Monday, April 16, 2012

In Response to Bridal Hunger Games

Preventing the Damage After the Wedding

It's hard to know what disturbs me most about the NY Times article Bridal Hunger Games printed yesterday. Was it the hopelessness of women who don't fit into their ideal image of what a bride should look like—willing to take dietary change to extreme measures to achieve short term “success”? Or my fright at the willingness of MDs and nurses, helping health professionals, whose “first do no harm” mantra has clearly been dismissed? 

Or maybe it's the NY Times itself for creating a piece that seems more like an advertisement for unhealthy weight loss schemes, rather than a balanced report on the pitiful state of our culture and the consequences of being lured into quick weight loss schemes?

Pressure on women for their “big day” abounds, and it's been addressed before on this blog But let's take another look, from the perspective of the newlywed in her post-honeymoon period.

It's now October or November, some months past the glorious wedding day. And as quickly as it was lost using a  starvation strategy—NG tube or HCG, or self-imposed restrictive dieting—her weight has been climbing. Those lovely wedding photos are images of the past, as she is now left with a rapidly gaining yet non-pregnant body. With  her deprivation diet, she began to crave foods like never before. Her thoughts about food and eating were all consuming (pun not intended) and her rigid pattern of restricting has turned into rebound binge eating. 

The more she withholds the calories her body needs, the more she feels stuck in the cycle of overeating and over thinking. Her thoughts become more black and white, as she feels that once she starts, there's no stopping her. She feels hopeless and depressed. And she certainly doesn't want her disgusting body, as she sees it, to be touched. This is hardly the fairytale she envisioned.

In fairness, this certainly might have gone somewhat differently. Perhaps her predisposition to developing an eating disorder, combined with the trigger of dietary restriction and stress leads her to continue her weight loss. Now her periods become irregular and soon ultimately stop. Her libido drops and her irritability worsens, along with depression. She spends way too much time thinking about food and eating and exercise now, and becomes more withdrawn, avoiding social encounters. Hardly wedded bliss.

In either case, there is hope. Food intake can be normalized and health, both mental and physical, can be restored. But the best thing would have been prevention—avoidance of these crazy, unhealthy diets which can cause this whole scenario to snowball. So if you're lured into believing that you'll be happier dropping weight for your wedding day, please think again!

But back to the article and all my issues.

Where the Medical Community Goes Wrong

Ok, so apparently the nurse tells the patients about the FDA risks about the procedure. Great. But action speaks louder than words. If a provider wearing a lab coat tells you he/she does this all the time and promotes it as a solution to your problem, don't you think it's fine to do? Won't you allow your unhealthy, irrational thoughts to buy into the “treatment”, forgetting the risks? 

Who ARE these providers, willing to inject patients with a hormone while supporting extreme starvation of 500 calories per day, a deficit of at least 1000-1500 calories daily for most moderately active women of average height? Or those willing to subject healthy women to a feeding vehicle reserved for the severely ill unable to consume enough food orally—cancer patients, anorexics, to name a few—simply to make a buck? And the nerve to call it “nutritionally balanced” when it is devoid of carbohydrate, and induces ketosis and self-starvation! 

And yes, the quoted Dr. Shikora gets it right—but regrettably fails to acknowledge that discomfort is the least of the problem; he acknowledges with what I suspect is a bit of sarcasm that having a tube shoved down your nose is “not always comfortable and pleasant”—perhaps because he hears more complaints of discomfort following the gastric bypass surgery he is well-known for performing.

And while Dr. Aronne wisely suggests that waiting until there's little time left for change (resulting in taking extreme measures) is not the best strategy, I'm still left questioning this assumption:  that brides need to lose weight for their wedding! Perhaps if the focus were not on losing weight for a dress or for a day's appearance, I'd be okay. If weight had been climbing as the soon-to-be-bride had become sedentary or had turned to stress eating to manage at her new job, I could certainly see room for change. Addressing her unhealthy behaviors to help her gain control of her emotional overeating, to strategize about alternative coping measures, or to learn to distinguish hunger from other eating triggers—these I could support. 

Helping the soon-to-be-bride feel better, I certainly endorse. But that's not what the article encouraged. Maybe it's me, but this seemed like a sensational article about how to lose weight rapidly, without appropriately highlighting the very serious consequences.

So if you're feeling hopeless about your weight, don't be lured by promises of quick fixes—wedding, or no wedding. Consider the consequences of your actions both on your thinking and your general well being, not just on your weight now but in the future. 

And if you're ready to make changes, be sure they are reasonable to live with—not just for a week or two, but for life. No eating plan that severely restricts calories or omits whole food categories fits this description! 

Shame on these doctors who promote such weight loss programs. And shame on the NY Times for such an unbalanced perspective of the costs of such measures. You could easily buy a new dress at Kleinfeld's for the future cost of an eating disorder program, and the cost of your time at the therapist, doctor and dietitians' sessions to undo the damage from these diets. 

Fitting into your grandmother's dress, or society's expectation of your wedding day appearance, is no justification for messing with your head, and your body.


  1. '“I don’t want to tell a bride she shouldn’t look good for the wedding,” Dr. Aronne said. “But we tell them, ‘You can get to the same place if you started earlier, instead of waiting until the last minute and doing something drastic.’ ”'

    Got to love the implicit statement that the bride (whether overweight, normal, or even thin to begin with) won't look good unless she loses those pounds. Because, you know, you'll never be pretty unless you're thinner (then once you're thinner, you still won't be pretty unless you're thinner...). Thanks for the wisdom, doc.


    1. Thanks for acknowledging the problems with this statement! And for the record, I am not a doctor, but a Registered dietitian and Certified Diabetes Educator.

  2. Seriously!!!!!! If it were possible, I would "like" this post ten million times!! I'm not married or engaged, but if I do end up having a wedding one day, I will guarantee and promise you that I will not try to get thinner for that day. And you know, the thing is, if you believe that you need to get thinner for a special day... you get caught in the fact that there is always a "special day." It might be you want to get thinner for your wedding day... and later you want to get thinner for vacation.... and two months later you want to get thinner for a family get together, etc. etc. When I hear people say things (even strangers that I overhear) say things that reveal they carry this type of belief, I want to tell them, "It doesn't have to be this way!!!!" Sometimes, I feel like recovery has gifted me a secret - a secret that all of society needs to be let in on - and that secret is there is a way to eat every food group in a sane way, the secret that no ingredient is going to make you fat or a bad person, the secret of FOOD ACCEPTANCE AND SELF ACCEPTANCE!!! When I had my ED (which was heavy on the restriction), I would get comments by a co-worker who was dieting like, "You're lucky you never have to worry about your weight." As if they thought I just naturally was at the weight I was at. I used to think, "You have no idea..." Plus, I, too, sometimes binged... it's not like I had no idea what it felt like to feel like they couldn't trust themselves to not overeat. Now - I'm in a way better place - and, last week, a classmate (back in grad school) who struggles with yo-yo weight saw me eating a piece of chocolate after my lunch and said, "Oh, I can't ever eat just some of a chocolate bar. I don't ever keep chocolate in my house." It's sad. It doesn't have to be this way. There can be peace.

    You said, "In either case, there is hope." That is so true and the best line of this post!

    Sorry for my long post!

    1. As usual, Laura, it's so refreshing to hear your inspiring voice to give others hope. Thanks for commenting.

  3. Replies
    1. In truth, I was so sickened by this article that I planned to avoid it altogether. but your prompting on Twitter pushed me to change my mind!

  4. It's no wonder "we" have eating disorders- if medical professionals are doing and saying such negatively reinforcing things - what is the rest of society telling women?!?!

    1. Yes, it's time to change some thinking. So if you agree with the messages you read here on this blog, do spread the word!

  5. Interestingly, I wasn't all that surprised or horrified. The thing that was most frustrating for me was how absolutely NOT surprising this is because it's so in line with everything that our culture has been pushing. I mean why is sticking a tube down your nose to lose weight any worse than people who undergo liposuction (which is major surgery!)? It's awful that something usually used for weight gain and nutritional sustenance for those who can't eat enough is now used for weight loss, but it's hardly the worst thing out there. I'm just so sad that people think that weddings are such a big thing that they have to change what they look like for it. I guess it's unfair for me to judge since I didn't grow up planning my wedding since age 4, but I just can't see the appeal of 10 days of an ng tube to look good for one day... I'd have more respect for anyone doing any diet if there's at least the pretense of trying to be healthier. I always hated seeing the signs at the gym for bridal boot camp and things like that, even if you didn't originally think you needed to lose weight for your wedding, you'd be hard pressed not to get the message. At work (in a bookstore) I occasionally have to shelve the magazines. Though I've done the bridal mags, I haven't looked closely, I wonder how many of them mix in workout and diet tips with the dresses and venues and centerpieces. As if we needed further evidence that the most important thing is how you look.

    But back to the K-E Diet...I wish there were statistics on the ratio of women to men who use this "diet." I also wonder how popular this will actually become. The suggestion that it's been used in Spain and Italy or wherever does little to convince me that it's a good idea. And they offered no concrete data on how often it's used or what kinds of complications occur besides the kind of "minor" ones listed. I am definitely in the "this is gross" camp, but I don't know that I think it's worse than having your nose voluntarily broken to have it "fixed" or having snake venom injected into your face. As dismayed as I am that anyone wasted time calculating weight loss with ng tubes instead of trying to cure something or solve an actual medical problem, I am more dismayed by the lack of progress we've made since fitness hit the scene in the 80s-90s (maybe before that?). I really loved Joan Jacob Brumberg's book The Body Project and how it explained the way our bodies have just become things to fix and work on... I don't know where I'm going with this, just wishing that this culture of "thin at all costs" would end soon. It's so pointless and only makes women feel bad about themselves. It's keeping women down! And the more time women spend cutting each other down and being cruel to each other, the less time we have to focus on bringing down the patriarchy... but I digress.

    1. I love this- you have said exactly what I wanted to, just in better words. Thanks :)

      Why is it always thin above all else?