Don't Super-Size Me: The push for calories on menus

I didn't see the movie Super Size Me, to tell you the truth. The thought of watching someone gorge on super-sized portions just didn't appeal.

IMDb (where I get all of my movie facts) tells us that movie filmmaker Morgan Spurlock embarks on the most perilous journey of his life. He can't eat or drink anything that isn't on McDonald's menu; he must wolf down three squares a day. He must consume everything on the menu at least once and super size his meal if asked.

Just not pretty.

In my two dozen plus years as a therapist, I've shied away from specializing in eating disorders. By not specializing, I do very well in this area, weirdly enough. I won't specialize because frankly, everyone is sensitive about weight (everyone). And weight is very hard to treat, even with "specialist" written before or after your name.

Because it's such a universal, when people tell me that they want to work on their eating I say, "You'll have to find another therapist if that's all you want to work on. I'll work with you on everything else, your behavior, your thoughts, your relationships, your organizational skill, your emotional management, anything almost, except for eating, and certainly not eating disorders. I won't set out to treat those. If they happen to change over our time together, great, but we're not setting out to cure them."

Why? (a) I like success in my work, prefer to see change fast, and (b) These are the hardest disorders to "cure." So put (a) together with (b) and you get my drift. Oh, and did I mention the paradox in all this?*

The truth? Eating really is an emotional affair. How can it not be emotional? It's about how we look and feel; it's so emotional that no matter how you slice it (all puns in this post may be intentional, I'm not sure yet) until you get yourself emotionally grounded, which can take years, it can be very hard, excruciatingly hard to control one's eating.

This is the essence of anorexia, by the way, control. You can't make anybody eat.

And far be it from me to try.

And you can't make anyone lose weight, either.

My patients lose weight, there's no question about it, without focusing on food as a therapeutic issue, perhaps by not focusing on food as an issue. When we spend a year (okay, more) on the emotional stuff, the pounds tend to peel off slowly, but still. It is a lovely thing to see. Two of my patients in the past year have lost over a hundred pounds each. Both had seen me for nearly three years before they started to lose.

No, it's not science, but it does seem to be a pattern in my practice, maybe is for others, too. Get therapy, take it seriously, and you'll get a handle on your life. Eating is a part of life.

I haven't tackled this topic on the blog until now because it's so huge, and I have so much to say about it. The only way is to begin a discussion is to focus on something in particular, and since WSJ offered me the perfect entree, let's start with Page 2, July 10, 2008, The Wall Street Journal, The Push for Calories on Menus.

Apparently some states are passing laws (or trying) to force restaurant chains to list the caloric and nutritional value of items they serve on their menus. Stu Woo tells us that the California and New York state legislatures have joined a movement approved by health advocacy groups such as the Center for Science in the Public Interest. Other advocates for content disclosure include the American Cancer Society and the American Heart Association.

These organizations agree that if we tell consumers what they're eating, they'll be less likely to eat as much.

Menus with caloric and nutritional information might make some foods less tempting, obviously, something restaurateurs are leery about. And they pay taxes, too, which is why state legislatures are keeping their sights low, only targeting large chains with 8 or more restaurants. Advocates believe these measures, posting calories on walls and menus, are a step towards addressing the country's obesity problems.

A May report by the Los Angeles County Department of Health indicates, based upon "conservative assumptions" that posting calories on menus might result in approximately 10% of restaurant patrons ordering reduced-calorie meals. Changing the eating habits of ten percent of anything is amazing.

And it sounds cheaper than years of therapy, so I'm all for it.

Because at the end of the day, weight control is all about calories in, calories out. If you eat more food than you use in a day, the rest goes to the thighs; or wherever your body feels most comfortable storing it.

But wait a minute! Here's another novel idea (not so novel, okay). What about learning the caloric content of food, cooking for yourself, eating from your own kitchen?

I realize it's easier to pick up the Weight Watchers meals (the only diet I ever recommend when pushed to opine). But there's really something very satisfying about seasoning your own food, sauteing those lean meats or vegetables in just a little olive oil, tossing out the egg yokes. Who cares how rich they are in vitamins?

But when I talk like this in therapy, when patients get me to talk weight control, to talk about exercise (they see my bike) and healthy eating (my sandwich), all I get back are blank looks that say, Why would I ever do that?!

Exercise regularly? Cook? Prepare food? Insane!

Which is why I don't treat eating disorders. Although I could steer away conversation about my bicycle, it would be impossible for me to not talk food, not to impose my palate, not to suggest the ideal sandwich. And a patient might think I'm not empathetic to the situation, which is totally not true, patently unfair.

And yet, just a little olive oil and some garlic, throw in a half-inch of fresh ginger, but don't forget to discard it before you eat. . .it's such a good thing. . .


therapydoc
*a paradox works paradoxically, meaning if I say I refuse to work on this with you, you're probably really going to want me to work on this with you.