Would you pay $1.44 more for a six-pack of Pepsi? What about 50 cents more for your favorite french fries?

Mark Bittman, journalist and food activist, is banking on the answer being no – and yes. In a recent New York Times opinion piece, Bittman outlined a push for creating an excise tax on certain foods deemed to be unhealthy, with the subsidies used to promote healthier options.

Despite my initial cringe at the reference to “bad food” (I work tirelessly to eliminate the categorical and moral language of “good” and “bad” when it comes to food among my patients), I read on to learn more about Bittman’s theory.

And what he suggests makes sense – at least initially. He starts his argument by reminding us all of the dangers of obesity (another cringe, but still reading…) and the increasing health-care costs piling up due to our heavily non-nutritive U.S. diet of potato chips and doughnuts.

He suggests that the food industry is incapable of marketing healthier foods (and based on my analysis of the baby carrot gaffe, I would have to agree) and are not incentivized to do so. Thus, he says, it’s up to the federal government to intervene on behalf of the health of its citizens.

What makes a tax such as this more palatable is that the funds generated – which are expected to be in the billions – would help to subsidize healthy food options for the poor, something that is direly needed regardless of the means. Indeed, a substantial proportion of our nation lives in what has been termed food deserts, areas that lack access to affordable fruits, vegetables, whole grains, low-fat milk due to lack of transportation, proximities of grocery stores, or other reasons. (To determine if your area is a food desert, check out this locator.)

According to Bittman, as well as researchers at the Rudd Center for Food Policy at Yale, an excise tax would work to decrease the consumption of sugary foods, decrease disease and health-care costs, and raise funds for health-focused programs. Millions of Americans would benefit from having nutrient-rich foods more available and making feeding their children healthy options one less thing to worry about. The potential impact of this cannot be overstated.

But we’re still left with the difficult questions about the role of government in helping us make our food choices. Bittman suggests that public health has always been the role of government. But does public health call for making Red Bull less affordable?

Also, what is the long-term impact of beginning to categorize foods as good or bad, as would be required to decide on what items to tax? If one food is taxed and another is not, should that really inform our food choices? What about making those decisions based on our own body’s particular needs and desires?

I also worry about the implications of the data that has and will most certainly been used to popularize these types of initiatives. When we talk about posting calories at restaurants and other such (formerly radical) ideas, proponents frequently point to the “obesity epidemic” and the “war on obesity,” a term and movement fraught with bias and discrimination. Is there a way to propose a food tax without implying fat people make bad food choices unless made to pay more? Perhaps, but it’ll require more creativity than we often see in politics and the media today.

Those are some of my initial thoughts, but I want to hear yours! What do you think?

Make sure to share your reactions, thoughts, and ideas in the comment section below! We need to learn from one another.

When Diana Spechler, author of the soon-to-be-released novel about a weight-loss camp, contacted me to tell me about a new website she had created, I was decidedly curious. In her email, Diana described the site as a “place where people can anonymously post their feelings about their bodies.”

As I thought about the potential for this body-focused PostSecret-esque venture, I wanted to know what had prompted Diana to create the site, so I asked her to share with me its evolution. “When I was writing Skinny… I was terrified to write about my characters’ body image issues and relationships to food because I worried that the book would get published and everyone would know that I had body image issues… I had to get over that before I could write the book,” she said.

So Diana began pouring out her “secrets” – the dark thoughts about herself and her body that she found so shameful – in the novel.  She recalled, “I had to remind myself a million times along the way to be honest, to stop hiding. It wasn’t easy. But five years later, I feel better. I can talk about my own body image issues and eating issues much more freely. And that’s because I spent so much time telling my secrets in my novel.

Like many others, Diana found healing in sharing what she had perceived as unspeakable. She gave voice to the negative thoughts that plagued her and found that as she shared these thoughts, they became less powerful. They loosened their grip.

“It seemed miraculous to me, and I wanted to find a way to give that gift to others,” Diana told me. “I wanted to tell the world, “Just talk about it! You’ll feel better!”

And so Body Confessions was born. It developed as a place for women to feel connected. Diana feels that “pretending that the problem is something different from what it is harms all of us and compounds the shame we already feel. [It’s] so we can say the things we aren’t supposed to say, and so that other people can read the truth and feel less alone.”

But does connecting over a shared hatred for our bodies really do us any good? Could it be more harmful than helpful? Where is the line between releasing shame and spiraling into negativity drawn?

These the question that began to stir in my mind as I perused the site. What I found saddened me for the women who had written the “confessions.”

Take this one, from an anonymous visitor: There are two possible reasons God did not create me as pretty and beautiful as other women. Either He thought I’d be able to handle it. Or I am just not worthy. I’m leaning towards the latter because I just can’t handle this.

Other confessions are equally heartbreaking (and potentially triggering), ranging from complaints about the size of one’s tummy to struggles with binging and purging to certainty that one’s partner will cheat because of one’s size. There are also the occasional uplifting posts, such as this one: I love myself the way I am. Affirmative posts like this are certainly more the exception than the rule on the site, however.

Personally, I didn’t leave the site feeling any better about my body. I actually didn’t feel much of anything about my own body, but rather a sense of helplessness in wanting to take away the pain of those posting these messages.

However, Diana has found that the site makes people feel less alone. And Glamour recently shared it on own of their blogs.

Interestingly, and perhaps contradictorily, Glamour’s recent piece in its March issue on body image included research suggesting that negative body thoughts actually shape our brains in an unhealthy way, promoting even more negative thoughts.

Ann Kearney-Cooke, Ph.D., a Cincinnati psychologist who was quoted for the article, said, “Neuroscience has shown that whatever you focus on shapes your brain. If you’re constantly thinking negative thoughts about your body, that neural pathway becomes stronger—and those thoughts become habitual,” she explains. “Imagine a concert pianist. Her brain would have stronger neural pathways that support musicality and dexterity than someone who hadn’t spent her life practicing.”

So, what do you think?

___________________________________________________________________________________

___________________________________________________________________________________

Respond to the poll and then share your thoughts in the comments below. We want to know! Do you feel it’s healing to get those thoughts out of your mind and onto the computer screen, knowing that others have “been there?” Or does it fuel more self-deprecation? Have you found writing your negative thoughts down to be helpful in other ways? What has helped you in overcoming negative body image? Would you ever use this site?

In a recent act of significant courage, Dr. Dana Udall-Weiner came out of the proverbial closet. A psychologist who blogs about food, family, and culture at The Body and the Brood revealed both on her website and through a guest post on Blogger Body Calendar that she has suffered from an eating disorder herself. As Dr. Udall-Weiner admits, this was not an easy decision.

Coming forward about having suffered from an eating disorder or disordered eating is difficult for anyone, and I commend the many bloggers who have done so bravely on their websites or in other forums. {Some of these rock-stars include Christie, Katie, Dorry, and Kendra, among many others.}

But when it comes to psychologists, the stigma seems to run even deeper. Our field is one of professionals who, in most cases, tend to keep their personal lives very close their chests, and at times even lambast those who do not. As psychologists, we are both implicitly and explicitly reminded that self-disclosure can come at a very high cost.

This isn’t simply so that we can seem holier-than-thou and deny that we have real lives with real problems, but rather to allow us (and the patient him- or herself) to focus our energy and attention on the patient. A more traditional view of self-disclosure suggests that being conservative in this area protects boundaries in the therapeutic relationship and allows the patient to work through issues. Some also suggest that it’s not usually in service to the patient to self-disclose, and that it may be done more for the sake of therapist.

A more relational and feminist view of psychotherapy would suggest that mindful and appropriately timed self-disclosure can foster a good relationship between the patient and therapist. Some studies suggest that patients tend to view their therapists more positively following self-disclosure, though research is mixed here. The idea is that the therapist becomes a real person who is on a equal playing field with the patient. The patient may see the the therapist as more genuine, able to understand, and connected.

So what if you learned that your therapist had, in the past, had suffered from an eating disorder? Would you feel uncomfortable knowing that information? More connected? Worried that they might not be recovered enough to help you? More or less inclined to share your symptoms?

Please participate in the poll below. Because this issue is so complex, please also share your thoughts in the comments so that we can all learn from each other.

Other questions to consider:

If you are comfortable, would you want your therapist to tell you him- or herself?

Would your response change if the issue were different (e.g. Bipolar Disorder, ADHD, depression)?

Are there any other factors that might might make your opinion above different?

How much does a therapist’s ability to relate to your specific circumstance impact you (e,g. being married or divorced, being of same ethnic background, sharing religious beliefs)?

_______________________________________________________________________________________

Come join the fun on the NTS facebook page here.

For those who have suffered from anorexia or bulimia, many will tell you that getting treatment was initially not  their choice. Many individuals, particularly younger ones whose families are involved in daily lives, are initially forced, or at least strongly encouraged, to seek help.

For some, the disease had become so unmanageable and the person so nutritionally compromised that he or she is not able to make sound decisions. The starved brain is unable to process information in the same way as a healthy brain, and perception and judgment suffer. Thus, loved ones or treatment providers may advocate for forced treatment to preserve the individual’s life.

Involuntary commitment of people with anorexia is a hotly debated issue. Some argue that a person who is forced into treatment will not benefit from what is offered due to a poor therapeutic relationship and resistance by the patient. Others suggest admitting someone against his or her will is unethical and in violation of their rights. Still others believe that the medical and cognitive complications of such a disease warrant drastic action. In fact, some would argue it’s loved ones responsibility to get the person treatment.

Forced treatment of people with anorexia or bulimia is not, however, what I would like you to consider today. Instead, I’d like to hear your thoughts on how your views on coercive treatment might apply or not to people with obesity.

For most of us, we wouldn’t consider intervening in the lives of someone who is obese. We might encourage that person to engage in healthier eating or more physical activity, but rarely will someone confront the individual about getting treatment for the issue. Perhaps it’s because the health risks associated with obesity don’t often carry the immediacy of those associated with self-starvation. However, the risks can often be serious. On the other hand, not all individuals who are overweight are unhealthy or share in health risks. Thus, the debate.

With the rising levels of obesity in our country and the advent of intervention shows like WETv’s I Want to Save Your Life, I’m curious about your thoughts on demanding that a loved one gets treatment for their weight issue. Because it’s unlikely that involuntary commitment  will be an issue, let’s just consider whether you would intervene strongly if someone’s obesity was affecting their quality of life. And how would you know if weight was impacting the quality of their life? Weigh in here:

Make sure to share a comment in the section below. This is a complex issue and we can all learn from each other!