The New Yorker

Big news this week: my letter to the editor was published in the New Yorker. If you're like me, you get sucked into reading The Mail every week, so by the time the next issue arrives, you've barely made it to Talk of the Town. When I heard that my letter might be included, I was over the moon - especially because it's such an important topic.

My original letter was heavily edited, so I've included the first draft below.

In case you're wondering what prompted my response, here's the original article. The author is thisclose to hitting the nail on the head, especially when she's quoting Tom Wadden and William Dietz, but never quite gets to what I think is the crux of the matter; namely, that we have created a society where weight loss is nearly impossible - and more importantly, that we have the power to change that!

The problem starts at the highest echelons of government and trickles down through conventional medical education all the way to the obesity epidemic. All is not lost yet, but without change on every level, the article's hypothesis may very well come to pass.

I think we can do much, much better. And I'm committed to doing my part to see it through.

xo
E

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from: emily wade
to: themail@newyorker.com
date: Tue, Oct 4, 2016 at 9:30 PM
subject: Letter to the Editor re: "Bariatric Surgery: The Solution to Obesity?"

Before we all rush off to get bariatric surgery, it would be smart to examine exactly why diets and exercise don't work for obese patients.

First is a systemic problem with medical education. Many doctors are trained to treat symptoms instead of uncover the root cause of disease, and nutrition education in medical school is often minimal. 

Second, patients need more support in making these tough lifestyle changes. Doctors might advise their patients to eat right and exercise, but without any follow-up or a clear plan of action, success is unlikely. 

In addition, patients need more tests, and insurance needs to cover those. Obese patients are often battling dysbiosis, psychological issues, food sensitivities or addictions, or hormonal imbalances, all of which can contribute to the inability to lose weight. Without diagnosing and addressing these contributing factors, patients are more likely to struggle. 

Finally, the biggest hurdle: the food system in the US. People are eating foods that contribute to obesity because these foods are accessible, cheap, easy to prepare, tasty, addictive, and because people are largely misinformed about what's healthy (the low-fat movement discussed in the article is just one such example). 

Obese patients need a holistic, personalized program in conjunction with ongoing support so they can make lasting behavioral change without feeling overwhelmed or giving up. Diets & exercise do work, but there is not a one size fits all solution, and we need to provide patients with not only a strategy, but also the support to help them see it through.

-Emily Adams, Certified Nutrition Consultant

Caffeine

Photo by Slawek Lukjanow

So many of us love our daily cup of joe. Whether it's the ritual of enjoying a warm mug in the morning, or the physical jolt that we get from the caffeine itself, giving up coffee is usually a challenging task. 

I don't include caffeine in my programs because of its health risks. Here's why - and what your options are instead.

There are lots of good medical reasons to reduce or eliminate caffeine intake, especially while trying for a baby. Caffeine's link to infertility - even decaf! - has been well-documented in scientific literature. Caffeine is also associated with increased incidences of miscarriage, low birth weight, and delayed conception. In addition, caffeine's toll on your adrenal health is suspected to degrade your baby's adrenal health as well - and low adrenal function could mean poor metabolism, healing, and stress response.

So what's an addict to do? Well, my programs provide a strong foundation to explore a few options:

1. If you want to try to break the addiction, you may experience up to 3 days of headaches. Knowing that in advance (and planning for it) can make dealing with the withdrawal symptoms easier. Drink lots of filtered water, rest, and distract yourself if possible.
2. If you don't want to kick the habit cold turkey, I recommend weaning yourself down or replacing your coffee with a less-potent form of caffeine such as green tea. If you choose to do this, make sure to drink extra water, as caffeine is a diuertic. 
3. Try going to bed 30 minutes earlier than normal and see if that helps to mitigate the need for caffeine in the morning. 

Test yourself to see how little caffeine you really need to "make do." And, if you're simply drawn to the ritualistic aspect of having a warm drink in the mornings, an herbal tea or hot water with lemon might be an easy replacement. 

Whatever happens, don't beat yourself up. Do the best you can, try different things, and be proud of yourself! Even just making a small change like this can switch up your routine and give you some good insights about what works best for your body.

What's your favorite non-caffeinated healthy beverage? Share your tips on our Facebook page.