Category Archives: Exercise

Extreme Disappointment

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In general, I don’t watch reality weight-loss shows. I used to. Biggest Loser was one of my favorites. I was always in awe of how many pounds the contestants would lose each season, many of them shrinking to half of their starting size. But, ever since I became a dietitian, I view these shows in a much different light. Shows like My Big Fat Revenge, Biggest Loser, and Extreme Weight Loss promote dangerous messages about weight management – namely, that fat people are inherently unhealthy and that the only way to be healthy is to lose copious amounts of weight quickly by drastically restricting one’s calories and exercising like a maniac.

Despite my dislike of these shows, I do (rarely) catch an odd episode from time to time. Many of my clients watch these shows and take what the “experts” say as gospel, so it helps if I am in the know about the latest and greatest gimmicks these shows use, so I can help re-educate my clients.  

Last night, I stumbled across an episode of Extreme Weight Loss that truly disturbed me. In this episode, a 23-year-old woman named Alyssa was the individual who was chosen to undergo a year of restrictive eating and over-exercising courtesy of trainer Chris Powell.  The episode started predictably enough: initial weigh-in tears, a loss of 100+ pounds over the first 3 months (Phase 1), and the inevitable struggles to lose weight during Phase 2 (months 3-6).  

This is where things take a serious turn. After Phase 1, Alyssa found that the weight just wasn’t coming off like it had been before. No matter how much she tried to follow the meal and exercise plan, her weight was at a plateau. So, in order to reach her goal of losing another 60 pounds during Phase 2, she decided to drastically reduce her calories even more, at times eating close to nothing. This resulted in rebound binges and subsequent purging. Alyssa developed an eating disorder (ED).

At this point, the show’s producers should have stopped the program for Alyssa, insisted she get treatment for her ED, and take all of the focus off of her losing weight. Instead, Alyssa had a heartfelt talk with Chris and his wife Heidi (who herself struggled with an ED for eight years), and despite the fact that clearly Alyssa needed help dealing with her ED, they continued to encourage her to lose weight and restrict her calories. She was instructed to eat 1500 calories per day while exercising for at least three hours per day to achieve “healthy” weight loss.

At the very end of the program (and after she had completed the program, losing a total of 200 pounds), Chris offered Alyssa a two-month stay at Shades of Hope, an ED treatment center. While at first she rejected the offer, Alyssa ended up going to the program two weeks later, as it was clear that her eating issues were continuing. Why wasn’t this offer made immediately after Alyssa admitted her ED to Chris? Why did they wait until the end of the year to offer her help?

When someone is struggling with an ED, there should be no talk of trying to lose weight, whether it is in a “healthy way” or not. In a sense, the show itself taught Alyssa how to eat in a disordered (re: restrictive) way, priming her for developing an ED. By letting her continue on in her weight loss program, the show did Alyssa a real disservice and gave the message that EDs are no big deal and are just a “phase” that can be dealt with easily. Unfortunately, EDs are not only extremely damaging (and potentially fatal), but they also often turn out to be a life-long struggle, not something to be glossed over.

These shows are not only doing damage to the contestants, but also doing an enormous amount of damage to their viewers. I am hopeful that one day these shows will run out of steam and stop reinforcing the idea that losing weight and the number on the scale are the end all, be all. Maybe someday shows will promote healthy behavior change, without focusing on the numbers. But, I guess that wouldn’t make for scintillating TV.

Fitspiration or Fat-Shaming?

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In fat-shaming news, Maria Kang, a 32-year-old fitness fanatic and mother of 3, posted a photo of herself and her three sons (then aged 3 years, 2 years, and 8 months) on Facebook with the caption “What’s Your Excuse?”  In the photo, Kang is wearing only a sports bra and tiny workout shorts, showing off her toned and sleek body.  Clearly, the photo and caption are meant to be “fitspirational” to all of the new moms out there who haven’t yet made losing weight their top priority and to show them that even with 3 kids under the age of 3, you too can have the body of a fit model.  Needless to say, the internet has been ablaze with both positive and negative feedback on the image.

I actually saw this woman on the Today Show this morning, and she was rather unapologetic about the message her photo is sending.  She reiterated the fact over and over that the photo was meant to be inspirational, not a knock against fat people.  That may have been her intention, but honestly, the caption clearly implies judgment against those who “haven’t lost their baby weight yet.”  That perhaps if these overweight women just tried a little harder, they too could bounce a quarter off their abs.

Kang, who is a former personal trainer and beauty queen, clearly has always been in good shape.  Given this fact, it’s not surprising that she was able to “bounce back” to her original shape after her pregnancies.  But the fact is that she is in the minority.  The average woman in the U.S. does not look like Kang and even if she were to put in all of the extraordinary time and effort to achieve Kang’s physique, it is very unlikely that she would be able to maintain it.

So, yes, I do believe that this image is fat-shaming. Instead of sending the message that if you just try hard enough, you can have a hard body after baby, how about telling new moms that they are beautiful and that they should appreciate what their bodies can do for them (e.g. give birth!).  Now that would be inspirational.

Problems and Privileges

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Thank you to everybody who showed up for the Race Wellesley First 5K and 10K this weekend, including runners, supporters, volunteers, and sponsors!  I love events that bring the community together, and as such I was really happy to both be sponsoring and competing in the race.

I finished the 10K race in 10th place overall and in fourth place in my age group.  I missed out on a third-place medal by 0.9 seconds.  The guy who earned the bronze passed me with about a mile to go.  Rather than keep up with him, I elected to stay back.  My plan was to let him think I was out of gas, but then to take him by surprise and out-sprint him at the end.  The strategy almost worked, but I could not quite catch him at the line.  He ran a great race and definitely deserved the medal.

I have never won a placement medal in my life, so when the standings were announced and I realized that I missed out on one by a single second, I was frustrated and could not believe I let the opportunity slip away.  It is easy to look back on a six-mile course and develop a list of second-saving could-haves, would-haves, and should-haves.  I am sure the guy who beat me could say the exact same thing about his own performance, but the reality is that neither one of us gets a do-over.

This is all pretty out of character for me.  People who know me well know that I care much more about race time than I do placement.  The way I see it, time is a better reflection of my progress because I can compare myself to how I have done in similar races.  We are more in control of our own destiny with time, whereas placement heavily depends on elements that are out of our hands.  If the Kenyan national distance-running team shows up or stays home, for example, I am going to finish in a very different place in the standings regardless of how hard I run.

So, if I do not care that much about placement, why did I care in this race?  I am embarrassed to say it is because we were a sponsor.  There I was wearing my green Soolman Nutrition and Wellness LLC racing jersey, our logo printed on all of the racing bibs and centered on the race T-shirts, and our brochures stuffed into the gift bags that each runner received.  I imagined that in the eyes of everybody who was there, my race performance would make or break their opinion of me as a dietitian.

That is probably the silliest and most off-base notion you have read today.  Furthermore, it is not even in line with my opinion regarding how a practitioner’s life influences (or does not influence) patient care.  I temporarily got caught up in a belief system in which I normally do not include myself.

This morning, I went to supervision group.  That’s the term used for when a small group of dietitians gets together to discuss best practices, difficult cases, and other matters of patient care.  It turned into an emotional meeting or sorts, as people in the group shared some of their own personal struggles as well as their fears regarding what their patients might think if they found out about these issues.  Without disclosing details that might make their identities known, I will tell you that one of the dietitians mentioned a personal history of an eating disorder, another shared her struggles with a debilitating and incurable disease, and another disclosed that she will be undergoing radical surgery this winter and has been overeating due to her increased stress.

I only listened.  Had I contributed, I would have told them about my persistent back problems: the herniated disc, the four fractures that will never heal, and other associated issues.  I remember my physical therapist telling me earlier this summer that she does not get too worked up about MRI reports because almost every scan reveals some sort of structural issue, and by and large these issues are harmless.  She told me she only gets concerned when a report contains the word “severe.”  Then she looked at my report, looked back up at me, and gave me a half-smile.  “Severe” appeared in my report three times.

Dietitians are just like everybody else.  Patients often assume that we are perfectly healthy, have perfect relationships with food, and in general lead the healthiest of healthy lifestyles, but the truth is that we have our problems too.  Like a cancer patient who goes on to become an oncologist, why do you think so many of us chose to pursue a career in health and dietetics?

So, taking myself down from the pedestal that some people seem to put me on, but on which I do not belong, is actually a big relief.  I do not have to live up to extraordinary expectations and feel bad about myself when I fall short.  Instead, I can just enjoy what I have, what I can do, what I have accomplished, and what is ahead of me.

It is a privilege that I have been generally fortunate with my health and that the problems I do have are manageable.  It is a privilege that I can go to physical therapy and work towards getting stronger.  It is a privilege that you, your neighbors, and your friends allow me to help you towards your own goals.  It is a privilege that I got to race in a great community event along a beautiful course on a crisp late summer morning with my wife cheering for me.

And yes, it is absolutely a privilege that I was able to finish one second shy of winning a medal.

Mountain Goats

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Congratulations to everybody who competed in Sunday’s USA Mountain Running Championships and NACAC (North American, Caribbean, Central American) Mountain Running Championships race at Cranmore!  The event attracted the continent’s best mountain runners.  Why the field was even open to the likes of me, I have no idea.

Because we were running on a lap course, I had a chance to see North America’s elite mountain runners up close as they lapped me.  Joseph Gray, on his way to the finish line and about to repeat as North America’s mountain-running champion, passed me as we were going up a steep and uneven section of trail.  His level of exertion appeared to equal that which I display while taking a nap.

As amazing as his performance was, I was even more impressed by my friend Darrin, of the Hartford-based Beat City Milers, who rebounded from a tough start to the season and came out of nowhere to win second place in his age group.  He went from disappointing finishes in May to now possessing a silver medal from USA Track and Field declaring him North America’s runner-up mountain-running champion for his age group.  The award reflects how hard he has worked this spring and summer.

Personally, I had a disappointing race.  My legs were unexpectedly tired during warm-ups and I felt winded after a couple minutes of jogging, both of which were red flags that something was wrong.  In an effort to stay positive, I tried telling myself that I would be okay once the race started.  Nope.  I could not get anything going on the steep uphills, nor on the steep downhills, nor on the flat . . . well, there weren’t really any flat parts, but you get the idea.

Oftentimes, we can forecast a bad performance.  Maybe we did not sleep enough, eat right, or fully recover from a previous race/workout.  Maybe we have been chronically overtraining or undertraining, or doing the wrong kind of training.  Maybe we are returning from a layoff or dealing with an illness or injury.  When one or more of these factors are in play, we can expect a subpar performance.

Other times though, bad days come out of the blue without a clear cause.  It goes both ways though – I have had great runs come out of nowhere when I least expected it too – and either way we have to play the hand we are dealt.  We all have off days sometimes and races do not get postponed because a competitor is having one of them.  The event continues and we just have to give it our best effort, no matter how much or how little that might be.  That’s life, right?

Cranmore was the last race in the USA Track and Field New England Mountain Circuit.  Despite my disappointing performance, I did manage to finish the circuit ranked 21st out of 164 male runners.  In the process, I earned “Mountain Goat” status, meaning that I get direct entry into next year’s Mount Washington road race.

Darrin and Mic, both of the Beat City Milers, and Jonah displaying their Mountain Goat shirts

I got started with mountain racing four years ago after seeing a documentary in which one of the subjects ran the race up Mount Washington.  Joanne and I watched it together.  If I remember correctly, her reaction was “That looks terrible!” while mine was “That looks awesome!”   Six months later, I found myself in that very race for the first time.  If you are similarly curious about trying it, put your name in the lottery and hopefully we will see each other there.

 

The Importance of Racing Strategy

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Independence Day is a popular occasion for road races.  I love events like this that draw the community together, as runners/walkers of all abilities turn out to participate and others line the courses to cheer on the athletes.  As great as these events are, they are that much more fun and rewarding when we perform our best.

Putting ourselves in the best position for a great race requires more than proper nutrition and hard work.  We need sound strategy, both during training as well as on race day itself.   To illustrate my point, let me share with you the planning that went into my 2011 Mount Washington Road Race performance.

The Mount Washington Road Race involves running up the 7.6-mile auto road from the mountain’s base to the summit.  The mistake I made when I ran the race in previous years was trying to keep my pace per mile consistent throughout the event.   On some courses, such as one that is perfectly flat, this strategy might make sense.  On this particular course though where the grade changes and the air gets thinner father up the mountain, it made little sense for me to act as if every mile was the same.  Going into the 2011 race, I needed a new strategy that incorporated these variables.

My new strategy was to keep my level of exertion consistent as the course conditions changed around me.  Using equations that take into account slope, speed, and altitude, I created a spreadsheet that determined the level of oxygen consumption (VO2) that I needed to maintain throughout the race in order to finish in my goal time.  The spreadsheet showed that I needed to maintain a VO2 of 43.6 mL/kg/minute for the entire event in order to finish in my goal time of 1:37.

MountWashingtonSpreadhseet

The next step was to convert 43.6 mL/kg/minute to METS, another measure of oxygen consumption.  The advantage of working with METS as opposed to VO2 is that METS appear on the digital displays of many treadmills, exercise bikes, and other cardiovascular equipment.  By using these pieces of training equipment at my desired METS level, I learned what it felt like in terms of perceived exertion to sustain that level of oxygen consumption.  I could then run outside at that same exertion level and be reasonably certain that I was running at the necessary VO2/METS level.

As my training continued across various modes, I built my endurance at this level of oxygen consumption until I could sustain it for close to the time I expected it would take me to finish the race.

The spreadsheet was not only helpful during training, but also the race itself, as it showed me what my time for each mile should be in order to finish within my goal time.  I wrote these times on the back of my left hand so I could easily compare them to my watch at each mile marker during the event.
MountWashingtonHand

I finished the 2011 race faster than I had in either of my previous two Mount Washington races.  I was not necessarily any fitter than I was in 2009 or 2010, but I was definitely smarter, and that made all the difference.

No matter the event for which you are training, make sure you have a sound plan in place that will get you to your goal.