Jumat, 11 Juni 2010

Why am I Gluten Free and Should I Stay that Way?

When trying out a gluten elimination diet, a 60 day trial is usually what is recommended. Well, it’s been 60 days. I’ve found avoiding gluten to be not as difficult as I would have imagined. The only time I really freaked out was at the wedding last weekend. I was cranky and hungry when we got to the reception and consciously made the choice to dig into the bread basket. That night I had a roll and a half and about a cup of spaghetti. Not exactly a “breaking my diet” binge. I didn’t feel any sort of urge to go all out or overindulge since I’d already given myself permission to “eat what I wanted”. And although there was lovely wedding cake, donuts, and other dessert-goodness, I was simply too full by that point to be interested. This all just reinforced to me that avoiding gluten was a choice I was making to see if it would improve how I felt, not a diet. I had none of the diet-breaking symptoms. This was fantastic news. One thing I did notice was that I craved a bagel the next morning when I smelled Cute Man toasting one. I decided to not go for it, then, so it definitely wasn’t an all-encompassing undeniable urge. I’ve remained gluten free since and it’s been fine.

My question, though, is: what is the purpose? Am I achieving what I sought out to do? I reviewed my first post about going GF from back in April and realized that I haven’t seen any improvement in the physical symptoms I described. The biggest is the heartburn and that is still raging, I must say. TUMS remains my friend and I’m living with it. The other things I mentioned all remain the same, too. With the gluten free trial period completed, I would expect to see some sort of difference. I realize that these things don’t happen right away, but after two months, I’d think I’d see something. So, it’s really an opportunity cost thing. For the inconvenience of avoiding this food, what I am getting? Nothing really that I can see.

I also need to balance these health concerns with my dieting history and make sure I’m not doing it in order to somehow continue to restrict my eating. I must admit that I hoped that avoiding wheat would have a “happy side-effect” of not exactly weight loss, but maybe leave me less bloated and more comfortable in my clothes… Well, the bridesmaid dress was definitely tighter last week than it was before the GF experiment. I’m not beating myself up about that or anything, it’s just a fact. So that hope (whether it was a healthy one or not) went out the window, too. As a result, I feel like I need to return to Intuitive Eating basics and stop the GF restriction at this time. It’s not helping me and may actually be triggering a bit of my ‘fantasy of finding the answer to my weight related woes’ issue. I can say that I’m fine with being fat all I want, but it’s a hard road to follow within our culture. I recognize that dieting has never had a lasting positive impact on my life but making peace with my body is an ongoing process.

Moving forward, I’m continuing to focus on treating my body well. I’ve been upping my yoga practice and enjoying it at home more often as well as my classes at work. I want to add more walking in my daily life but I’m otherwise pleased with my ability and inclination toward activity (it’s no longer something I should do, rather it’s something I want to do because it feels good). This is a huge shift for me! I also know that keeping processed foods to a minimum helps me feel better, too, so that will continue. As for the continuing heartburn, it is what it is. For now, I think medicating with TUMS isn’t the end of the world. I’ll mention it to my doctor the next time I’m there and see if she has any ideas. It’s time to give myself a break and just trust I know how to feed myself: Eat when hungry, stop when full. I can do that!

Kamis, 10 Juni 2010

Why Incentive and Penalty Programs to Encourage Health are a Bad Idea

Over at Budgets are Sexy, J. Money brought up the subject of Employer and/or health insurance incentive/penalty programs. It really got me fired up! My comment got so long, I decided to bring the discussion over here.

The problem comes up with who decides what’s healthy and how to incentivize “healthy” behaviors. When you bring up something like smoking, it’s seems easy and kind of clear cut. Smoking is indeed 100% a choice. It’s good to not smoke. However, something like obesity is much more nuanced. How are we going to police that and do we really want to?

Being overweight is not a behavior, it’s a descriptor or you could say, a symptom. Same with high blood pressure, etc. Things like the kind of food you eat and exercise you do are behaviors. As an aside, we all know thin people who can eat “whatever” they want and never seem to gain weight (maybe like my friend J. Money?) We also know fat people who have dieted their whole lives who nonetheless, remain fat (me). Somehow, the former “makes sense” and we can assimilate that info but the latter somehow means that the person must be lying about their habits or “not trying hard enough”. And on the flipside, what about all the people training for marathons well into middle age and “draining” the health system with all their joint replacements and doctors visits? Somehow, pushing your body to the max is OK and dealing with all the injuries is a small price to pay for so-called “good” health. Not to really knock marathoners – I’ve completed 2 myself – shocking for a fat girl, but true. Was I being irresponsible to risk such an endeavor at my weight? Did anyone suggest that I might be a burden on the medical system? No, I got congratulated for my efforts. I’m making a point that it’s all about CHOICE – and who gets to decide which ones are good and bad. We do not want third parties deciding this stuff for us because in the end, it’s more about moral judgments than budgets and certainly more than actual real concern about health.

In any case, if we can agree that determining health can’t be as simple as looking at someone’s weight or BMI (which I hope we can!) do you really want to be turning in food diaries and tally sheets of your exercise to your employer or insurance company? As an individual, do you really want to give over that much info and control so that you can get a fair price for medical coverage? Should we really be penalizing those that need the most help? An example of a corporate wellness program I’m aware of is one rolled out by Whole Foods where they give an extra discount to employees who meet certain criteria (BMI, blood pressure, and cholesterol must be in the “normal” range) and are willing to share it with the company. Sounds great, right? But when you think about it, why wouldn’t you want to impede access to healthy food to the employees who are overweight, etc? Aren’t they the ones who (supposedly) need it the most? Who’s to say they won’t use that info to quietly weed out these “undesirable” employees?

As always, the devil’s in the details and I don’t think anything good can come from these types of programs when they’re tied to incentives or penalties. How about our private lives remain our private lives? How about we funnel public resources into making sure every family in America has food to eat? Grocery stores nearby that carry fresh produce? Bike paths and parks to encourage exercise for fun and socializing (moving your body isn't a punishment, it's fun, remember)? Money to fund quality school lunches, physical education, and ball parks for ALL students? How about we take worrying about “obesity” out of it? Don’t we all deserve to have access to healthy food and activities? Isn’t it good for EVERY body? We do not need to stigmatize people to get us (as a whole) to collectively do a better job of providing healthy options.

From a personal perspective, I work for an organization that offers an array of healthy workforce initiatives – yoga, pilates, and Zumba classes, seated upper body massages, and two fitness facilities – all onsite at reduced cost (the gyms are free). I don’t have to prove to anyone that I’m making progress or give them ANY personal info to take advantage of these things. Do they make me enjoy working where I do? Do they add to my quality of life? You bet. Do I feel pressured to use them under threat of losing privileges? Nope. I think it’s a fallacy and insulting to suggest that people just don’t know what’s good for them and we need to give out gold stars and detentions to get it into their heads. Taking good care of yourself takes time and it takes money. Providing that as a society to people will do far more to improve our overall health as opposed to creating invasive programs to police our personal lives.