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Are We Becoming A GLP-1 Nation

Recently I watched the 3 hour long Making the Shift conversation by Weight Watchers and Oprah Winfrey regarding conversations about diet culture. The "making the shift " conversation explored the complexities of diet culture, and both Ms Winfrey and Weight Watchers' CEO and director Ms. Sistani, admitted their roles in contributing to diet - culture. Ms. Winfrey spoke about her experiences with shaming and discussed the shame felt by individuals who use GLP-1 medications to lose weight. The discussion whilst interesting felt more like an international sales pitch for GLP-1 medications. 

Ms. Winfrey expressed her opinion about using medications for weight-loss stating emphatically "That I am done with the shame!". She argued that each person should respect "grown individuals choice". I agree with that. I agree that we all need to respect the decisions made between an individual, their family, their nutritionist, their therapist and their families. No matter what the choice was, whether that individual chose to use obesity medications only, or to use a combination of exercise, nutritional changes and therapy to treat obesity or to do nothing at all. However, we know that diet-culture is very rarely individualistic, and that the insiduousness of obesity, undereating or avoidant eating is not as simple as - choice. 

The idea of simply choosing to eat nutrient dense foods and minimize processed foods, may sound good on paper, and in front of an international audience-the reality is that when it comes to lasting behavior change, change often takes years. Our choices are influenced by multiple factors including underlying beliefs about our selves and food. Further complicating the issues, is the role of persuasive advertising that is strategically geared towards targeting our psychological needs and wants. On an explicit level, we all know this. We know that when we sit in front of the television and see the latest diet commercial, or food advertisement, that on some level our emotional needs and wants to be accepted, to feel better about our selves and to be attractive to our spouses is often a hard call to resist. For a compulsive eater however, ihese commercials with the hope of having that "beach-body", "being healthy", and "fitting into those jeans", can all be triggers for those unmet needs and wants. With an initial determination to dig into the next diet plan with iron willed determination often falls flat with the first sign of an obstacle. This one set-back can often be the start of the binge-diet-cycle that often leads to feelings of loneliness and low self-worth - and the cycle continues.

As I watched the 3 hour long Making The Shift conversation, I had mixed feelings about it. On the one hand, the use of GLP-1 Medications to treat obesity and help individuals reduce their risk of heart-disease is life-changing. However, I know that often if something sounds like it's too good to be true, it might be. I am reminded of a close friend who told me about her story with the drug Fen-Phen. We sat on the beach talking about her near death experience and her struggles with obesity. She shared that she lost a great deal of weight, but also suffered with issues with her heart valve. I felt saddened and shocked for my friend who was now left with a scar following cardiovascular surgery to repair her heart valve. 

As I listened intently to the stories of professionals and regular Americans as they shared their stories of shame. I cried throughout the discussion as I saw myself in many of these women and men. I felt deep empathy for all of us who shared in the solidarity of the pain that can be caused by lack of acceptance. However, I wondered whether or not we had learned anything from the side-effects of the drug Fen Phen - and I thought about my friend who thankfully survived a life threatening drug designed to cure all her obesity problems. In the early 1990's it was the drug Fen Phen which was advertised as the miraculous weight-loss cure. The reports of weight-loss were truly touted as miraculous, until millions of people, mostly women were seriously affected and the drug was pulled from the market. I wondered, is there another way besides another drug!

As part of my work in mental health, I work with clients struggling with the pain of body image issues and binge eating behaviors, and like the old men’s hair club commercial famous quote says; “I am not just the President, I am also a client". You see, I am a compulsive overeater and I work with clients who struggle with compulsive eating. For as long as I can remember, body image issues and weight has been a public discourse for over 60 years. At the center of the conversation is the impact of persuasive commercials to shape diet-culture. 

For example, several years ago, if a woman was too skinny she was encouraged to gain weight. Many of the themes in the 1950s weight gain advertisement promote body shaming and appeal to innate psychological needs for acceptance, love and belonging. Those are core emotional needs that goes to the heart of everyone who is human. For instance, the above print ad overtly stated that being skinny meant guys were not interested and were left out in the cold. If these ladies wanted a man, they should pack on some pounds! Whereas today, a mere 74 years later, we have probably been bombarded with hundreds of solutions to the problem of obesity-which incidentally is out of control despite the hundred of weight-loss pills, diets, surgeries and injections manufactured to solve the obesity epidemic.

Throughout the 2000's we saw an increase in every diet for weight loss imaginable. The Atkins diet re-branded and offered free starter kits, Jenny Craig continued to offer at home pre-package food with personal support. Following behind was Nutri-System which redesigned their packaging and began advertising on HSN and QVC. Then we saw the diet heavy weigh-champion Weight-Watcher's up their marketing by offering flexible payment plans, support and joined forces with Media Mogul Ms Oprah Winfrey! We also saw the miraculous transformations of bodies on the Paleo, Keto, Carnivore, Fruit diets. Then, entering the ring as the life saving of them all is intermittent fasting and vegan dieting. At every turn, we were bomboarded by the alluring promise of health and acceptance through weight-loss. For many of us who tried one or all of these diets, success was short-lived, and the weigh returned with a vengence. Feeling defeated many return to the binge patterns that create hopelessness and despair.

However, over the past few years, and more specifically since Ms. Winfrey admitted to using GLP-1s to help her lose weight. Weight-Watchers joined forces and jumped on the GLP-1 band wagon by rebranding themselves and advertising an all encompassing approach to weight-loss as a novel idea. The message though is still the same in 2024 as it was in the 1990s with Fen-Phen. We, the people are enticed by the alluring promise of GLP-1's as a cure all for the obesity epidemic. Whilst GLP-1's are not new, and there have been several studies on the positive impact of the medications to improve cardiovascular disease and several other health markers, I am concerned about the long term side effects of these medications on the overall health of individuals. Having struggled with obesity personally and having worked with individuals professionally, I can tell you that behavior changes are often non-existant. The magical expectation that simply losing weight will now fix years of unhelpful behaviors is still at the fore-front of many minds. Many people taking GLP-1's do not change their exercising and eating behaviors and eventually over-eat the effects of the drug, or lose significant muscle that can often lead to a slowed metabolism. Like I said, I have seen this medication help individuals lose weight, but It would be equally important to address the unresolved issues that led to obesity including trauma, over consumption of processed food and environmental factors that continue to impact the quality of life of millions of Americans.

One of the things I share as part of my skills training with ADHD clients is pills don't take the place of skills. Perhaps we can apply a similar logic with these GLP-1 medications. If 60 years of medicating ourselves through pills, surgeries, diets and medications have not resolved the obesity epidemic, why do we think that this time it will be different. I am reminded, that the definition of insanity is doing the same thing, but expecting a different result. In my treatment of bingeating and body-image issues, I explore the emotional, spiritual and physical impact of compulsive eating through a holistic, integrative and faith-based approach. It is slow work, and sometimes unpopular and difficult-but it is worth it, because you are worth it.

I hope you know that your journey is as unique as you are. God formed you and has the blueprint for your life, yes, even matters of body image, weight and nutrition. Change is not a quick fix. It is a lifetime process of discovery, meant to transform confusing and painful messages about your body into purpose! I want you to know, it is possible to make peace with food, to make peace with the hurtful messages you received and to identify ways to reduce self-sabotaging behaviors. If that’s what you want to do. If you are struggling with body image issues, overeating and binge eating, I can help.

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