Monthly Archives: October 2015

A Lack of Information is Fattening

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“I am lazy, stupid and fat!”  A cruel statement, right? But this is what my patient who is recovering from Bulimarexia hears in her head every day, all day long. The reality is that she is a hard worker, very smart and a normal weight after years of struggling with an eating disorder.

But her fear of suddenly or somehow becoming “fat” is so intense that it may take another couple of years for this voice in her head to go away, and it may never go away completely.

Sound crazy? It isn’t unusual for people to think this way.  We are afraid of being obese as a culture. The sight of an obese person strikes fear in the hearts of many. Unfortunately we often hate the things we fear, which leads to stigma. And stigma, especially in the case of obesity, gets in the way of recovery, as it tends to be internalized by the individual being stigmatized. It also impacts members of our society that are not obese in ways that are detrimental to their health.

What I see when I look an obese patient is a person with a medical condition, a person that is often very ill. As a health care provider that has had great success working with the morbidly obese, I know that the problem can be reversed and that with the right information the person can lead a perfectly normal life.

But most people will not see or relate to the illness. They will react with fear, and/or they will stereotype the individual that is obese. Research on the stigma attached to obesity shows that overweight individuals in the U.S. are assumed to be lazy and lacking in intelligence. They are often viewed with disgust. They regularly experience bias in the workplace as well as in many other areas of their lives. Even their own doctors may be biased when it comes to treating them.

For example, according to an article in Psychology Today “A survey involving a nationally representative sample of primary care physicians revealed that, not only did more than half of respondents think that patients who are obese were awkward and unattractive, but more than 50 percent believed that they would be noncompliant with treatment. One-third thought of them as “weak-willed” and “lazy.” 

I recently published an article in Western Pennsylvania Healthcare News on the failure of medicine to treat obesity effectively. While doing the research for that article, I discovered that the rates of obesity are high among physicians, many of whom are overworked and most of whom do not understand the role of nutrition in obesity. For example, the standard advice today from most physicians is still to recommend eating more grains and less fat, which is exactly the opposite of what you should be doing if you are overweight. (Link to why grains are bad for you and why saturated fats are good for you) So much for “Physician heal thyself”.

But the other thing that really stood out while I was researching the article was how overwhelmed physicians felt while trying to treat obese individuals. I also get this from my doctor friends. In another study the researchers found that as the patients’ weight increased, “physicians reported having less patience, less faith in the patients’ ability to comply with treatment, and less desire to help them.” 

When it comes to my own patients, I am always amazed to discover that the issue of their weight does not come up with their primary care doctor even when they have serious complications of obesity and/or need to lose anywhere from 100 to 200+ pounds. One patient said “Talk about the elephant in the room! If I were oozing blood or had a terrible rash, I am sure my doctor would mention it. But because it is my weight, and he makes the assumption that I can’t or won’t do anything about it, we gloss over it.”

The problem with this is that the stigma of being obese can lead to more obesity as well as to other serious problems. Being stigmatized for being obese sets up many vicious cycles or self-fulfilling prophesies. For example, if going to the doctor doesn’t help, then going to the doctor becomes less likely. This in turn means that the complications of being obese, which include diabetes, heart disease, and high blood pressure, may not be diagnosed until they are advanced.

Likewise, many obese individuals are uncomfortable going to a gym or putting on work out clothes because of their fear of being judged. Obviously this makes it less likely that they will workout or get fit, and more likely that they will continue to gain weight.

The obesity epidemic may also be one of the reasons that younger children, older women and more men are developing Anorexia; I believe that these conditions are over-reactions or maladaptive responses to the fear of being obese. Of course, fear of being obese also leads to bingeing and purging, or bulimia.

The point is that obesity is a serious medical condition. However I do not believe that it has anything to do with will-power or motivation, and it certainly is not related to one’s intelligence. It is the direct result of the polluted nature of U.S. foods.

In other words, OBESITY IS NOT THE RESULT OF EATING TOO MUCH. It is the result of EATING POLLUTED FOOD.

The sooner we face that as a nation, the sooner we can stop blaming the victims of food pollution and start fixing the problem. Some people would have us believe that the obesity epidemic is getting better. It isn’t. The reason I say this is that nearly 30% of today’s children are obese. Nearly 72% of men and 67% of women in my generation are currently overweight or obese. When we were children, only 10% of us were overweight. This does not bode well for the future or for our children.

U.S. foods are polluted with addictants, obesogens, carcinogens, GMOs, MSG and trans fats to name a few of the pollutants. All of these “ingredients” drive overeating and/or bingeing. They also cause us to store more fat than we need and feel less like being active. Finally they damage the mechanisms for regulating eating and fat storage.

Yes, that is correct. Even if you eat a little of them, you can gain unneeded weight. (You can also develop many other problems, like vascular disease, autoimmune disorders, cancer and type 2 diabetes.)

Sound like an over statement? Consider that the U.S. is the wealthiest unhealthiest country in the world. We are also the most obese and we are nearly dead last when it comes to general health, with one of the lowest infant survival rates, despite having the best medical technology.

Are you surprised? I find that most people are surprised to hear these things despite the fact that this information is definitely out there. We just don’t think of ourselves this way. We have all drunk the coolaide. But ignorance, in this case, is not bliss. It is sheer agony and it makes those who are the victims feel ashamed and weak, which makes them more vulnerable to remedies that do not work, such as dieting, or bypass surgery, or cryochambers. (link to article on woman dying)

What disturbs me the most is that if we keep believing that we can eat anything, as long as we eat it in moderation, we are not going to fix the problem. The foods that are the most dangerous are “designed” to make us keep us eating them.

We cannot fix the problem with this kind of thinking even though it is very fixable! Find out more about what your food is really doing inside your body. You may be surprised. What I can promise you is that lack of information is fattening.

-Dr. Norton

#GetSunEatCleanBeWell

 

Don’t take away my Bacon! (As long as it’s non GMO, pasture raised)

baconThis morning I woke up to twitter ablaze with the latest WHO findings that processed red meats cause cancer and that red meat is “probably carcinogenic.”

I’m going to break it down for you, because to me, as a professional who deals with food myths on a daily basis, this report is irritating.

In my practice, I am constantly dispelling myths left right and center, in hopes of educating people on how to eat to nourish their bodies for optimal function.

When the article refers to bacon, what kind of bacon are these scientists talking about? Because to me, that is actually the important information. If it’s non-gmo, pasture raised bacon (which, albeit, can be tough to find) then I have to tell you, I am eating it. If it’s name brand bacon full of gmo slop feed, with nitrates, then thanks, but I think I agree with them, and I’ll pass.

Clearly, although these foods have they same name, they are actually totally different.

Let’s take it further.

For example, would I ever recommend that people eat bologna? No. Would I ever recommend that people eat beef? Absolutely. But again, we are back the same kind of requirements that I have about bacon. If the beef is grassfed, pastured, non gmo, no antibiotics, etc. Then yeah, I’ll take a steak grilled spiced with fresh rosemary. But if it’s conventional beef, grain fed on a lot? I’d rather pass.

In terms of the carcinogenic aspect of red meats, I’ve always understood this to be related to the cooking method. Red meats and lamb are often grilled or broiled. The article mentions this prevailing concept, but then quickly says the scientists didn’t have enough data. This is why I eat my steak with Rosemary. It’s helps to mitigate the carcinogenic effects up to 90%. Here’s a study that explains that. I also typically eat a lot of greens when I have steak. The chlorophyll from the greens also has a mitigating effect.

I’d be wary of recommending that a person not eat any grassfed beef. Grassfed beef is so full of vitamin b and zinc, both of which actually play a really important role in a person’s mental health, believe it or not. Vitamin B deficiencies can present as anxiety, insomnia, depression and zinc deficiencies can lead to symptoms of depression, ADHD, and difficulty with learning and memory.

So my take on the latest research? Too general to really be helpful. Follow the guiding principles of eating clean in your daily life, it’s much simpler.

-Dr. Norton

#GetSunEatCleanBeWell

When it Comes to Anorexia, Is It Willpower or is it Addiction?

According to the New York Times, researchers[1] have found that when people with anorexia nervosa think about eating low fat foods, the part of the brain responsible for habit formation and addiction is engaged, which is the opposite for non-Anorexic individuals. In other words the researchers demonstrate that restricting may actually be more of a bad habit, aka and addiction, than a conscious choice.

This represents a shift in thinking, in that we often credit the Anorexic with “super willpower” when it comes to resisting the foods that most people would find tempting. It turns out that they are not depriving themselves but are actually experiencing a reward for restricting; a reward that I believe they have consciously programed into their psyche. I have speculated for many years, based upon observations of how patients justify restricting, (which defies reason from any objective point of view) that they are addicted to restricting. Now there is neurological evidence to back up these clinical observations.

Using functional magnetic resonance imaging — which tracks activity in the brain in real time — the researchers monitored 21 women with anorexia nervosa and 21 healthy individuals while they made a series of choices about what food to eat. As expected, individuals with anorexia nervosa consistently chose more low-fat foods and in so doing activated receptors in the brain. But the real news has to do with the part of the brain, called the dorsal striatum, that lit up at the sight of carrots for those suffering from Anorexia. This part of the brain is associated with habit formation and/or addiction.

If we think of restricting as an addiction, and we understand that addiction is a conditioned response to a stimulus, it changes the focus of treatment. I believe that this research helps to explain why a clean eating approach to treatment for Anorexia succeeds where traditional treatment fails. When I use the term “clean eating” I am referring to eating foods that are free of toxins, loaded with nutrients and antioxidants and have a healing effect on the body and the brain. In my experience, it is much easier for Anorexic patients to switch from low fat to clean foods than it is for them to switch from low fat foods to processed or fast foods, which is what they are expected to do in most treatment programs.

The traditional model of treatment is “moderation” meaning that the goal is for the individual to be able to eat everything and anything without fear. Here is a quote from the director of a very successful residential treatment center that I interviewed a few years ago. “If she isn’t able to eat a Big Mac, fries and a Coke without fear, she isn’t ready to leave our program!” While I am onboard with the no fear part, there are simply some foods we should not eat and fast foods are the best example.

Fast foods are polluted with excitatory neurotoxins, denatured proteins, trans fats and carcinogenic food additives that have been scientifically shown to damage the parts of the brain regulating eating behavior. They have also been shown to be the primary reason for the current obesity epidemic in the U.S.. Despite the evidence pointing to the damage that such foods are doing, the “all foods in moderation” approach is staunchly defended by residential treatment centers and the National Eating Disorder’s Association.

The assumption such groups make is that it is counter productive to encourage the individual with Anorexia to avoid any food, no matter how bad the food is. While this may have been true 35 years ago when food in the U.S. was of a better quality and therefore safer, it is no longer true. The U.S. is currently the unhealthiest wealthiest country in the developed world, with the most obese population and one of the lowest infant survival rates, despite having more food, better medical technology and significantly more resources. Clearly something is amiss and the common denominator is the food.

It is my belief that most people want to be healthy and that those suffering from Anorexia are no exception. Indeed, in my experience, they are often foodies beneath a cloak of starvation. But like many of us, they have been victims of the demonization of fat that began in the 80’s. Simultaneously, they have also fallen prey to the relentless pursuit of thinness in our society. The drive to be thin in a society where obesity is a national epidemic puts pressure on even the youngest members of our society. Researchers have found that little girls start to worry about being fat at age 3. Given that Anorexia is proliferating, affecting younger and younger children, more men and older women than ever before, I believe there is a connection between the two extremes that is driving some of the disordered thinking when it comes to eating.

Resisting “unhealthy” food is much harder now than it was in the past, because food today is actually designed to cause overeating and addiction. In the face of these intense pressures to be thin while surrounded by foods that are designed to make you overeat them, what’s a girl to do?

Train herself to resist. That is what makes this research so interesting. I have been observing this behavior for many years and describe it as more like self-inflicted brain washing. The dialogue in the head of the anorexic never stops, constantly finding and broadcasting evidence that food, especially food containing fat, sugar, calories, salt, (what ever she deems to be unsafe) is the enemy. This inner voice screams at her that if she eats one bite of that chicken breast, she will never be able to stop and she will end up obese, which will result in public humiliation and/or abandonment by everyone that matters in her life. Whereas this thinking used to be completely irrational, back when food was just food, it is no longer as irrational as it sounds.

These thoughts/fears are so powerful and so present, that they become associated with danger, and in that sense are punishing. Relief and therefore, reward, comes in the form of restricting. In treatment, I can demonstrate, quite convincingly, that clean food is safe and that you can eat as much of it as you want and not worry about gaining unwanted or unneeded weight. Many of my patients get that right away, making the transition to clean eating fairly easy. The earlier they begin treatment, the easier it is to make this transition, as there is a progression from being afraid of foods with fat (salt, sugar, calories) to being afraid of all food the longer they have the disorder.

Another component to consider when it comes to stimulus and response, or conditioning, and this may be the most important thing for some people, I find that the majority of my patients have developed food sensitivities that make eating grains, dairy or highly processed foods physically uncomfortable. In many cases, the food sensitivities may have led to an aversion to food, and ultimately to restricting. The restricting often gets rewarded with weight loss and the attention most people receive when they lose a lot of weight.

In contrast, clean food doesn’t cause bloating, constipation or allergic reactions of any kind. It feels good in you. If you are gluten and dairy intolerant, eating pizza may taste good, but it doesn’t feel good. Finally, not only does clean food feel good, it tastes really good!

Using language and behavioral techniques, along with solid data on the healing role that clean food plays in weight and wellness, I am able to help patients form a new conditioned response to food, except this time it is a conditioned response to clean food that gets rewarded and not to restricting. The bottom line is that it is much easier to convince a patient suffering from Anorexia to eat an organic scrambled egg with sour dough toast than it is to convince her or him to eat an Egg McMuffin.

The most common response I get from recovered patients is that they learned to “trust” food again. Eventually eating clean food becomes habitual and not something that occupies the majority of your thoughts day in and day out. When this happens the individual no longer needs to condition a negative response to food and a positive response to restricting. In other words these individuals can reclaim their lives.

[1]The findings appear in the journal of Nature Neuroscience. Columbia University Medical Center, New York State Psychiatric Institute, the Mortimer B. Zuckerman Mind Brain Behavior Institute, and New York University

“Dr. Norton, Why Is My Hair Falling Out?”

Why is my hair falling out?

If you have Hashimotos, or any of a number of autoimmune diseases, such as Alopecia, or hyper or hypothyroidism, one of the most upsetting things that can happen is that your hair falls out.

The traditional treatment for thyroid disease is Synthroid, which is a synthetic version of T4. But it doesn’t work for everyone. Several studies have shown that a subset of patients feel and do better on a combination of T4 and T3, not just T4 (i.e., levothyroxine drugs like Synthroid).

My patients report that by adding T3, they have less depression, brain fog, and fatigue. This could be huge for those individuals that don’t feel well on their current thyroid therapies. However, even with the right combination, hair loss can still be a problem. Hair loss can be so stressful that it makes it even harder for medications and supplements to work.

What is Normal for Hair Growth?

Normally, each hair grows about a half inch a month for about three years, and then it goes into a resting period. One in ten hairs is in a resting period at any one time, and after about three months of resting a new hair pushes the old one out. When too many hairs go into a resting period at the same time, or the conversion process speeds up, hair loss occurs.

One of the things that speeds this process up is the conversion of testosterone into dihydrotestosterone, or DHT. DHT is very unfriendly to the hair follicle. It attacks it and shrinks it, sometimes making it disappear entirely. Hair becomes thinner and finer, and may stop growing entirely.

The conversion of testosterone to DHT seems to speed up in some patients with hyperthyroidism or hypothyroidism, despite what is considered sufficient thyroid treatment.

The key when it comes to hair loss is patience. That said, being open to alternative medicine in the form of supplements is also very helpful. For example, evening primrose oil (also known as EPO) is a nutritional supplement that seems to work well. In his book, “Solved: The Riddle of Illness,” Stephen Langer, M.D. points out that the symptoms of essential fatty acid deficiency are very similar to hypothyroidism. He recommends evening primrose oil – which is an excellent source of essential fatty acids — as helpful for people with hypothyroidism and hair restoration.

Kenneth Blanchard reinforces the usefulness of evening primrose oil, “For hair loss, I routinely recommend multiple vitamins, and especially evening primrose oil. If there’s any sex pattern to it — if a woman is losing hair in partly a male pattern, like the bald spot on the back of the head – -then, the problem is that there is excessive conversion of testosterone to dihydrotestosterone at the level of the hair follicle. Evening primrose oil inhibits that conversion. So almost anybody with hair loss probably will benefit from evening primrose oil.

As an individual with hair loss and as a practitioner that sees a lot of hair loss, I can vouch for it’s effectiveness. Again patience is a virtue, as it takes a few months to a year.

Look at Other Alternatives

In one study, Dr. Hugh Rushton, a professor at Portsmouth University, also found that 90 percent of women with thinning hair were deficient in iron and the amino acid lysine. Lysine is the most difficult amino acid to get enough of via diet.

Lysine helps transport iron, which is the most important element in the body and essential for many metabolic processes. When L-lysine and iron levels are low, the body probably switches some hair follicles off to increase levels elsewhere. Meat, fish and eggs are the only food sources of lysine. There are also supplements that contain lysine. I take L-lysine every night. It also prevents fever blisters.

Some other natural ways to deal with hair loss include:

  • Arginine (be aware that L-lysine and Arginine compete and net each other out. So take one in the morning and one in the evening to get the benefit of each)
  • Cysteine
  • Organic Green Tea
  • Polysorbate 80
  • Progesterone (in a bioidentical drop form)
  • Saw Palmetto
  • Trichosaccaride
  • Vitamin B6
  • Zinc

Did I miss a protocol that you swear has resulted in hair growth? Tweet me @DrRenae and let me know!

No Eggs-cuses Breakfast

No Eggs-cuses Breakfast

No Eggs-cuses Breakfast

Some of us have a really tough time making breakfast. In the rush to get the day started, these Egg Muffins have saved the day, many a morning! You can have all the convenience of “fast food” if you just take a little time once or twice a week to make these and store in the fridge. I actually love to have them on hand as a snack when my days are crazy. I need all that protein.  You can mix up the vegetables if you like, just be conscious of whether or not the vegetable has a lot of water (i.e. zucchini).

Egg Muffins

Ingredients
1/4 cup red bell pepper, diced
1/4 cup carrots, grated
1/2 cup frozen spinach thawed and wrong out
2 to 3 tablespoons basil, diced
1/2 teaspoon sea salt
1/4 teaspoon fresh ground pepper
1 teaspoon bourbon smoked paprika
10 – 12 organic pastured eggs
Instructions
1. Preheat oven to 375 degrees

2. Grease a 12-cup muffin pan with coconut oil

3. In a medium bowl, combine red bell pepper, shredded carrots, spinach, and basil

4. In a large bowl, whisk together eggs, salt and pepper

5. Add egg mixture to the veggie mixture and stir to combine

6. Using a measuring cup or a ice cream scoop fill muffin cups with egg mixture being sure not to fill cups to the rim (about 1/4 to 1/3 cup in each cup)

7. Bake the egg muffins for 20 to 25 minutes or until eggs are set in the middle

8. Muffins can be stored in an airtight container in the fridge for up to 3 to 4 days

 

If you make these, let me know how they turned out on twitter @DrRenae.

#GetSunEatCleanBeWell

-Dr. Norton

 

#MotivationMonday Change Stage Five-Maintenance

Precontemplation

Here we are in my #MotivationMonday series about Change. This week we are talking all about, Maintenance. Now, if you remember last time, I told you that the number one mistake that people make while trying to change is thinking that Action is the last stage of change. It isn’t. Although modifying your behavior is the most visible stage of change, I would argue that the most important stage of change is Maintenance.

During Maintenance you must work to consolidate the gains you have attained during action and other stages to prevent lapses and relapse. In fact, Maintenance is so important that I would warn anyone that if they are doing any kind of program or therapy that promises easy change- to reconsider. I can almost guarantee them that the program will not address or acknowledge that Maintenance is a long, ongoing process. This is actually one of the reasons why I am unsupportive of inpatient residential facility treatments for eating disorders.

What can you expect during the Maintenance stage of your change? You can expect to be surprised that after doing so well, for so long, suddenly an old behavior will creep up again.

Are you surprised by that? Take heart. If you have been coasting along feeling like everything is clicking along and then you hit the holiday season and start to find yourself backsliding, then know that you are in the maintenance stage. And you need support. Stressful events, and triggers can send a person who thinks they have changed into feeling like are on the brink of losing their all their hard work.

That’s why it’s so crucial to your success to be working with someone throughout the change process who knows your history.  You need someone you can call up six months, seven months, 2 years into your change process and just check in with them.

Join me next week when we talk about the final stage of change, Termination.