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Tuesday, 27 March 2012

Standing up to the diet industry or David vs Goliath



Taking on big corporations (emphasising our issue is with the corporation Jenny Craig, and not the CEO, Amy Smith) takes courage. Charlotte Bevan, UK, writes from her heart in explaining why:

They never like anything that upsets the status quo or threatens their income stream. 

I think we have to remember that we live in a world where fat – all fat – is bad and we are about to all die of obesity.  No one in the real world seems to get that Jenny Craig (owned by Nestle) is in the business of making money – a lot of money – not in the business of making us happy, healthy bunnies.  Repeat business is what they need to sustain their profit levels and repeat business is what they get from hundreds of thousands of (mainly) women, with their self esteem in shreds, because of a number on a scale.


It is nothing but a number, people.  It is not a measure of physical or mental health.  Whether people are eating disordered or not, this constant bullying by the diet industry, which has no evidence base to support its more preposterous claims of becoming happier by losing half a stone (7 lbs or 3.2 kg), is putting people’s mental health at severe risk and ruining lives.

Jeez, they have more power than the tobacco industry had in the 1960s and PEOPLE BELIEVE THEM.
Sigh

2 comments:

  1. I am listening and applauding!!!!

    ReplyDelete
  2. Anonymous02 May, 2012

    Hi Charlotte,

    This is not a comment about the post above, but I wanted to make a comment on something you posted on AroundtheDinnerTable and couldn't find another way to contact you here (I'm a graduating medical student, so I read ATDT but am not a member.)

    You have been writing about the NICE guidelines and lack of sufficient evidence for them to suggest FBT. I am not sure this is true. I think virtually every major children's hospital in Canada considers FBT the first-line evidence-based treatment, and simply the automatic default. Also, UpToDate, probably the most-referred to evidence-based source for physicians in both Canada and the US, says this:

    "Family therapy has been shown to be beneficial for adolescents with anorexia nervosa [27,28]. In one study, weight gain was greater when patients and families were seen separately [29]. The Maudsley method, incorporating family therapy, has also shown promising results [30]. This therapy encourages parents to refeed their children at home with the support of a family therapist. Parents are placed in charge of the actual feeding regimen of the affected child.

    The Maudsley method of family therapy was also more effective than supportive psychotherapy in a randomized trial of treatment for bulimia nervosa in adolescents [31]."

    It doesn't include it in an extremely brief list of summary recommendations at the end of the article, but that's as much because the article is somewhat poorly done compared to most on UpToDate and lumps all the eating disorders together as anything else.

    Similarly, our Canadian Pediatric Society 2010 guidelines for the community physician say this: "Evidence regarding the optimal treatment of AN in children and teenagers is growing; however, much remains unknown (3,4). Although current treatment approaches vary in Canada and elsewhere, the evidence to date suggests that family-based treatment (FBT) (5-8) is the most effective treatment for children and teenagers with AN. A key component of the FBT model is that the parents are given the responsibility to return their child to physical health and ensure full weight restoration." They even offer suggestions on how to initiate it. Here is the link: http://www.cps.ca/english/statements/AM/AH10-01.htm.

    It is true that the evidence base is not strong, but normally the way that is handled in guidelines is by grading the strength of the recommendation based on the quality of evidence. So it might be a Level B recommendation rather than a Level A recommendation, but it should still be a recommendation.

    I don't know if any of that is helpful, but thought I would try! :) In Canada, we do have wait lists that are much too long, and there are problems with access to care in areas without a children's hospital, but at least the treatment at the children's hospitals seems to be good once people can get there. (Adult treatment is something of a different story, and more complicated.)

    As a side note, I wondered if this might be useful for anyone: http://www.mcmasterchildrenshospital.ca/body.cfm?id=373

    It's a list of McMaster's recommended resources for physicians, and includes guidelines for admission orders for an eating disordered inpatient. McMaster is one of the meccas of evidence-based medicine in the world - many people have heard of them even in the UK, I think.

    Best wishes!

    ReplyDelete