Fed Up

Social media has been all atwitter about the new documentary Fed Up with Katie Couric. The name certainly is apropos in that it perfectly sums up how tired I am of this weight debate: totally fed up. Though I speculate that Katie had a different meaning in mind; something more like over-Fed weight-Up.

Notice what emotions come up as you watch the Fed Up movie trailer: anxiety? pride? panic? Notice that the trailer is set to the same macabre music as a thriller or horror film. [Sounds of a ticking clock + sounds of soda cans being opened.. images of cows eating. Images of people standing like zombies in the candy aisle.] Sensationalist language. Eye opening proclamations. And statistics we’ve never heard before…

A recent comment in the ASDAH community:

“Digging deeper for the movie would reduce the sensationalistic aspect and doomsday predictions that are building the hysteria. They need the hype to create traction to sell tickets and copies. The sad thing is they are behaving the same way as they accuse the food industry (which needs to be questioned for sure) with lies, poor and inaccurate science and incomplete data. Manipulation, stereotypes with a judgmental tone are in no way healthy.”

Is there a problem with our food system? – undoubtedly. Is it easier to eat sugar today than it was 100 years ago? – absolutely. But because this film touts so many bogus claims, I am skeptical about the whole documentary. It’s really a shame that a film that could’ve illuminated the corruption in the food industry settles with silly facts and inaccurate science meant to scare the dollars out of us.

Let’s dissect some of the claims from Fed Up:

1. “Your brain lights up with sugar just like it does with cocaine or heroin. You’re gonna become an addict.”

4 Problems with this:

1. There is no existing human study that supports the hypothesis that sugar is addicting, or plays a role in eating disorders. (See: Benton, D. 2009) Making the assertion that sugar is addicting (loosely defined as craving, tolerance, and symptom withdrawal) implies that a person experiences out-of-control cravings for sugar, builds up an increasing tolerance to sugar, and when denied access would experience physical withdrawal symptoms akin to a detoxing from cocaine or heroin. And further, that a human exposed to painful stimulus (like electrocution) while ingesting sugar will continue to eat it with abandon. I don’t know many people that would do that.

2. Yes, eating sugar lights up human pleasure centers of the brain. But do you know what else lights up those same pleasure pathways? Music, sex, smiling faces, attractive faces, a mother recognizing her child, winning a prize, and humor (Robison).

That such a wide range of pleasant phenomena activate these mechanisms suggests that rather than seeing the stimulation of these pathways as something unusual or worrying, it can be viewed as one of the wide range of positive experiences that routinely stimulate a common circuitry. (Benton)

3. Many of the studies positing sugar as an addictive substance are demonstrated on rats. First, rat behavior is not a reliable indicator of the human condition. Second, the experiments themselves are fallible. In these rat studies – typically the rats are first starved for 12 hours, then given 12 hours of access to sucrose (which they binge on – duh), and this cycle repeats. The authors then conclude that (a) sugar is addictive because the rat’s pleasure centers light up upon feeding, and (b) sugar causes binge-eating. The problems with this model are so obvious, I don’t think I need to explain. If we try to extrapolate these results in rats to a human level, this is what we might be able to conclude:  If a human starves themselves for 12 hours and then sits in front of a bag of candy, he/she might eat until sick.

4. Let’s say (for sake of argument) that sugar is addicting. Dieting is still not the solution. “..it will lead to counter-regulatory symptoms of cravings and withdrawal.” (Benton) Dieting leads to restriction and avoidance inevitably making cravings increase, which likely produces over eating. “Calling it an addiction takes away the power to change, and learning to use food in an enjoyable, moderate way.” (Michelle May, M.D.). Several studies show that feelings of guilt and shame from eating predispose a person to overeating.

I remain unconvinced that food can be physically addicting (like that of nicotine, drugs, or alcohol). For more information, take a look at what other researchers, dietitians, doctors, and bloggers have to offer on this subject:

(non-HAES) Marion Nestle “Is Sugar Addictive?
(non-HAES) Andy Bellatti’s take on Food Addiction
(HAES) Jonathan Robison “The Other White Powder
(HAES) The Fat Nutritionist (Michelle’s) take: Is Eating an Addiction?

2. “This is the first generation of children expected to lead shorter lives than their parents.”

Unlike the “sugar is addictive” argument which has a more debatable element, this proclamation of shorter lifespan is straight-up unfounded. This claim was initially made in an opinion piece in the New England Journal of Medicine, and it had no statistical proof to back it up.

Bewildered by the claims, Scientific American tracked down the authors for a clarifying interview. The authors were asked where/how they came up with such a statistic. They responded, “these are just back of the envelope figures” and we “never meant for them to be portrayed as precise.”

In reality, this has no factual, statistical basis. Life expectancy is not decreasing. It is increasing.

“Life expectancy increased dramatically during the same time period in which weight rose (from 70.8 years in 1970 to 77.8 years in 2005). Both the World Health Organization and the Social Security Administration project life expectancy will continue to rise in coming decades.”  Weight Science; Bacon, L.

Further,  the “overweight”category of BMI is statistically the longest-lived, and there is evidence that “overweight” may be protective among older adults.

3. “Over 95% of Americans will be obese or overweight in two decades.”

This producers of Fed Up failed to provide a source for this statistic. Regardless, this is in direct contrast with current research. Studies have routinely demonstrated that the weight of Americans has plateaued over the past decade. The NIH data appears to indicate that obesity rates are not increasing exponentially, but rather are leveling off. See here. And here.

4. “By 2050, 1 out of every 3 Americans will have diabetes.”

Another very confusing statistic proclamation. I am unable to find this verified in any studies. What I am consistently finding is that anywhere between 8-10% of the population has diabetes (not distinguishing between type 1 and type 2). That this has increased by 1.3% every 20 years or so. And therefore it may be plausible that by 2050 11.6% Americans may have diabetes, or 1 out of every 10. This is significantly less than Fed Up would have us believing.

5. “This year for the first time in the history of the world, more people will die from the effects of obesity than from starvation.”

The CDC estimates that 25,800 excess deaths yearly are associated with overweight-related illness.

As for starvation: Professor Mark Gregory Robson of Rutgers University in 2014 placed the number of annual hunger-related deaths annually at 10 million. Oxfam International states that as of 2009, about 24,000 deaths daily (or nearly 8.8 million a year) from hunger-related causes.    And according to the World Food Program, among children under age 5 alone, 3.1 million die every year from hunger and hunger-related causes.

I… Yeah. No words…

6. A calorie is not a calorie, in that the “toxicity” of sugars is an inherent and unique contributor to obesogenicity. When your liver gets that big sugar rush [after drinking a sugar-sweetened beverage] … it has no choice but to turn it into fat immediately.

The problem with statements like these is the research doesn’t back it up. “A moderate body of evidence suggests that under isocaloric controlled conditions, added sugar, including sugar-sweetened beverages, are no more likely to cause weight gain than any other source of energy.”(NEL) The assertion that sugar turns immediately to fat is over-exaggerated, as well. Robert Lustig (of Fed Up and Fat Chance fame) asserts that “insulin shunts sugar to fat”.

While there is a sliver of truth to this, Lustig’s claims are grossly over-exaggerated. “…the truth is that only a very small portion [of sugar metabolism] would be used for this purpose; therefore, it is extremely misleading to suggest this. We are very ineffective at making fat from carbohydrate (Hellerstein 2001) and when we do overeat sugar and consume excess energy, fat accumulation through fat synthesis from the sugar accounts for only a very small fraction of the positive fat balance (McDevitt et al. 2001).” -Kern. For more information on this, I recommend Dr. Mark Kern‘s critique of Lustig’s book Fat Chance.

Pinpointing sugar as the main cause of “obesity” is incredibly reductionistic. As we’ve talked about in the post all about weight, dozens of factors contribute to a persons weight. And while we are unsure exactly to what degree sugar plays into accumulation of excess weight, current research would suggest that Fed Up is greatly exaggerating their claims.

In summary

Going through every statistic and proclamation on Fed Up would make me go insane, so I’ve only tackled the heavy hitters. It’s a shame that producers have to stoop to such lows to get ratings (and a paycheck). While there may be snip-its of truth throughout the documentary, the rampant misuse of research and concepts of human nutrition is incredibly discrediting to the entire film. I don’t expect the average American to sift through the BS of this documentary to pick out the tiny nuggets of truth – what little there appear to be – and resolve to consume sugar in moderation. What’s more likely to happen is a surge in dieting. Followed by a surge in over-consumption of sugar. Followed by a surge guilt, shame and self loathing. and Repeat.

Let me just reiterate my recommendations as a dietitian. I promote:

1. Eating that is: healthful, conscious, pleasurable and flexible. This means eating a balance of:

(a) carbohydrates (high fiber, minimally processed, whole grains, fruits, veggies. Less processed sugar, HFCS, and artificial sweeteners)
(b) fat (more mono & polyunsaturated fats.. low/no trans fats)
(c) lean protein at meals and snacks.

I promote eating in accordance with hunger/fullness cues (which is often every 3-4 hours), and finding joy and pleasure in food. This means paying attention to how foods make you feel, and making choices to nourish your body with a variety of wholesome and delicious foods. This means taking joy in preparing food, eating food, and relishing the satisfaction of eating what you love.

You may notice certain words missing from my recommendations: weight, loss, bad, good, calories, only, don’t, be wary of, never.

2. Movement that is: joyful, sustainable and flexible
3. Size & body acceptance, love and appreciation

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