Toni Hartley, MPH, RD

My Weigh-In: The CHS Dietitian’s Take on the Biggest Loser Finale

February 6, 2014Toni Hartley, MPH, RD2 Comments

I don’t watch NBC’s The Biggest Loser, but this morning a colleague of mine tipped me off about last night’s controversial finale.

If you haven’t heard, the winner, 24-year old Rachel Frederickson lost an astounding amount of weight. A record-breaking amount of weight. Many are saying she lost too much weight. Many are criticizing the way her body looks. Many are criticizing NBC for not having stricter standards ensuring contestants can only lose a “healthy” amount of weight.

I’m a dietitian who works mostly with the late-adolescent collegiate population, the population most at risk for disordered eating and eating disorders and equally at risk for overweight and obesity, owing to the fact that I work in the United States of America.

Let me tell you this: one cannot tell how healthy someone is by the way he or she looks. Period.

I’m not saying Rachel Frederickson is healthy. I’m not her dietitian. From what I’ve read, she lost 60% of her body weight very quickly down to an underweight BMI. Do I condone any of that behavior? No. Women and men who struggle with eating an inadequate amount of calories or exercising excessively put themselves at risk for cardiac dysfunction, bone abnormalities, a decline in reproductive health, and more. However, the fact remains that none of us has any of this information about Rachel’s health.

I’m not trying to defend The Biggest Loser. I have only seen one or two episodes, mainly because it makes me supremely uncomfortable to support a show that so openly promotes the thin ideal – the premise that the idyllically slender, “beach-ready” body (don’t even get me started about how much I despise the term “beach-ready”) is the gold standard for health and beauty.

What I am trying to say is that we can’t know if Rachel’s weight loss was good or bad for her body by looking at her. We don’t know if she’s getting her period or if her bones now have holes in them. Do I hope she is being followed by a doctor, a therapist and a dietitian? Yes, because in a perfect world, we all would have such a supportive, health promotion team. Plus, in Rachel’s case, she’s just finished a significant feat that might have various impacts on her physical and emotional health.

The bottom line for me is, again, to urge everyone to remember that we can’t tell how healthy someone is by the way she or he looks. I see some skinny minnies in my office who have sky-high cholesterol levels and insulin resistance, and then I have larger patients with perfect lab work who could run a 5K at the drop of a hat. You just don’t know how healthy someone is by the number on the scale.

Further, whether someone is 105 pounds or 205 pounds, frankly, is none of our business. Body snarking only continues to feed an environment of shame, low self-esteem and confusion about weight and health, which, as I’ve seen in my office a hundred times, are the very things that lead to disordered eating and eating disorders. Ease up on the body policing, people.

And Rachel, congratulations on the win, honey. Now, go see your dietitian.

If you are a UNC student, have questions about food or weight and would like to see a registered dietitian at UNC Campus Health Services, click here for more info.

Why Dieting Makes You Dumber

September 23, 2013Toni Hartley, MPH, RD3 Comments

Some of you may have seen this article in yesterday’s New York Times business section about dieting and the mental strain it causes. I read the first paragraph,

”Diets don’t just reduce weight, they can reduce mental capacity. In other words, dieting can make you dumber,”

and I thought, Yes! Another anti-dieting tool for my toolbox that I’ll use to convince my patients that diets don’t work and balance is best!

I was nodding my head, Yes, through the author’s descriptions of various studies showing again and again how dieting lowers IQ. It looks like dieting makes us dumber because the constant thoughts of “Should I or shouldn’t I have that cookie?” take up precious bandwidth, or mental capacity, and make us less able to focus on other, likely more important, stuff. Like studying for that chemistry exam or being a patient friend or partner.

Another point that I found interesting and that I preach in my office on the daily, is the idea that “dieters have spontaneous self-generated cravings at a much higher rate than nondieters.” That is, even when there aren’t cookies around to drool over, dieters tend to fixate on foods that they’ve placed on their “bad” or “do not eat” or “no-no” list.

I often refer to this as the pink elephant effect. If I tell you, whatever you do, do NOT think about a pink elephant…well, chances are you just thought about a pink elephant. Best to be open to all foods and fit them into your meals and snacks in balanced ways. More on that later.

The author goes on to talk about how other types of scarcity, like poverty, similarly reduce bandwidth and negatively effect decision making. The main idea: the more stressors we pile on, the harder it is to make good, balanced decisions. As the article states, “diets create mental conditions that make it hard to diet.”

So, there I was, nodding my way through the article and then BAM! My bubble was burst when I got to the prescriptive portion. The author’s recommendation for managing scarcity: try the Atkins diet because it requires less thinking. No no no.

I am not trying to diss the mega-industry that is Atkins, but in an article that clearly shows that banning foods causes “spontaneous self-generated cravings” that can be derailing both for someone’s physical and psychological health, how in the world does it make sense to recommend banning all carbohydrates? An entire food group! No no no no.

Yes, “Atkins requires less thinking,” but is the goal really to do less thinking about our foods and tune out what our bodies are telling us? Shouldn’t the goal be to tune in?

There is no one prescription for healthy eating. I teach most of my patients the plate method and I truly think all foods can fit in a balanced diet. But I say we also need to focus our energies on alleviating scarcity and managing stress, and that’s why I often refer my patients to counseling. Getting rid of diet rules and building positive self-esteem is often the first step to wellness.

My recommendation: stop demonizing the cookies. Love your body. Go see a registered dietitian. Or a therapist. Free up some bandwidth.

One change that could save your health, time, money, the Earth, and your sanity. For real.

Image August 29, 2013August 27, 2013Toni Hartley, MPH, RD2 Comments

Any time I’m helping a patient increase physical activity, we always talk about active commuting. Heading to work or class for many folks means hopping in a bus or car. And while I’m all for carpooling and public transportation, there’s a problem: most Americans already sit way more than we need to, and it’s pretty clear that sitting isn’t doing us any favors health wise. [1]

UNC-Chapel Hill researchers have found that active commuting via biking or walking has major health benefit s. [2] Active commuting also saves money, saves the environment, and, for some, it can save time. [3] Plus, it’s a mental boost. [4] It’s pretty hard not to bike to work or class without a smile on your face.

For those of you who are intrigued, here are my top five tips for active commuting:

If you’re biking on campus, you’ll need to take two minutes to register your bike with public safety. Hint: your bike’s serial number is usually on the underside of the frame. Also, check out this public safety website full of recommendations for safer biking.
Think you can’t actively commute because you wear gear that might seem not so conducive to comfort or propriety (i.e. skirts, heels, slacks)? Whatever. After a trip to Amsterdam a few years ago, where I saw people biking in just about anything, I decided it can be done. Roll up your pant leg or use a rubber band. A tip for skirt wearers: lean the bike on its side as you mount it or wear shorts underneath. Easy
How about sweat? You have a few options. Head to a UNC gym for a shower. Or, since all Chapel Hill buses have super easy bike racks, you could load up your bike and bus it in and then bike home. You could also simply carry a towel or wet wipes and just wipe down.
Don’t have a bike? Th e Recyclery bike shop in Chapel Hill teaches bicycle repair and maintenance and allows community members to earn a free bike. Pretty cool. Back Alley Bikes or The Bicycle Chain are both local shops that sell bikes. Or try Freecycle or Craigslist for free or cheap rides.
Finally, if you do decide to bike, don’t even think about going helmet-free. You study or work at UNC-Chapel Hill for a reason: you’re smart. Protect your brains, people! Again, check out Freecycle or Craigslist for cheaper options if cost is an issue. And just for fun, drool over this futuristic invisible helmet and these cool bike lights.

Have I convinced you? Pore over this awesome active commuting toolkit, which pretty much addresses any questions or concerns you might have. Signing up for the Cyclicious listserv is also a great way to keep up with local bike events. Also, walking and biking aren’t the only ways to actively commute. Skateboarding or Razor scootering would get the job done, too.