Tuesday night, after Jason asked me what I felt like watching, and I told him I didn’t care, he opted to put on the most recent Rambo movie that TiVo had captured for him to watch at his leisure. For future reference, “I don’t care” will not be my response next time. While I was barely watching, I managed to catch heads rolling, blood pouring, and dead bodies hanging, but even with my eyes purposely averted, just the screams of horror, and the swish-swish of long scary knives decapitating and otherwise killing people had me squirming and hoping I wouldn’t be the star in my own Southeast Asian guerilla warfare nightmare later that night.

Coincidentally, a little later, AMC was showing the original Rambo movie, First Blood, which I had never seen. I only half watched, mostly to comment on the bad acting and absurd plot premise. It was not anywhere near as gruesome as its more recent version, so at least I was spared additional cinematic gore. We were not however spared the agony of a crazy amount of commercial breaks. Sometimes we’ll watch a movie on AMC, and it’s hard to overlook that they have more commercial breaks than you can imagine, but Tuesday night, it seemed worse than ever. I didn’t actually time it, but I’d be surprised if more than 10 minutes of the movie played at any given time before there was a commercial interruption. What made it even more annoying was that it was the same commercials over and over again, one of which was for Nutrisystem D.

I’ve already grown weary of weight loss program commercials appealing to those who resolve to lose weight once and for all in 2010, but if I have to see this Nutisystem D commercial one more time, I’ll scream. Initially, the commercial didn’t register with me, even though the onslaught of commercial breaks are also twice as loud as the movie (I kid you not, watch AMC and see for yourself), but by the 4th or 5th time it aired, I started to take notice. A diet plan for people with T2 diabetes that will supposedly help them lose weight and lower their A1c?

I looked on the website. From the Nutrisystem homepage: “Lose weight & help manage the ABCs of diabetes – A1C/Blood Sugar levels, Blood Pressure, and Cholesterol.” I clicked to get more details, and on the next page, the claims were as follows:

• Lost up to 16x more weight
• Lowered blood sugar levels 5x more
• Lowered A1C by 0.9%
• Lowered total cholesterol level by 20.9 mg
• Lowered triglycerides level by 42.7 mg

I imagine anyone with T2 who is overweight and loses a significant amount of weight would have comparable results. The obvious hurdle is, of course, losing the weight, but Nutrisystem purports to facilitate overcoming that obstacle.

Then I went digging for a little more information in the form of reviews and opinions. First I found the Diet Blog, a site to which I’ve never been before so I can’t speak to its credibility. My anti-diet philosophy aside, it seemed OK overall though. They seemed to make some valid points worth noting. The Nutisystem D diet is based on a study at Temple University (my alma mater, it should be noted) School of Medicine. The sample size was small with only 68 obese participants, so no definitive conclusions should really be drawn, let alone an entire diet program developed based on them. Furthermore, and even more troubling, “The lead figure on the study, Dr Gary Foster, wrote the NutriSystem Diet’s ‘Mindset Makeover’ behavioral guide. Also, NutriSystem provided an ‘educational grant’ for the Obesity Management In Patients With Type 2 Diabetes dinner meeting at Temple University’s School of Medicine.” Can we say, “conflict of interest”, boys and girls?

My next stop was our very own Diabetes Daily where Elizabeth Edelman did an impressive and comprehensive review which you should totally check out to get more details and insight into this diet. One thing she noted was the obscene amount of sodium in the packaged meals. Sodium is bad for diabetics, and while it’s especially dangerous and needs to be watched by those of us with blood pressure, heart and/or kidney-related problems, if you want to take steps towards avoiding those health issues, you’d likely be doing yourself a favor to keep an eye on your sodium intake. What struck me was the first quote I lifted from the Nutrisystem homepage that the diet would help with the ABC’s of diabetes including blood pressure – yet the food is loaded with sodium? I guess what they strategically omitted was that their packaged meals are more likely to raise your blood pressure, not lower it.

Elizabeth also noted that the diet doesn’t teach participants how to eat once their supply of packaged meals is depleted. This is the problem with just about every diet that exists though, and that brings me to the true take-away message I want to impart.

I don’t believe in weight loss diets, so my bias in that respect should be noted. I believe in eating a wide range of foods, heavy on whole grains, produce and low-fat protein, light on processed foods, all in moderation – well, except for diet soda (it’s my vice, so sue me). It’s vague I guess, but after spending half my life in a tete-a-tete with food, I made peace with food and this works beautifully for me. I’m sure there are a few sporadic souls out there somewhere for whom a weight loss diet has worked to the point that they were able to reach their goal weight and maintain their weight loss, but for the vast majority of people, that isn’t what happens. So what good are weight loss diets? Well, they might help you lose weight for a time, but they are by their very nature nearly impossible to maintain forever so the weight inevitably returns. Weight loss diets make the people who write the books about them, and the people who run the weight loss program companies fat… in the pocketbook sense, of course. It’s a billion dollar industry because people keep feeding it, pun intended.

I know, I know, if you’ve met me or seen enough photos of me, you’re asking who the heck am I to talk about weight loss diets? I’m not fat. I’ve never been fat. I was slightly overweight when I was 14 after eating myself into oblivion one summer to alleviate what I now recognize as depression. My obsession to lose those 20 or so pounds resulted in an 18-year eating disorder, diabetes complications, and all the accompanied fallout. So my food and body issues aren’t the same as someone who’s obese, but if I hadn’t hobbled along with my compensatory behaviors – insulin omission and self-induced vomiting – for the better part of two decades, I can assure you, I’d be as big as a house with an attached 3 car garage and an in-law suite. I’ve despised my body. I’ve been engaged in obsessive power struggles with myself about whether or not to eat something. I’ve felt deprived. I’ve felt completely out of control with my eating. My end result was different from someone who’s overweight, but I think my struggle was comparably miserable, and achieving balance and making peace with food and my body, no less monumental.

My weight is now healthy and stable. Thus, I have no reason to consider weight loss as a New Year’s resolution. There are plenty of things I should consider – exercising and cleaning my house would be good starts – but in the end, I don’t do New Year’s resolutions. The very concept of getting motivated to do something that’s likely been an ongoing problem for an extended amount of time, in January of all the cold, dark, depressing months of the year, just because you have to get used to writing a new number on your checks seems inately ludicrous to me.

Yesterday I saw this post, “New Year’s resolutions – no more!”, written by Doris Smeltzer on Eating Disorders Blogs: Advice for Parents, and tweeted by @gurzebooks, a publisher of books about eating disorders. I encourage you to read the post, but in brief, Ms. Smeltzer spent years making resolutions to lose weight. The time came when she found the key to achieving the number on the scale she had so longed to see – chemo to treat breast cancer. She swore off diets after that, but whatever messages had been conveyed to her daughters about loving – or in this case, hating – one’s body were learned. One of her daughters eventually died from an eating disorder. I’m sure that isn’t the sole reason her daughter developed an eating disorder because an eating disorder is a very complex mental illness. However, I suspect, just as Ms. Smeltzer does, that her daughter garnered some very negative messages about her body by watching what many would say is typical behavior – a New Year’s resolution to lose weight. You want to lose a few pounds, maybe you ate too many Christmas cookies, maybe you haven’t lost the baby weight, maybe your genes just don’t agree with you being a size 6 or wearing a size 34 waist, so New Years rolls around, and you decide you’re finally going to lose those pesky pounds by going on a diet.

Ms. Smeltzer, who no longer diets and whose daughter is dead, quoted the spring 1991 issue of Radiance Magazine:

In 1990 Congress investigated hazards and misrepresentations of the diet industry. C. Wayne Calloway, M.D. practices endocrinology in Washington, DC and has held prominent positions with the Mayo Clinic, university medical centers, the U.S. Department of Health and Human Services and the National Institutes of Health. He testified, “The great mythology is that the diet works and that you have failed. Most likely, the act of dieting itself leads to the compulsion to eat. Bingeing is a normal consequence of starving.” (p. 15)

So should you just say screw it? Well, no, not if it’s in the interest of your health to lose weight. I don’t claim to have the secrets to weight loss, and I do think that achieving weight loss is a very individual thing – much like diabetes management. I’ve never had to lose a lot of weight and then maintain it, but if you think I don’t know about learning how to eat like a normal person so that I could maintain weight without slowly – or quickly – killing myself, then hello, I’m Lee Ann, nice to meet you, so glad you popped by today.

Luckily, as people with diabetes, it’s generally easy for us to justify meeting with a registered dietitian, and that’s what I think anyone who wants to change their eating habits should do. The people at Nutrisystem or Jenny Craig are sales people before all else, and they want to sell you the dream that you can be whatever your magic scale number is. I know some people swear by Weight Watcher’s, but if you have to keep going back and paying over and over again, I can’t help but think that they just want to make a profit off you and your desire to lose weight too. Your diabetes team, your healthcare providers are the ones who are better situated and better qualified to help you devise a plan to lose any weight that might be compromising your health. Sales people are not.

So this year, instead of deciding you need to lose 20 pounds, and then beating your poor psyche to a pulp in 6 weeks when you haven’t made whatever progress you envisioned on a diet that you know you can’t indefinitely sustain, decide you’re going to get a kitchen scale and start weighing your portions. Make a new rule that you aren’t going to eat straight from the box, bag or container. Trade your half-gallon of ice cream for single serve bars or cups. Are you going to lose that 20 pounds by doing any one of those things by itself? No, but any one of those things are good steps to take towards learning to eat a healthy, varied diet of the foods you actually like in moderation. Then, if you must make one, spend your New Year’s resolution on something fulfilling, like remembering all the things that make you awesome, no matter what the number on the tag in your pants is.

I am by no means an expert on T2, and I generally don’t write about it because I don’t have any noteworthy personal experience with it. I have learned a lot about it over the last couple of years because I enjoy various diabetes message boards, and I read a lot of articles about diabetes for the sake of staying informed so I catch a good bit of news on T2 that way. When I have to explain how T1 is different from T2 to people who think diabetes is one disease I don’t want to perpetuate myths and misconceptions about it. I also have a general interest in diet and nutrition (I’d love to go back to school and become an RD), so I like to read about cultural eating issues which often tie in to public health issues and T2 diabetes these days.

Inuit Whopper Virgin, courtesy of Burger King

Because I have these interests, I’ve become fairly critical of the marketing practices of the food and restaurant industries and its affect on the choices people make regarding their diets. Thankfully we watch most of our favorite TV shows on the DVR so we usually miss many of the commercials that would otherwise garner my contempt. We watch football live though which means lots of commercials, and while we normally only watch the Eagles game, yesterday we also watched the Oakland-Tampa Bay game because we dearly needed Tampa Bay to lose if the Eagles were going to have any shot at the playoffs. Two football games meant double the commercials, including at least two viewings of Burger King’s latest ad campaign, Whopper Virgins. Have you seen these commercials testing the Big Mac against the Whopper amongst people Burger King has labeled Whopper Virgins? Before game time, I had seen a couple of these commercials, but it wasn’t until yesterday that I gave it much thought.

I’m not a fan of fast food, and I’d like to thank my mom for that. I know people like to take their kids there, and kids like to go there. I was no exception, but unlike the parents of kids I knew, my mom tried really hard to limit the garbage I ingested so we almost never went. Since I never really developed a taste for it, it’s not something I ever crave so I eat fast food maybe once a year at most. When I do, it’s typically because I’m with someone who enjoys it and I’m trying to be accommodating, or I’m out and about, can’t find a Wawa, and I’m starving to the point that my stomach is starting to consume itself. On those rather infrequent occasions I do end up eating there, I don’t eat hamburgers.

While I rarely eat that food, I still have preferences. Of The Big Three, I prefer Wendy’s because they used to have salad bars (I was a weird kid). McDonald’s comes in a distant second (they had some relatively decent salads last time I was there, but you have to read the nutrition data on the website because some salads aren’t much better than the standard fare), and Burger King comes in a distant third. Not that I ever cared for Burger King to begin with, but they haven’t earned my favor by having such disturbing commercials over the last few years. Jason actually likes Burger King because he ate it as a kid, but he and I have been endlessly perplexed about how that creepy stalker king makes anyone want to eat there. I don’t know much about marketing, but I do think Burger King needs to get a new advertising agency. I’d be delighted if I never saw that creepy stalker king again, but I can’t say I’m thrilled with this Whopper Virgins ad campaign either.

Now I hadn’t thought much of the few Whopper Virgin commercials I had seen, but yesterday I saw a version during the Oakland-Tampa Bay game that I hadn’t seen before. The Whopper Virgins tasting the burgers were Inuits. Burger King took their food into these communities of people who have miraculously evaded Westernization. They got the people to taste-test Whoppers, comparing them to McDonald’s Big Macs, and say which they liked better.

This struck me as some really despicable, irresponsible garbage, much like the food they serve. I started to feel outraged as I was watching this commercial, and when the commercial aired again during the Eagles game, my disgust just heightened. All I could think was: Is this for real? Are they trying to sell burgers by documenting the introduction of their nutritionally-void fast food to an ethnic group shown to be susceptible to T2? T2 is a serious public health problem amongst Native American (1) populations, including the Inuits (2), due to both genetics and increasing obesity rates. There are studies (3) that suggest adopting mainsteam American dietary habits – like eating fast food – has been a contributing factor to the increasing rates of T2 amongst Native American populations. Even beyond the obesity and T2 problems that have become a plague for these ethnic groups, why would any clear-conscienced human being intentionally bring what amounts to poison into a community? Would people just sit back and accept it if a company dropped barrels of nuclear waste or canisters of hazardous biological waste into these communities? I’m pretty sure people would get upset about those things, so how exactly is feeding fast food to these people who don’t ordinarily eat it any better?

Of course, I was delighted that the Eagles trounced the Cowboys, and are on their way to hopefully do the same to the Vikings next Sunday, but oh, how I cringe at the thought of seeing that commercial again because not only does it represent so much of what is wrong with this society, but it also represents one of the monsters we’re all up against in reining in the T2 epidemic. So I’m interested in what others think about this. Am I over-reacting or does anyone else think Burger King has crossed the line?

Additional Resources:

Burger King Ads Underscore Imperialism of the Fast Food Nation

The Inuit Paradox

‘Whopper’ Commercial Angers Some

Burger King Ads Flame-Broiled in Controversy

References:
1. Bassett, M. T. (2005). Diabetes is Epidemic. American Journal of Public Health, 95 (9), 1496

2. Jorgensen, M. E., Bjeregaard, P., Borch-Johnsen, K., Backer, V., Becker, U., Jorgensen, T., & Mulvad, G. (2002). Diabetes and Impaired Glucose Tolerance Among the Inuit Population of Greenland. Diabetes Care, 25, 1766-1771.

3. Schulz, L. O., Bennett, P. H., Ravussin, E., Kidd, J. R., Kidd, K. K., Esparza, J., & Valencia, M. E. (2006). Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S. Diabetes Care 29, 1866-1871.