Earlier this week, Governor Chris Christie, who has been lambasted for his weight for years, announced that he underwent “secret” gastric band surgery in February.  In an interview with NBC Rock Center’s Brian Williams, Christie said that after turning 50 last fall, he began to reflect on his life and realized that he wanted to get his weight “under control” so that he could be healthier for his wife and children.  His weight-loss doctor likened Christie’s obesity to having cancer, asking Christie, “If you came in here with cancer and I told you that I had a 40-minute surgery that’d give you a 90 percent chance of cure, would you sign up?”  Of course, Christie answered in the affirmative.

Lap-band surgery, in which an inflatable silicone device is placed around the top portion of the stomach to slow the consumption of food, is not the “cure” that Christie’s doctor says it is.  For nearly half of the patients who have the surgery, the devices need to be removed due to erosion or other malfunctions.  While most patients lose between 48 and 99 pounds in the first year after having the procedure, a number of studies have shown that the procedure is not successful over the long-term, resulting in sub-optimal weight loss and increase in failure rates.  One of those studies saw a 36.9% failure rate (defined as an excess weight loss of <25% or major reoperation) after seven years.

Now, I am not saying that weight-loss surgery is necessarily the wrong choice for Christie – everyone has the right to make his or her own health decisions – but I am concerned about his doctor’s message that weight-loss surgery is the cure for obesity.  While such surgery might be helpful in the short-term, it often leads to weight regain and numerous complications.  I am hopeful that those who take particular interest in Christie, and perhaps want to emulate him, will do their own research and make informed decisions. 

Body Mass Index (BMI), or the relationship of one’s height and weight, is most often used by the medical community to determine someone’s health risk.  BMI is really meant to assess the health of populations, not individuals.  If a researcher wanted to assess the health of adults in Massachusetts, for example, BMI could work quite well.  The problem is that it is inappropriately applied to individuals, partly because it is easy to do so as opposed to monitoring other markers that require more expensive testing and/or equipment.

There are a number of examples that call the BMI’s accuracy and usefulness into question.  For instance, Tom Brady’s BMI of 27.4 and Paul Pierce’s BMI of 26.5 put them squarely in the “overweight” BMI category, which is associated with increased risk for heart disease, diabetes, and a number of other health problems. Obviously, both of these athletes have a great deal of muscle mass and are in top physical shape. Would you call them “overweight?”  Of course not!

On the flip side, there are numerous people who fall into the “normal weight” BMI category that can’t even climb a flight of stairs without getting winded and have high cholesterol or high blood pressure.  In other words, lack of muscle mass can contribute to somebody being labeled as “normal weight” even though they are actually pretty unhealthy.  Some individuals with eating disorders also have “normal” BMIs, as do some formerly overweight patients who have lost weight due to diseases such as cancer or AIDS.  So clearly being healthy is about more than just one’s BMI.

Instead of just focusing on one number, there are so many other factors we need to take into consideration. Measuring blood pressure, cholesterol levels, and waist-to-hip ratio are just a few ways to get a better picture of someone’s health status. Other things to look at could be an individual’s physical fitness, mental and emotional health, as well as feelings of well-being. I think it’s important for all of us to remember that one number cannot tell us everything about a person’s health and that there are many ways to define what health is.

The internet is a wonderful tool.  I often wonder how in the world we were able to survive without it 20 odd years ago.  It provides a wealth of knowledge at our fingertips, and we can find the answer to almost any question with the stroke of a key.  Unfortunately, while the web has a lot of solid information about various topics, it also has a vast amount of bogus information.  This is markedly evident when looking for answers to nutrition questions.  I can’t tell you how many clients (as well as many of my friends and family), tell me about the latest diet or miracle food that they found out about online. Inevitably, there is very little truth to these food myths.

Here are some examples of the misinformation one can find online:

• Carbohydrates make you fat/gain weight.
• Bananas are not as nutritious as other fruits.
• Foods that are high in dietary cholesterol cause high blood cholesterol.
• Foods that contain fat will make you fat.

Given our thirst for immediate information, many of us turn to the web to help us figure out what is true and false.  The problem is that these diet myths are almost always written by individuals who are not nutrition professionals.  What is truly scary is that nutrition information is not policed on the internet.  Anyone can write almost anything and call it truth, and then millions of people can read it and be misinformed.

The moral of the story?  Don’t believe everything you read online about nutrition!  Unless the person writing it is a registered dietitian and has peer-reviewed, valid research to back it up, it is very likely that this nutrition information is false.  If you have questions about what foods will make you healthier, talk to your friendly registered dietitian, as he or she has been trained in nutrition and is qualified to answer your questions.  Be a savvy internet-user, and don’t believe the hype!

Intuitive eating, the practice of eating when you are hungry, stopping when you are satiated, and honoring your body’s innate wisdom, seems like such a simple concept, but it can be very difficult for many of us to practice.  When we were little, we knew when we were hungry. As babies and toddlers, when we would feel physical hunger, we would ask for food.  Likewise, when we had had enough food, we would push it away.

But somewhere along the way, many of us began to tune out our bodies’ hunger and fullness signals. Maybe your parents insisted that you “clean your plate” at dinner, pushing you past your feelings of fullness or perhaps you learned to ignore your hunger cues and skipped a meal because it wasn’t “time to eat” yet.  Or maybe you’ve been bombarded by the media’s messages about dieting and how eating less and especially not eating even if you are hungry are the keys to weight loss. Over time, as we continue to ignore our bodies’ signals, we begin to not recognize them anymore.

The majority of my patients look at me with complete disbelief that they would ever be able to regain their hunger and fullness cues again and trust their bodies to tell them when and how much to eat.  But, with practice, many of my patients soon realize that they recognize what it feels like to be hungry before a meal and how much food it takes them to feel physically satisfied.  It takes time and patience, but eventually you can begin to trust your body to tell you what it needs.

Intuitive eating does not happen overnight, and it takes a lot of time to “unlearn” certain habits and behaviors, such as skipping meals or cleaning one’s plate regardless of hunger or fullness. But when you learn to trust your body’s innate wisdom and be kind to yourself, you will be amazed at the progress you make.