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Check Your Attitude towards Weight & Obesity

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Our attitudes towards weight and obesity may be unknowingly biased. This needs to change – not just by primary care health professionals, but also by us.

In a presentation about the new Canadian Adult Obesity Clinical Practice Guidelines, one of the lead authors Dr. Sean Wharton emphasized the importance of recognizing our internal biases against people who are overweight or living with obesity. Wharton challenges health professionals to check their attitude. I think this exercise is valuable for all of us.

Take a look at the three questions below and answer them honestly. The first step in reframing our attitudes is recognizing our own biases.

  1. Do you assume a person’s health characteristics, behaviours and abilities are based on their body size, weight or shape?
  • Reframe your attitude: People come in different sizes and shapes. Body size, weight and shape are not directly associated with a person’s health, work ethic, willpower, intelligence or skills.
  1. Do you think that everyone with a larger body size or a higher Body Mass Index has obesity and needs to lose weight?
  • Reframe your attitude: Obesity is a chronic disease where abnormal or excess body fat impairs health. Body Mass Index (BMI) is an indicator of body size and not an indicator of health. Not everyone with a large body size or high BMI has obesity.
  1. Do you believe people with obesity are personally responsible for their condition?
  • Reframe your attitude: Obesity management isn’t just about eating healthier and being more active. There are many factors beyond a person’s control – such genetics and environmental factors – that can contribute to obesity.

Let’s work to let go of our attitudes. These new Guidelines are just the beginning.

Intermittent Fasting – the new weight loss trend?

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Fasting has been practiced for centuries around the world, typically for religious reasons. Now, intermittent fasting is becoming a trendy way to lose weight. But does it really work and should you try it?

There are a few variations of intermittent fasting:

Alternate day fasting was researched by Dr. Krista Varady who is an Associate Professor of Nutrition at the University of Illinois in Chicago. The idea is to alternate back and forth between eating about 500 calories one day and then eating a moderate high-fat diet the next day. In her research trials, she found that adults lost an average of 11 pounds in 12 weeks. Plus, the alternate day fasting lowered the participants’ levels of the “bad” LDL (Low Density Lipoprotein) cholesterol which helps to lower their overall risk for heart disease.

The 5:2 fasting diet is a modified version of the alternate day fasting diet. The general idea here, according to proponent Dr. Mark Mattson, is to eat no more than 500 calories on two non-consecutive days each week. On the other five days of the week, you can eat your usual diet. Mattson is a Professor of Neuroscience at the John Hopkins University. In his research, overweight and obese women who followed the 5:2 diet for six months lost just slightly more weight than women who were following a low calorie diet. Mattson is now exploring whether this diet can help improve brain health in seniors.

Time-restricted eating is another type of intermittent fasting where you only eat during a small window of time. This includes ideas such as a longer nighttime fast (for example, not eating from 7 pm to 6 am) or eating just one big meal a day instead of three typical meals. Animals who fast in these ways do lose weight, but there are hardly any scientific studies with people.

Here’s our advice:

1. Intermittent fasting is not easy. In fact, 10 to 20% of participants who try intermittent fasting find it too difficult and quickly stopped. Those who stick with the diets admit that it is very challenging for at least the first few weeks.
2. Intermittent fasting isn’t a miracle weight loss cure. The studies show that you can lose about the same amount of weight whether you fast intermittently or just cut back on calories every day.
3. Intermittent fasting is NOT for everyone. For example, if you are pregnant, underweight or have type 2 diabetes, then intermittent fasting is not suitable and can be dangerous for you.
4. The best “diet” is the one you can stick with for the rest of your life. Healthy eating is about enjoyment, not deprivation. If you’re interested in trying intermittent fasting, perhaps start with the least extreme option of extending your nighttime fast. Think of the motto “Done after dinner.” Eat your dinner and then skip any bedtime snack. Refuel with a good breakfast in the morning.
5. Talk to a registered dietitian for safe and expert advice on diets and weight loss.

5 Ways to Celebrate Food Revolution Day

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Food Rev Day May 20 2016

Jamie Oliver Food Revolution Day 2016

Globally, 41 million kids under the age of five are overweight, and another 159 million kids are malnourished. Something has to change. For over 15 years, culinary hero and food activist Chef Jamie Oliver has been campaigning for better food and health with a goal to improve global child health.

May 20th marks the third annual Food Revolution Day. The Food Revolution is an ongoing global campaign to improve child health by inspiring positive, meaningful change in the way our kids access, consume and understand food. And it all starts with good, fresh, real food.

Here are five simple things you can do today to build a healthy and happy generation for tomorrow:

1. Cook together! Chef and TV personality Guy Fieri says it best, “Cooking with kids is not just about ingredients, recipes and cooking. It’s about harnessing imagination, empowerment and creativity.” Cooking is a life skill.

2. Explore with food. Talk to the farmers at the local farmers’ market. Take the kids grocery shopping to see the variety of produce available all year long. Grow your own veggies. Plan a family outing at a pick-your-own berry or apple farm. Spend a day at the Royal Agricultural Winter Fair. Watch cooking shows together (MasterChef Junior, anyone?)!

3. Make a family cookbook. Go online, look at recipe apps, dust off your cookbooks and magazines. Try new foods and flavours. Put your favourites into a family cookbook – what a perfect holiday gift for friends and family!

4. Sign the Ontario Home Economics Association petition which urges the government of Ontario to make at least one food and nutrition course compulsory in high school. In Japan, cooking classes are mandatory in grades 5 to 12 – and could it be a coincidence that the Japanese have one of the lowest rates of obesity?

5. Sign up for Jamie’s Food Revolution. Starting at 10 am BST (UK time) or 5 am EST on Friday, May 20, watch live videos on Jamie’s Facebook page where you’ll see him dishing up advice and starring in cooking videos.

“Eat Less, Eat Better”…is it that simple? Rethinking our message about healthy eating and obesity

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Will we solve the obesity crisis by simply telling people to “eat less and eat better”? A one-day health professional forum was held in Toronto to rethink our messages about food and obesity. The event featured key leaders in obesity research/treatment and health communications: Dr. Ayra Sharma, Ted Kyle and me! Here’s what the experts were saying.


Dr. Ayra Sharma – Chair for Obesity Research and Management, University of Alberta
• Obesity is a complex chronic disease.
• Simplistic messages about obesity are misleading, can promote unhealthy weight obsession and promote bias and discrimination.
• Prevention and intervention strategies should focus on improving health behaviours rather than on just changing body weight.


Ted Kyle – Founder, ConscienHealth
• Use respectful, people-first language that is free of bias and stigma – e.g. “unhealthy weight” or “high BMI” instead of “fat” or “morbidly obese”.
• “Obese” is a harmful label. “Obesity” is a disease.
• Shift the conversation from “being obese” towards health.


Sue Mah – President, Nutrition Solutions
• “Eating better” means cooking, eating together and enjoying food.
• Consumers are bombarded with food/nutrition messages that simply don’t “have the scientific muster to present as fact” (quoting Dr. Oz here!)
• Health and nutrition communications needs to be creative to capture consumers’ attention.
• From celebrities and chefs to dietitians and politicians, everyone has a role in being a champion for change.

Ontario Healthy Kids Strategy

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One of the greatest public health concerns today is undeniably childhood obesity. In 1978, only 15% of children were overweight or obese. Almost 30 years later, in 2007, 29% of adolescents were at unhealthy weights. If current trends continue, by 2040, up to 70% of adults aged 40 and over will be either overweight or obese.

Last January, the Ontario government set an aspirational target to reduce childhood obesity by 20% in five years. Charged with this mandate, the Ontario Healthy Kids Panel outlined a three-part strategy in their recent report No Time to Wait: The Healthy Kids Strategy:

1. Start all kids on the path to health. A woman’s health and weight before she becomes pregnant and during pregnancy have a direct influence on her child’s health and weight. The Report recommends pre-natal and educational programs for all young women about the importance of healthy eating, active living, smoking prevention/cessation, and healthy weights. Support is also recommended to encourage women to breastfeed for at least the first six months.

2. Change the food environment. The healthy choices should be the easiest choice where kids live, learn and play. Some of the many recommendations for this strategy include:
• A ban on the marketing of high calorie, low nutrient foods/beverages/snacks to kids under the age of 12;
• A ban on point-of-sale promotions and displays of high-calorie, low-nutrient foods and beverages in retail settings, beginning with sugar-sweetened beverages;
• Mandatory calorie listing on menus at restaurants, fast food outlets and retail grocery stores;
• Nutrition rating systems for products in-store;
• Incentives for Ontario food growers and producers to support community-based food distribution programs;
• Access to safe, affordable, nutritious and culturally appropriate foods, especially in areas of low income and “food deserts”; and
• A universal school nutrition program for all Ontario publicly funded elementary and secondary schools.

3. Create healthy communities. A comprehensive healthy kids social marketing program is needed to focus on healthy eating, active living and active transportation, mental health and adequate sleep. The Report recommends implementing community based programs based on EPOCE (Ensemble Prévenons l’Obesité des Enfants – Together Let’s Prevent Childhood Obesity) which is used in 15 countries worldwide. The EPODE philosophy involves mobilizing all local stakeholders in an integrated, long-term obesity prevention program. The aim is to change the environment and facilitate the adoption of healthier behaviours and lifestyles into everyday life.

My take on the Report: Having just finished writing a series of key messages on healthy weights for children and teens, I was thrilled to see the Healthy Kids Panel Report acknowledge the key determinants impacting a child’s weight – healthy eating, food and nutrition skills, active living, adequate sleep, mental health, resilience and the influential role of parents, teachers and caregivers.

Given the recent controversy over NYC’s soda ban though, I wonder how a junk food ban would be received. Neither a junk food ban nor an advertising ban helps kids with media literacy or how to discern between truth and advertising. We don’t even have an official definition of “healthy food” in Canada, so where would we start in defining “unhealthy”?

I’d also love to see more dialogue on how to eat, not just what or what not to eat. Research tells us that mindless eating is an unhealthy habit which can have negative consequences on our satiety cues and overall intake.

Finally, let’s be careful not to point blame at anyone or anything. The Report acknowledges that some children are genetically predisposed to be heavier. There are over 50 different genes that contribute to obesity. All efforts in reducing overweight and obesity must be free of any weight stigmatization or bias, and involve all players – individuals, communities, politicians and food industry.

The Healthy Kids Panel has mapped out an incredibly ambitious goal – to reduce childhood obesity by 20% in five years. I’ll be watching, listening, helping and hoping that we’ll get there.

To read the full report, go to http://www.health.gov.on.ca/en/common/ministry/publications/reports/healthy_kids/healthy_kids.pdf

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