Allured By Diet Pills & Laxatives?

I got carded yesterday in the middle of the afternoon. Yes, in spite of my grey hair and my approaching 50^th birthday, I was forced to show my ID. This was not to buy a Chardonnay or a 6-pack, but rather to purchase something taken in much smaller doses—cough medicine. In spite of my visible maturity, the drug store required me to prove I am of legal age for such a purchase, given risks of using these products to produce methamphetamine.

Fair enough. But here's what struck me. At this same pharmacy, just 2 weeks ago, they were giving out samples of Senna laxatives, those natural-yet-lethal stimulants, which are anything but safe, especially if taken beyond the very limited time frame recommended. Use beyond the limited 7 days can result in dependency and can impact potassium balance with major consequences to your heart and other muscles. It’s not recommended in pregnancy or for nursing woman at all, nor for kids. And they certainly aren’t helpful for weight loss, yet that hasn’t stopped people from taking them with the hope that maybe these will get the pounds off.

As you might have guessed, I simply couldn’t keep my mouth shut about their promotion of this freebie back then. And here I am, getting carded to buy a bottle of Robitussin CF to legitimately control a hacking cough.

As I strolled around the store yesterday, I walked through the supplement aisle—just looking of course—lined with supposed diet products to melt the fat away and control weight. Laxatives, Sensa and other diet pills, formulas promising aid for the aging body—those were all there—with no ID required to protect our safety or our sanity.

Why aren't we in an uproar about this scam, about our being manipulated by the promise of this unrealistic dream of harmless weight loss? Why aren’t we protesting the ease of availability, alluring us to potentially damaging products that are deemed innocent enough to stock the shelves—deemed innocent until proven guilty? Why aren’t we shouting about the unwanted and unsolicited junk emails falsely promising weight loss we’re being bombarded with this time of year?

Why, instead, are we up in arms attacking soft drink manufacturers for selling Cola, Sprite and the others fearing their impact on the obesity epidemic?? They promise nothing—at least they're honest! Sure, excessive intake of regular Coke and Pepsi may contribute to obesity and may take the place of nutrients we could be eating. And excessive intake of Diet beverages, in my view, is no less concerning, as it displaces nourishment we all need and provides a false sense of fullness—which those of you struggling with anorexia clearly don’t need.

Buyer beware, is the advice I’ll leave you with. And do consider speaking up if you’re a recipient of unwanted diet promotions!

Body Wraps, Toxin Removal and More: What I Learned at the Gym Today

I'd much rather be hiking...

It's hard enough starting at a new gym. Generally, I dislike going to gyms, preferring instead to enjoy a long bike ride, a hike or a cross-country ski or snow shoe when weather permits. But living in New England, there are times, like now, when conditions are simply not favorable for either of those activities.

So off to the gym I went, attending my first spin class of the season, at a new gym with a new instructor. And I could barely get through it. No, I am not that out of spin shape—although those cycling muscles certainly needed a workout. Rather, I was feeling my blood pressure rise as I sat through the marketing pitch and endless misinformation by this supposed promoter of health—the spin instructor.

I'm still headachy from it, so in truth, I am blogging to air my annoyance and frustration.

You know me be now—I am not shy to share my opinions, particularly those I feel strongly about. But this was a challenging setting. Jane, I'll call her—no, Barbie better suits her—stood before the class of about 35 cyclists confidently spewing her crap. Misinformation spilled from her mouth with no objection from the group, until I, a newcomer there, just had to speak up. But it was hardly the forum to debate in, and my rebuttals could be endless if I countered every outrageously false claim about weight loss.

No, neither body wraps nor green
powders will remove body fat.
Sorry!

She endorsed a powder she was selling with her personal testimonial about how she believed it really helped her, as it releases the toxins from the body, those horrible things which fester and cause disease. (Toxins, by the way, are released from our bodies every day, with no need for a product to make it happen.) And it gave her natural energy and promotes weight loss. (For the record, calories are the form of energy we get from foods; a product with no calories has no energy, although you may get a short-term boost from stimulants such as caffeine.) Then I heard her endorsement of the body wraps for sale, which essentially shrink your body a size or so overnight! All without dehydrating you! And finally I learned that you should be drinking half your body weight in ounces of water each day. 300 lbs? That's 150 ounces each day of water, about 5 liters or quarts per day.

So why am I all upset, you ask? Where shall I begin?!

• because while for me it was simply an irritation (and a big one at that), I know how others will be lured by this misinformation, sold products with false claims, sucked into unhealthy thinking and potentially dangerous supplements; more misinformation makes sensible thoughts a challenge;
• because she was speaking to a group of completely normal weight individuals, none of whom could afford to lose weight;
• because no one should be sucking down water or non-caloric beverages instead of eating when they need fuel, simply to mask their hunger;
• because she's setting people up for failure and unrealistic goals, luring them for her personal financial gain, to buy a product, in the case of the wrap, that at best may contribute to a decrease in hydration for a temporary appearance or short-lived sensation of lightness;
• because if we each spoke up every time we heard something we know to be false or inaccurate, then maybe we could make a difference!

Yet another gym promotion. Uggh!

There, I feel so much better now. I think I'll go have dinner, now that I can more calmly and peacefully enjoy it.

Thanks for letting me rant!

Obsessive Workouts and Protein Powders: How Concerned Should We Be?

Reactions to the NY Times article and the Pediatrics study on teens and muscle-enhancing behaviors.

I'm bothered by something I read. "Compared with a sedentary lifestyle of video games and TV, an obsession with working out may not quite qualify as a health hazard", as stated in last week's NY Times article. While the article brought to light the silent struggle many boys deal with—or rather, don't deal with—their obsession with weight training, dietary modification and steroid use to achieve the 'perfect' body—it failed big time in educating readers about when to be concerned, and what we can do to prevent this unhealthy trend. But this is not just about boys—the Pediatrics article identified that girls, too, are taking steroids and more frequently protein shakes to increase muscle mass while pushing activity.

Yes, teens, both boys and girls, have become more focused on increasing their muscle mass. "Strong is the new skinny" is a current sentiment; neither being healthy nor slim is good enough. The bar has been raised necessitating increased muscle mass to change one's appearance. And the price they pay is far greater than suggested in the Times' quote above.

Lean and muscular, yes, but nor much of a sex drive!

But how big a deal is it if a teen—or an adult—takes a supplement or pushes their training to change their appearance? The actual study, in my humble opinion, did little to differentiate unhealthy disordered behaviors from more innocuous ones. What's the issue with weight training to increase muscle mass, any way? What's the harm in your taking a protein shake to bulk up your muscle a bit? (Steroid use is another story, and that is well addressed in the Times article.)

If you're like twenty-three year old Nathan, it's quite a big deal. He relied on the gym-endorsed protein powders, "to promote muscle growth". All things high in protein were considered safe—if they were also very low fat. Despite my urging to reduce his exceedingly high protein intake, and to liberalize his intake of fats and carbohydrate, his kidneys began to fail, struggling to filter the extraordinarily large load of protein waste products. His thoughts were all consumed with when he'd be able to get to the gym and when and what he'd be eating next.

But this is not solely a male thing, as the Pediatrics study shows. Girls, though, are more likely to modify their diet, while boys will increase their gym training to 'meet their needs'.

And what if it were high in carbs?

Like Karen, you may be spending more and more time at the gym while restricting your intake, ultimately finding it too stressful to live life with school and work demands, along with your rigid workout regimen.

Certainly, drinking protein supplements is not itself a cause for alarm. But relying on shakes in lieu of real food is. It impacts our ability to socialize, to be flexible in eating situations and to get all that we need nutritionally. A diet devoid of fats and carbohydrate will be deficient in much-needed nutrients, and typically in calories. A sense of deprivation often results, accompanied by obsessive thinking about food and eating and weight.

As for the workouts, where do we draw the line about what is healthy and safe, and what is excessive? If you're in a community of triathaloners, marathon runners or iron men/women, a few hours at the gym will seem inconsequential. 

But is it driven by a preoccupation and distortion that anything short of a few hours will leave you fat or unfit? Many of my patients believe falsely that working out is always a good thing. Nothing can be further from the truth. When intake is inadequate, working out not only won't build muscle mass, it will help break down muscle to convert it to fuel! And when net intake is substantially less than need (either because of very high activity or low intake) metabolic rate slows down, so you burn fewer calories 24/7. Certainly not what you intended!

Surprisingly, there was no mention of the low testosterone levels that result in males, similar to the drop in hormones seen in females with anorexia. Tell this to those boys and it might motivate for change. Sex drive drops, facial hair diminishes and risks to bone density increase as well. For boys in their growing years—which might last until 18 or 19 years—the consequence may be stunted growth. And the opportunity for catch up is lost once the bone growth plates have closed. Most boys and girls do care about their height, but do they realize this may result?

And what messages are we conveying to our kids with their school BMI screenings? Are we faulting them for their high BMI (which will remain high as muscle mass increases and height fails to increase)? Or are we fairly looking at an increasing BMI percentile for that individual as a possible marker for unhealthy behaviors—be it steroid use resulting in rapidly increasing muscle mass or binge eating? Are we presenting being obese as so horrific that even if their behaviors are healthy, we tell them they need to lose weight? Is a drop in BMI in an overweight child healthy if they starved themselves or compulsively exercised to get there? 

Shouldn't we be screening with questions about thoughts and behaviors, not just BMI?

Are we reinforcing their interest in fitness because we perceive it as healthy—no matter what? Do we share the same distorted views about all things protein-rich being "good" while villainizing carbohydrate-rich grains and fat-rich foods, too? Are we contributing to the misinformation they hold fast to? Why don't we recognize that there is sometimes pathological thinking and behaviors that drive extended workouts and dietary changes?

I don't have the answers.  But I do know that we are influenced by cultural standards of beauty, and that these images have become more and more unattainable. Yes, without steroids, you can't possibly bulk up like many of your weight-lifting role models, nor can you be both healthy and low weight as the air-brushed magazine pics would lead you to believe.

Something has to change. And it can start with you. Add your comment. Share this piece. Counter misinformation and acknowledge unhealthy behaviors—even when society fails to.

Consider these older posts for more information on topics covered in this post:

http://dropitandeat.blogspot.com/2010/07/daily-exercise-is-must-or-so-you-think.html

http://dropitandeat.blogspot.com/2012/03/protein-new-black.html

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 http://dropitandeat.blogspot.com/2011/09/wedding-diet-guaranteed-to-change-your.html. 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.

Diet Rules: In Response to the Diet Pill Disaster

Imagine the disappointment!

Didn’t you want to believe it? “Finally, a diet pill I can endorse! Check out this link”, with yours truly as the sender. Yes, my Twitter account was hacked, or hijacked, as they say. Someone managed to get into my account dispensing a bunch of tweets as if they had come from me. And this was just one of the creative gems they sent. 

Now, if you have been reading Drop It And Eat for a while, I suspect you were a bit skeptical. And hopefully, you even had the wisdom to stop yourself from clicking and perpetuating the myth.

Maybe you even believed it, but knew it would be trouble, a slippery slope, getting into diet pills. You knew it was too good to be true.

Perhaps you feel addicted to hope—hope for a solution to your daily eating struggle—for assistance with binge eating, obesity, or body dissatisfaction, in spite of a normal body size. Yes, at times a pill may seem like the only answer.

But, dear readers, there are no pills, no magic bullets. Never mind meds; there is no quick fix, no special diet to cure our ills, I’m so sorry to say.

How ironic that this violation of my name and of my Followers came when I was vacationing, reveling in the beauty of Acadia National Park with its stunning vistas, by foot and by cycle. And while enjoying the fabulous bakeries, the flavorful oils and vinegars and local restaurant cuisine. And no, I didn’t enjoy the muffins and scones solely on my active days when I was burning it off; I even enjoyed them at breakfast, before the almost 6 hour drive home, sitting on my butt.

How does this fit with good health, you may be wondering? What kind of dietitian are you, endorsing pastries and other indulgences?

I often find myself defending my approach to eating and to weight management and disease prevention to others—to strangers wondering why I’m photographing their lovely loaves, to friends who question my aversion to seemingly healthy fat free foods, even to patients and Followers who wonder if I really practice what I preach. So I thought I’d share a few thoughts following my 5-day vacation in Maine.

Yes, it's all about balance.

A truly healthy diet:

• is a way of eating that promotes both physical and psychological wellbeing.

• indulges the senses with the pleasure of quality—flavors, textures, smells, experiences.

• involves selecting foods that may be rich, such as the fabulous baked goods from Little Notch Bakery—and enjoying them when hungry (but not so hungry that you can’t savor the flavors and enjoy the food).

• allows for pastries, and chocolates, and cheeses as snacks or as part of a meal, not as a reward for eating a “healthy” meal. Tuesday, it meant blueberry pie mid-morning, after a lovely bike ride. Wednesday, it included blueberry scones (yes, wild Maine blueberries are in season), a chocolate croissant and delectable carrot muffins at breakfast. Monday, it meant a shared apple tartlet as an afternoon snack.

Thanks for helping to make my vacation fabulous! 

• means eating just as much as we need, and trusting that we could always get to the bakery again for another great purchase. Yes, I hit up Little Notch Bakery three times over my 5-day vacation in Acadia—once in each area of the island.

• also means bypassing fat free spreads on my toast—because I don’t like their taste—and dipping my sourdough, white flour bread in olive oil instead. It entails selecting oils with intense aromas, fabulous flavors and nutritional benefits, like those found at Fiore in Bar Harbor.

• means choosing a lighter entrée, at times, because I prefer a less dense dinner after my day of snacking. So it was poached salmon (still a high fat fish, I might add), but in a lighter prep than the other options available.

• means having what I really want, but eating only as much as I truly need. I was in charge of cutting up the baked goods, served on a platter in bite size pieces for 5 of us to share.

I chose the middle one. What a crust!

I’m not kvetching today, post vacation, about my week’s intake; I enjoyed every minute of it. I did not need to go crazy with my eating simply because I was on vacation, because quite frankly, eating like this is totally normal for me. I eat this way all the time. I buy great breads weekly (if I haven’t made my own with the help of a bread machine), I enjoy delicious cheeses (but am mindful of the portions) and I have my share of baked goods (and clearly you’ve already learned of my love of chocolate!). Really. Just ask my friends and family. But I pass on anything sub par, because I truly want to enjoy what I put in my mouth. I take my food pretty seriously.

Tags from a line of women's clothing. Great, no?

Does this eating approach seem foreign to you? Trust me, there is still hope for change. It takes time to learn that you are allowed to enjoy good food, great tasting, quality food. Yes, whether you are overweight, normal weight or underweight you are entitled to the pleasure of eating whatever you would like. Just be sure to eat the amount that’s right for your body.

That is a truly healthy diet.

Recovery Happens. But Not Without Your Help.

Statistically, she was likely to fail. She had a long-standing eating disorder, and was well entrenched in her 31 year of thoughts and behaviors. She lacked motivation to change, and continued to live in a toxic environment, from a recovery standpoint. And quite frankly, her eating disorder worked for her. 

Yes, you read that correctly. While unhealthy and quite dangerous, ED helped Cathy on many levels. It was her drug of choice, so to speak. It numbed her, allowed her to live invisibly, and allowed her to have no expectations for herself.  If you only knew the details of Cathy’s life, you wouldn’t be judging her for her choice.

That is, if it were a choice. She was not the first generation of her family to live with an eating disorder. Genetics? Environmental? A combination? There’s no quick answer, but likely a combination of factors result in developing an eating disorder, and in maintaining it.

Cathy’s began at the age of 16. Yet she first presented to me at the age of 37. Her only experience with ED treatment was at her 3 hospitalizations, the last one just prior to seeing me, a stay prompted by her suicidality. Hardly enthused about recovery—never mind being there, she presented to my office only to please her therapist (with the consequence of losing her if she failed to show).

This was no quick fix, and in truth, the battle isn’t fully won—yet. She’s had great support from her therapist, moving forward not just in her relationship with food, but her ability to begin to advocate for herself. It hasn’t been easy—for either of us—but it is so satisfying to read her unprompted words below. So I just had to share. Cathy would never frame her amazing recovery as her accomplishment. But there’s still time to work on that in therapy! Hope you feel inspired by Cathy’s shift, occurring over a 3 year period.

"I've been so sick - literally laying in bed for most of the week).  I managed the hell day yesterday of consuming only liquids and endured the copious amounts of Gatorade and Miralax (prepping for the colonoscopy).  You were right, the test was fine - knocked out cold for both tests - but it was the prep that was not so. 

How in the world did I use this whole laxative thing before???  It's just awful and I actually hate it!  I can't believe I would use laxatives!!!  I am never, ever going to use them again - and this only reminded me of why I wouldn't want to use them again!  Also, let's talk about barely eating --- how in the world did I manage that one too????  I couldn't tell you how damn hungry I was all yesterday!  

Am I that far removed from ed that I am soooo out of practice by barely eating anything?  I was dragging, unenergetic, blah blah blah.  I was unable to finish the last 2 glasses of the Gatorade blend (so I cheated) but they didn't say anything about it today (thought I was going to get spoken to!)  I was so close to throwing up the end of that Gatorade, I absolutely wanted to throw up my stomach hurt so much from that, so it was a fight (even putting my hands in front of my mouth) not to puke it up.  I decided it's better if I skip some than throw up all I had. 

I wanted to share these thoughts with you, and why?  Because I was just reminded of how lousy I feel when I'm ingesting laxative pills, and barely eating anything.  It sucks!  And I guess it reminded me that also that after days of being sick, then topped off with yesterday's recipe of clear liquids and Gatorade, I just want to feel well!  

Maybe this is me saying I am liking feeling healthy.  I am hoping tomorrow morning this sickness will be gone, and I'll be able to fill my tummy with coffee and wheat toast - and even a morning snack!  I want energy back!  I guess I appreciate better health more than I thought."

Diet Pill Death Shouldn’t Destroy Your Hope

Won't be long before they're pushing diet pills for him

Weighing In On the Risks of the "Quick Fix"

Another diet pill bit the dust. Last week, the FDA killed the promise of a quick fix for losing weight. They demanded of Orexigen Therapeutics a long-term study for safety, concerned about the possible risk of heart attacks that might result from use of Contrave, it’s new product. Apparently Contrave had already demonstrated success in raising blood pressure, something those with obesity hardly need to add to their woes.

So why a post on this? I am delighted with FDA’s stand, yet alarmed by the details of diet drug and laxative availability and the potential harm to users. Meridia, for instance, another useless diet pill, approved for 13 years, was only recently removed due to a 16 % increased risk of heart attack, stroke and death.

Chai, not Senna tea!

Some weeks ago I was visiting my mother, searching her cupboard for a tea I would like. “Dieter’s Tea” popped out, a product I was unfamiliar with. My mother, of course, didn’t purchase this product, but rather was given it “by a friend”. The box was open, but she had never tried it. No, she had no idea what was in it or how it “worked”. 

So I read the ingredients, and then began to Google. My greatest concern was the Senna. You know, that natural plant substance that helps constipation. Gotta be healthy, right? And here’s one of the many articles that confirmed my suspicion: http://www.livestrong.com/article/121254-dangers-senna-tea/

Because it is over the counter, readily available, comes without a warning, and marketed as a natural remedy, it is most worrisome. Because I know people are seeking a quick fix. And they are not researching the ingredients and their risks while at the supermarket deciding between Earl Grey and Dieter’s Tea.

 So back to Contrave.

At best, subjects lost 4.3 % more weight, compared to placebo, the fake stuff. If you’re 5’4” 175 lbs,, with a BMI 30, you’re considered obese, making you eligible to use a prescription diet drug.

In 12 months, that amounts to just over 1/2 pound additional weight lost per month, 2 ounces more weight lost per week. Wow! Rapid? Significant, even? Enough to justify the cost, either financially or medically? And risk free? Hardly.

Interesting, no?

How much health benefit would you gain from that additional 2 oz. per week?  And self esteem? Would it change how you see yourself? And would it justify the unknown risks? The potential changes in blood pressure and increased heart disease risk?

And how necessary is it anyway to lose weight if we are obese, but fit? Yes, those two phrases can exist side by side!

Some months ago, the promise of a new medication for MS hit the news. A pill, the very first, to offer hope for those of us living with this potentially debilitating disease. The advantages were clear. Swallow daily, or inject daily or multiple times weekly. And the studies showed the medication to be at least as effective as the injectables.

Aren’t you thrilled, friends and family asked, knowing my 8-year history with this illness? Yet all I could think about was the cost. Not financial, as I am fortunate enough to have good insurance coverage. But the risk of this new med, with its list of horrific potential side effects, including blindness and fatal herpes infection, to name a few.

Now if the benefit strongly outweighed the risk, it might be worth it. But, thankfully, I am not debilitated by my disease. I am lucky enough to be able to engage in all activities I care to. And it’s possible that you, at your current weight, may not be debilitated, even if your doctor sees your weight as the number one “disease” for you to tackle. See my point?

We all want a magic bullet, for everything. So we’re drawn to lottery tickets, diet pills, surgical fixes for whatever might hold promise of a better life.

Would a new diet pill really change anything, even, if compared to placebo, it took off 5 % more of your weight? Because that’s enough weight change necessary to get it approved.

Disturbing photo from the MFA, Boston

Finally, those of you at the low end of the scale may cling to the benefits of staying there. The fear of change keeps you focusing only on the positives of where you’re at. Is it really so positive? Is the benefit of your eating disorder really greater than the costs, physically, psychologically, socially?

Reminds me of how we remember old boyfriends (or girlfriends). We longingly recall all the great times, how wonderful it was being together. Until we reality check and remember—I was miserable with him!

In summary, be an accountant. Look at the list of benefits of staying where you are, in terms of weight and behaviors. Then give some serious thought to the negatives, the risks. And hopefully the risk of taking diet pills, laxatives, and cleanses in addition to your own unhealthy actions, will be reconsidered.

As always, I'm eager to hear your opinions!