was skinny, and I didn't feel well. My blood pressure was high and my face super-red." (She doesn't like the word skinny, particularly when her husband uses it. "Sometimes he'll say, 'You look skinny' and it really freaks me out. I don't mind the word fat – I wouldn't use it towards other people, but I do say it to myself. But the word skinny bothers me." It raises the spectre of comparison. "Like, are you comparing me to the old me, or to a model? It doesn't mean anything.")
The photo of Kozerski looking thin and unhappy is one she keeps on her phone as a useful reminder not to get any smaller. The naked photos act as its counterweight; a decisive gesture towards embracing "imperfection" and a desire not to eradicate all signs of her struggle. She's not so sentimental as to "love" the folds of skin. "I hate the skin." But it's a good visual reminder of how she once was and the choice she made not to be that way any more. When she looks at the skin, she thinks, "I don't want to fill it back up." With some effort, she says, "This is where I came from, it's the baggage to show I'm not trying to be a model. This is a real person. And I like having conversations about it. People say, 'Oh, I have stretchmarks after having a child.' It's not just about weight, it's about everyone."
She calls the photos "grotesquely beautiful", and they are. They are alienating in the best way, acting against the industrialised uniformity of most high-profile women. But, given that Kozerski is on the shy side, how on Earth did she get to the point of putting the images on the internet?
She laughs. As with the weight loss, she took baby steps. First, she took them into college and showed them to classmates. "I felt safe, with a little community of artists, that they would see it isn't pornography or exploitation. So I had that buffer."
Then she submitted the work to a gallery show in Colorado. The theme was food, and she sent a photo of herself naked and demoralised in front of the fridge. "And it won. And it got publicised all over. And then I thought, 'OK, this is it.' I didn't have a choice. It was out there."
For the first time, in Colorado, she started to talk to strangers about the psychology of size and her search for a happier way to be. "I just had the most wonderful conversations with people about the work and my experiences."
Since then, Kozerski has had a lot of exposure. There have been negative reactions, mostly from abusive male posters on websites. What do they write? "Superficial stuff, like 'She's still ugly.'" Kozerski shrugs. "People are brutal. It's out there."
Where does she think the anger comes from? "People are insecure about nudity. And it's not the nude people want to hang over their fireplace."
Mostly, however, she has encountered a huge wave of positive interest from people. (Her dad, she says, would prefer it if she was still taking photos of flowers like she did in high school. "But I think he's very proud of what I've done, especially with the health concerns. I'm improving my life.")
In one photo in the collection, Lovers' Embrace, she lies alongside Tim, her defender and champion. "I thought it might be too personal, and relate too much to me. But he's a symbol for all the people who have been supportive throughout."
She has, at the end of it all, come up with something like a theory of happiness. It rests on two things: to allow for the possibility of failure and "to disconnect from comparing yourself to other people. To figure out who you are."
How do you do that when the entire world turns on comparisons?
"Well," Kozerski says, "when I look at a picture of a model, I go, 'OK, she's pretty. But she's not me, she's not working my job, she's not married to my husband, she's not living in my house.' So," she smiles at her luck, "it doesn't matter."
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