How ironic that on Wednesday May 6th 2020 Suffolk County Legis. William R. Spencer (D-Centerport) announced a new initiative about putting the Town of Huntington on Long Island, New York on a “voluntary diet” in an effort to avoid weight gain during the COVID-19 pandemic. This day, May 6th, is also International No Diet Day, which per it’s Wikipedia page “is an annual celebration of body acceptance, including fat acceptance and body shape diversity. This day is also dedicated to promoting a healthy life style with a focus on health at any size and in raising awareness of the potential dangers of dieting and the unlikelihood of success.”
The Huntington diet initiative, also backed by Huntington based bariatric doctors, describes that it’s an effort to keep residents healthier and avoid risks of weight gain during quarantine which they report is linked to having a less favorable outcome if infected with COVID-19. This weight gain, the doctors claim, is due to emotional eating triggered by stress and anxiety because of the COVID-19 pandemic. The program includes virtual movement classes and videos by a bariatric doctor including advice to eliminate “junk food”, eat fruits and vegetables, plan meals, weigh in regularly, exercise, get ample sleep, and hydrate. Dr. David Buchin, bariatric surgeon, is quoted as saying people have gained an average of 15 pounds during the pandemic, hence the “quarantine 15”. He will be going on Facebook Live to talk about how “to control emotional eating and how to avoid comfort food and high carbohydrate rich foods and how to make healthy food shopping lists.”
Although only recommended as a “friendly suggestion”, this call for a town-wide diet without considering individual situations such as food insecurity and eating disorders or the negative health outcomes due to weight stigma or chronic dieting is highly problematic and potentially harmful for the residents of the town of Huntington.
Fat Phobia is Alive and Well in 2020
COVID-19 has hit Suffolk County, Long Island hard. With over 1,600 deaths in Suffolk as of this writing, and over 35,000 confirmed coronavirus cases in Suffolk, stress levels are at an all-time high. Along with the illness itself comes increased unemployment rates, racism, xenophobia, domestic violence, homelessness, food insecurity, and mental health struggles. There has also been increased body dissatisfaction, dieting, and fat phobia. The Quarantine 15 rhetoric has been going on since the very beginning of March and it’s only getting worse. There are countless memes about “getting fat in quarantine” and they are not only showing rampant fat phobia, but they are also causing immense harm for people who are struggling with their relationship with food and body, people who have eating disorders, and people who are in larger bodies.
The fears about a 15 pound weight gain over the span of one month are completely unfounded for most people. A study involving internet connected scales found that the average user gained only 0.21 pounds between March 2020 and April 2020, with 37% of people gaining more than one pound. This is not even close to the projected “Quarantine 15”, and what is never mentioned is that people who are currently dieting or who have a history of dieting are more likely to gain weight rather than people who have a healthy relationship with food. This is because people who have a healthy relationship with food, or who are intuitive eaters, know that emotional eating is a part of life and it can be very comforting, but it is also not the only coping mechanism they have, so their weight will likely stay stable within a few pounds on any given day. Registered dietitian and owner of Happy Body Nutrition in New York City Alanna D’Aries, RD, CDN, CNSC adds that “to offer a blanket statement assuming that everyone’s emotional eating is triggered by COVID-19 and to use that as a fearmongering tactic against fat bodies is irresponsible and ignorant to the actual complexities around emotions and eating behaviors.”
Blaming Weight for Everything is Just Lazy Medicine
The top ten COVID-19 comorbidities in New York are hypertension, diabetes, high cholesterol, coronary artery disease, dementia, chronic obstructive pulmonary disease, renal disease, cancer, and congestive heart failure. Some sources, including the CDC, list obesity as a risk factor for COVID-19. However, as registered dietitian and certified intuitive eating counselor based in Long Island Kim Hoban, RDN, CDN, CPT notes, “the limited research we have seen on the risk of contracting COVID-19 and negative outcomes being related to weight status are flawed and ignore weight stigma, a discrimination based solely on body size. A recommendation for an entire community to be put on a “diet” and exercise regimen is not only unfounded, but it completely ignores social determinants of health such as education, economic stability and access to food or healthcare resources.”
Weight stigma often leads to increased co-morbidities in people with higher body mass index (BMI) because they may be reluctant to seek out medical care since the doctor always recommends weight loss at every visit and blames every health condition on their weight, they may have yo-yo dieted and weight cycled which leads to poorer health outcomes than being at a higher BMI, or they may not have received adequate medical care since studies have shown medical professionals hold negative biases towards people in larger bodies.
New York City based dietitian D’Aries notes “the context around this “health” program is making people feel like their bodies are wrong and if they suffer complications from this virus that they are responsible.” If long term weight loss was sustainable for the majority of the population, then it would be a different story, but evidence suggests that there is no safe way to lose weight and keep it off long term, so we must support people’s health without a focus on weight.
It is a Privilege to Be Concerned About Gaining Weight During a Global Pandemic
With unemployment rates higher than they’ve ever been, more and more people are worrying about where their next meal will come from. And, during this pandemic, dietary intake may have to change. “People may purchase more frozen or shelf-stable items to reduce their trips to the grocery store or choose convenience foods due to financial constraints during layoffs” says Jessica Jaeger, MS, RD, CDN, a Massapequa based dietitian specializing in eating disorders and intuitive eating. It may be an accomplishment for someone just to put a meal on the table to feed their family, and judgment about whether or not a meal is completely balanced or encouraging meal preparation in bulk or creating shopping lists with “healthier foods” may be completely out of reach for some people right now. Now more than ever during this time of global crisis, we should be encouraging people to do the best they can with what they have and where they are instead of putting unrealistic standards on them and being worried about losing weight. If there was a true concern for peoples’ health, we would leave weight out of the equation and just focus on health enhancing behaviors. As Madeline Basler, MS, RDN, CDN and owner of Real You Nutrition succinctly puts it, “gaining a couple of pounds should be the least of people’s worries at a time like this, when people are actually dying.”
My Clients With Eating Disorders are Struggling and Your Fatphobic Comments Don’t Help
It’s always a hard time to have an eating disorder, but this global pandemic where we are social distancing, making jokes about fat bodies and about gaining the Quarantine 15, and may not be able to get our usual foods at the grocery store are making eating disorder recovery so much harder right now. One very modifiable factor in the above list is to stop with the weight gain rhetoric. We can stop talking about how being fat is the worst thing that could possibly happen to us. We can stop demonizing certain foods and holding others up on a pedestal.
You can not tell someone has an eating disorder just by looking at them. Many people with eating disorders or subclinical disordered eating behaviors hide it very well in an effort to appear “normal” with food. People with eating disorders are also of all ages, genders, sizes, socioeconomic status, and nationalities. With an estimate of over 30 million people with an eating disorder in the United States, and with someone dying every 62 minutes as a direct result of their eating disorder, this is certainly something to be concerned about. And, since dieting can sometimes lead to eating disorders, I’m still thinking a diet is not such a good idea.
Okay, So What Can We Do To Enhance Our Health Instead of a Town-wide Diet?
“Shame is not an effective strategy for inspiring behavior change. In fact, it can ironically trigger stressors that lead to overeating” writes Long Island based Registered Dietitian Melissa Vasikauskas RDN, CDN, CLC who specializes in family nutrition. We know that diets are not the answer to the collective anxiety and trauma we are all experiencing surrounding this pandemic. We simply can’t shame people into being healthy. A diet may give us something to do and it may feel good for awhile, but inevitably the diet will end and the weight will come back and the negative feelings will return.
Long Island based eating disorder therapist Stephanie Van Schaick, LMHC agrees that claiming diets are the answer to this fear of weight gain during a pandemic is harmful and also adds that “as a society, we must stop overlooking the effects our mental health has on our overall health. I propose that we replace diet education with education on building sustainable habits, creating a healthy and balanced relationship with food as well as with our bodies, and encouraging moving our bodies in ways that are both mindful and enjoyable. This takes care of our physical health and our mental health, which I believe is the key for our overall health.” Dieting disconnects us from our bodies, and now more than ever when we might be feeling disconnected from others and life as we knew it, it is important to at least feel connected to our own bodies.
Ultimately, this virtual “diet” concocted in hopes of improving the health of town of Huntington residents has completely missed the mark. In continuing to reinforce the idea that being in a smaller body is better, public officials and medical personnel continue to uphold the core beliefs of a culture deeply rooted in diets and fatphobia and will continue to do more harm. If we are concerned about the “emotional eating” our residents are facing, why aren’t we addressing the emotions? Why aren’t we acknowledging the grief, the anger, the sadness, the joy, the disappointment, the heartbreak, and all of the range of emotions right now? A diet is simply not the answer.
If you or someone you know is struggling with food or body image during the COVID-19 pandemic, please reach out to me, Christina Frangione, MS, RD, CDN, RYT, a registered dietitian and certified intuitive eating counselor based in Centerport, NY, or one of the dietitians or therapists quoted in this article for assistance finding peace with food and your body during a chaotic time. We promise not to put you on a diet!