I often talk with patients about the distorted images about our bodies that industry and the media widely propagate. It’s hard to live in our society and yet avoid thinking that we all need to look like Brad Pitt or Angelina Jolie in order to be attractive.

This is particularly true for women: I recently read research suggesting that only 12% of U.S. women are very satisfied with their attractiveness and only 2% describe themselves as beautiful.

In many discussions I have with patients, we ultimately come to the conclusion that the only people who look like Brad Pitt or Angelina Jolie are…Brad Pitt and Angelina Jolie. And that we don’t have to look like them to be healthy, happy, or attractive.

But, as the video below suggests, not even Brad or Angelina actually look like the unattainable, air-brushed, make’d-up versions that we see on TV, billboards, and magazines!

I just found this video, but you may have seen it back in 2006 when it was created as part of a marketing push by Dove called the Campaign for Real Beauty. While their goal was to sell Dove products, it is a testament to them that they shed some light on this (and a shrewd marketing campaign).

I’d like to stop this post now, but can’t help but add one more thing: if you now go to www.CampaignForRealBeauty.com, you get to a website owned by Medifast, the commercial diet company, which sells the typical “weight loss at all costs” message (and products).

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Later today, researchers from Yale University will present an important new study at this year’s American Public Health Association conference. Their research study shows that food companies continue to aggressively market sugary drinks and other junk foods to young children, despite prior pledges to improve child-directed advertising.

Nearly 600 products from 14 beverage companies were studied. Few of their beverages were nutritionally sound, though many presented misleading health claims – such as claiming “all-natural” or “high in antioxidants” on a high-calorie soda or “low sodium” on drinks that are essentially all sugar.

From 2008-2010, kids’ exposure to ads for sodas doubled, and their marketing has become particularly aimed at low-income and minority populations.

Decades of social science research has shown that marketing strongly affects our preferences and choices. Kids are particularly vulnerable to marketing; they are essentially “sitting ducks” for advertisers.

A recent study that I’ve repeatedly discussed showed that marketing can essentially define what kids like to eat. When kids see a licensed character (such as Shrek or SpongeBob) on a packaged food, they say that the food tastes better than the exact same food packaged without the character. All else being equal, in a “taste test” between the exact same food in a similar packaging, but one of the packages simply has a picture of a fun character on it, kids say that the one with the character tastes better (and, of course, they are more likely to choose it). I’ve spoken and blogged about this.

This is particularly important because we live in a new world in which chronic, often nutrition-related, health problems are the most common causes of disease and death in the U.S. This is a stark change from just a few decades ago, when acute diseases, such as infections like tuberculosis, were the biggest killers.

We would never let our kids be attacked by advertisements for germ-infested products that would make them sick or tobacco products that would give them cancer – yet this is what’s happening right now. Sugary drinks and other junk foods contribute to the unhealthy eating and obesity that is killing as many Americans as tobacco.

And this study shows that things are getting worse, despite the pledges of many food and beverage companies to regulate their advertising to young kids.

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HHS officials released their end-of-decade assessment of progress made toward the Health People 2010 goals. If you’re not familiar with Healthy People, see here.

This public health program aims to identify the nation’s health improvement priorities, and provide measurable objectives and engage multiple sectors and stakeholders toward achieving these priorities. It’s redone every 10 years as a set of public health goals for the coming decade.

The final review was positive in many ways. Americans are living longer. Fewer are dying from cancers, including breast, colon, and prostate. And we continue to make progress in the fight against tobacco.

One area that seems futile to many is the obesity epidemic. But as I’ve written previously, and as I discussed in an article published on WebMD today (and pasted below), I believe we’ve actually taken many important steps forward that set the stage for a productive decade ahead.  [Read More…]

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Got a nice email from one of my medical students today. Here is a brief piece:

“…Teaching medical students about obesity is so important and it would nicely fit into a semester-long course. Instead of wasting endless hours on learning about the biopsychosocial model as a vague concept, we could actually spend time learning about direct approaches to specific problems that all physicians face (depression, obesity, diabetes, heart disease, etc.) Instead of spending one lecture on a multitude of topics we should spend most of our time on the most common pathologies/illnesses. You’re advice to me to “not get lost in the minutiae of medical school” is so important because medical school is all about the minutiae and it’s easy to forget that there is a civilization beyond the medical school/hospital doors where most of our learning will actually take place. It’s ironic that physicians often say “don’t look for zebras” when the first 2 years of med school are all about the zebras (rare disorders). I’m not sure what has to happen to shift the focus; it’s something I need to look into.”

It can’t be easy putting together a 4-year medical school curriculum; there’s certainly lots of stuff to cram into young med students’ brains in a short time. But we really need to rethink the process. We waste a lot of time on things that no one will remember, let alone appreciate, and we fail to teach the stuff that really matters. Like relating to patients, building relationships, and helping guide and partner with patients on difficult behavior changes and health and life choices…not to mention some real education and guidance in how to work with patients who have obesity and other chronic diseases.

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This article was published in The Huffington Post on September 23, 2011.

My initial reaction to last week’s announcement of a new Michigan policy to track kids’ weight was emotional and negative. Indeed, so many recently publicized policies and prescriptions regarding weight seem to be uninformed and often stigmatizing toward people who have obesity. For example, there have been calls for taxes levied against people with obesity and proposed laws against serving food to people with obesity, not to mention doctors who systematically refuse to treat patients who are heavy.

So when I heard that Gov. Rick Snyder would mandate doctors to report their patients body mass index (BMI), I jumped to the conclusion that this was yet another example of punishing people for their weight in a society that strongly pushes overeating and weight gain.

But let me explain why this is a good public health measure: It’s a core, essential step in our approach to the childhood obesity epidemic. That is, as long as it’s done right. [Read More…]

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Health reform is an ideal platform to make progress in how we support the treatment and prevention of obesity and related health problems.

My colleague, Christine Ferguson, wrote a Huffington Post article describing the recommendations we submitted to the Department of Health and Human Services (HHS) Secretary Kathleen Sebelius regarding the inclusion of obesity services in the essential benefits package for health reform.

Our position:

No obesity services should be summarily excluded from the EHB package and obesity should be given the same consideration as any other health condition, particularly with regard to coverage and cost-sharing.

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The Good News About Obesity

September 16, 2011

Published in The Huffington Post on September 18, 2011.

The CDC’s recent report of the top 10 Public Health Achievements of the past decade overlooked one of the most important: progress in the fight against obesity.

I bet you’re surprised to read this. While there are many “no brainers” on the CDC’s list, such as tobacco control, motor vehicle safety, and heart disease improvements, scary statistics and media reports suggest that we’re losing the obesity fight.

To be sure, obesity rates only increased over the past decade, continuing the epidemic rise that has progressed over the past half-century. But hidden underneath the scary statistics is quite a bit of good news:  [Read More…]

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Great little article by film director Kevin Smith in this week’s Newsweek:

I tried to get on a Southwest Airlines flight last year, and it didn’t go too well. I had just done a podcast for the International Bear Rendezvous, which was a big gay get-together for dudes who look like me. It was a fantastic feeling because I was in a room with people who for the first time were sexualizing me. I boarded the plane, and the stewardess showed me to the only available seat on this flight. It was between two petite women. Then a lady from the front desk told me to get off because there were “safety issues.” And I said, “Ma’am, please don’t make me leave this plane because you’re saying I’m too fat.” After I left, I tweeted about what happened. My mistake was thinking the story was going to be that I caught a lousy corporation that f–ks with people. But instead the story became “fat guy in a little chair.”

I was at the top of Google News for three days, and all the articles said I was fat. It was horrible. It was like being publicly naked. [Read More…]

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This was published in The Huffington Post on August 23, 2011.

Last week, the 11th Circuit Court of Appeals declared the individual mandate of the Affordable Care Act (ACA) invalid, and now some people are changing their bets about whether the Supreme Court will put the issue on its docket for next session.

But what no one is talking about is the curious bind this opinion puts on the 26 state plaintiffs, who brought the suit the 11th Circuit reviewed, and especially Governor — now Republican Presidential candidate — Rick Perry. The phrase that rings the warning bell is: “Numerous Supreme Court decisions have identified the regulation of health matters as a core facet of a state’s police powers.”

You read that right: A state’s police powers. [Read More…]

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Fat is bad?!

August 8, 2011

Just got an email from one of my medical students, who let me know about an NPR article regarding weight bias and stereotypes.  See below…

Hi Dr. Kahan,

I am sure you already know about this, but on the off chance your summer has been too busy, I thought I’d send it your way. This is a refreshing perspective for the (somewhat) mainstream media!

http://m.npr.org/story/138958386?url=/2011/08/08/138958386/big-fat-stereotypes-play-out-on-the-small-screen

I was eating dinner with some college friends last night, most of whom are on diets because ‘fat is bad’ and I was really excited to share with them the perspective you gave us. Not sure I really convinced anyone, but its a start right?

Hope you and your family are having a great summer!

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Training young docs: we need healers

July 27, 2011

A patient of mine recently alerted me to this exciting NY Times article that describes the admission process of Virginia Tech‘s medical school. Rather than the traditional interview questions about test scores and grades, this process is more like “speed dating,” in which candidates are randomly exposed to 8 standardized patients (actors) who each present […]

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Baby Carrots

July 26, 2011

This is AWESOME:  http://www.babycarrots.com/. I’ve repeatedly discussed the backwards “defaults” that drive the obesity epidemic (for example, see my TEDx talk where I was asked to answer the question Why We Eat the Way We Eat). A particularly striking one is the aggressive marketing of unhealthful foods, particularly to kids. Marketers know, and social science repeatedly […]

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“Tiny Belly” Ads – Yet Another Outrageous Scheme

July 17, 2011

The Washington Post detailed an ongoing FTC investigation of the “Tiny Belly” ads that are ubiquitous online. It’s an interesting read – but mostly just describes more of the “same old, same old”…immoral schemers preying on peoples’ insecurities and hopes.

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Read this if you have, or you work with patients who have, a mental illness

July 1, 2011

Expert on Mental Illness Reveals Her Own Fight N.Y. Times, June 23, 2011 HARTFORD — Are you one of us? The patient wanted to know, and her therapist — Marsha M. Linehan of the University of Washington, creator of a treatment used worldwide for severely suicidal people — had a ready answer. It was the […]

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Media bungles nutrition study – again

June 24, 2011

You may have heard about the New England Journal of Medicine study published this week by Harvard researchers and widely reported in media outlets: Changes in Diet and lifestyle and Long-Term Weight Gain in Women and Men. Many of my patients were confused when reading the newspaper articles covering the study.  Reporters seem to be […]

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White Asians in Bergen County, NJ

June 6, 2011

Today is the first day of a 2-week, intensive course – Problem Solving in Public Health – that I teach twice yearly at Hopkins. It’s a great course. I co-teach it with Bob Lawrence, a pioneer of public health, preventive medicine, and human rights. We teach a systematic method for addressing public health problems. More […]

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TEDx Manhattan video produced and published

June 5, 2011
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The TEDx talk I did in NYC a few months ago was just edited and published online. The TEDx conference was entitled “Changing the Way We Eat,” and I was asked to talk about “Why We Eat the Way We Eat.” Got pretty good feedback on it in NY. It’s a topic on which I’m […]

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“Emotional Eating”

June 4, 2011

A few weeks ago I got an email from a patient who was in a bit of a pickle. She’s a young woman who had just been offered a new job in New York, and she was having a terribly difficult time figuring out what to do: uproot her entire life and move 200 miles […]

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Is the Scale a Litmus Test for Medical Care?

June 3, 2011
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Originally published in The Huffington Post. Last week, the South Florida Sun Sentinel reported that several area OB-GYN doctors are refusing to accept overweight women who are otherwise healthy as their patients. In defending their decision, the doctors cite concerns about potential complications in care, risk of malpractice suits and medical equipment that is not […]

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New Food “Plate” Released by USDA

June 2, 2011

Earlier today the USDA released the the “food plate” to replace the “food pyramid” as the visual companion to the 2010 dietary guidelines. It’s a big change – iterations of the food pyramid have been with us for nearly 2 decades.  And there’s a lot to like about this new direction, I think. I’ll write […]

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Obesity is a Disease. Really.

May 19, 2011
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Originally published in The Huffington Post By now, virtually everyone reading this is familiar with the alarming stats on obesity rates and the health outcomes associated with excess weight. And by now, we’ve all had a chance to develop our own opinions about what obesity is and why most of us are getting fat.  Here’s […]

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NEDA conference

May 10, 2011
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Last week, my policy organization, the STOP Obesity Alliance, joined the National Eating Disorders Association in hosting an event called “Pounds and Policy: Effectively Communicating about Weight and Health” on Capitol Hill.  The event was a great success, and brought a number of important perspectives to the table. The discussion’s goal was to advance an […]

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The Atlantic Food Policy Summit

April 27, 2011
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Yesterday I had the honor of joining Ezekiel Emmanuel (White House Health Policy Advisor), Susan Neely (President and CEO of the American Beverage Association), and Jennifer Grossman (Senior Vice President of Dole Foods) on a panel discussion at The Atlantic’s 2011 Food Policy Summit.  The title of the panel was “Consumer choice, nutrition, and policy.” […]

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Fat Tax

April 7, 2011

My colleague, Christine Ferguson, Professor at GW and Executive Director of the STOP Obesity Alliance, spoke on CNBC about the “fat tax” that’s been discussed recently among some politicians.  You can watch her segment here.

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Providence Hospital Obesity Summit

March 28, 2011

This morning I had the great honor of speaking at Providence Hospital alongside Surgeon General Regina Benjamin, DC Mayor Vincent Gray, DC Health Commissioner Mohammad Akhter, STOP Obesity Alliance Director Christine Ferguson, and several other politicians and public health leaders. The event, titled “Live Well DC!” was an wellness summit focusing on obesity and preventive […]

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Podiatrists. Ugh.

March 22, 2011

Went to the podiatrist yesterday to try to deal with a several year long problem of plantar fasciitis. It started out fine: she was a nice lady, seemed to know what she was talking about. Then she started berating me for not stretching enough. She made me promise that I’d stretch more. I did, but […]

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The context shapes our behaviors

March 18, 2011

Last week I appeared on a cable TV show, Destination Casa Blanca, alongside several colleagues who work in public health and health policy. The discussion centered around childhood obesity (and obesity in general), and included interesting perspectives from Lisa Pino of the USDA Food Stamp Program (now known as the Supplemental Nutrition Assistance Program), Jessica […]

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Genetic predisposition and obesity

March 18, 2011

Another topic discussed yesterday was the role of genetics in obesity (and in the development of the obesity epidemic).  Frankly, I cringe whenever I hear questions about obesity that start with something like “Well, but isn’t discussing genetics an ‘excuse’…” (which is kinda how the question was asked!). In any event, here’s my answer:

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The food industry and obesity

March 18, 2011

Another topic that came up during last week’s Destination Casa Blanca panel was the role of the food industry in obesity. This is, of course, a highly charged issue (though, somewhat less so at this panel since none of us were employed by industry and we all agreed that the food industry does have an […]

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TEDx Manhattan

February 18, 2011
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This past weekend I spoke at a TEDx conference in Manhattan, which was organized around the theme, “Changing the Way We Eat.”  I was joined by a group of fascinating speakers and attendees, including Laurie David (producer of An Inconvenient Truth), Ken Cook (president of Environmental Working Group), Josh Verteil (founder of Slow Food USA), […]

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Fox News

February 12, 2011
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I was recently asked to speak on Fox News regarding 3 weight control medications that FDA is reviewing for approval.  As I’ve written previously, we need numerous “tools” to help manage weight in our “obesogenic” society.  As I discuss in the interview, no medication will “cure” obesity, but they can be of significant help for […]

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Study shows prevention is the best medicine

February 11, 2011

A study published in Archives of Pediatrics & Adolescent Medicine showed further evidence that encouraging healthful lifestyle changes during childhood and adolescence can improve health and prevent disease throughout life. Read about the study here.

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PBS Roundtable on Obesity

February 11, 2011
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As part of a PBS Roundtable discussion on obesity, I was asked about my thoughts on “junk food taxes.”  In this brief clip, I describe that there are many determinants, or factors, that go into our behaviors and choices.  One of the key factors is cost.  All else being equal, when something costs a relatively […]

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Dietary Guidelines for Americans Released

February 11, 2011

After more than 3 years of work by an expert advisory committee, the 2010 Dietary Guidelines for Americans have been released to the public. Though the major points of the new guidelines are not significantly different from the 2005 version, the general message is, quoted from the guidelines, “Enjoy your food, but eat less.” On […]

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Genes load the gun, environment pulls the trigger

October 18, 2010

A pair of recent studies published in Nature Genetics identified more than new 30 genes that are linked to obesity and abdominal fat.  Genes linked to abdominal fat are particularly intriguing targets, because this type of fat is more likely to be associated with adverse metabolic consequences (such as diabetes and heart disease) and poor […]

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Lack of sleep and weight – an issue of muscle loss?

October 18, 2010

Many recent studies have looked at the effects of sleep on health, weight, obesity, disease risk, and other outcomes.  Although we don’t yet have definitive data on the topic, it’s fair to say that the evidence is mounting that poor sleep makes weight management even more difficult. Now, a study published last week furthers the […]

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IOM seeks food label that highlights harmful nutrients

October 18, 2010

The Institute of Medicine released a report last week on front-of-package food labeling and rating systems. In contrast to the typical front-of-package health claim advertising that currently exists (for example, when an unhealthy sugar-cereal highlights a “goodness corner” or “healthy check-mark” to trick kids and parents into thinking the cereal is a health food because […]

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Appetite hormones may predict weight regain after dieting

September 24, 2010

A new study extends our understanding of how hormones and neurochemicals affect appetite and weight, and furthers the explanations for why managing weight and weight loss is so difficult. Read the CBS News article that quotes Dr. Kahan here.

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Farm Bill 2012 approaching…

September 24, 2010

With 2011 around the corner, sights have been set, and jockeying is heating up, for the 2012 Farm Bill. In coming months I’ll write much more about this; for now, here is an article I wrote in the Baltimore Sun in 2007 that describes the importance of this central piece of legislation.

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Teaching doctors about nutrition

September 23, 2010

With the majority of deaths in America being caused by lifestyle- and diet-related diseases, medical schools are (slowly) beginning to education doctors-to-be in nutrition and diet.  Read the New York Times article discussing nutrition education in medical schools here.

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GW researchers calculate obesity costs

September 23, 2010

Researchers at the George Washington University published a unique analysis of the financial costs of weight gain and obesity from an individual perspective.  Read the Time article that summarizes the study here.

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FTC investigates Rice Krispies’ health claims

June 8, 2010

Just more of the same old BS: http://www.ftc.gov/opa/2010/06/kellogg.shtm

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“Diet” Doctors

June 25, 2009

I’m not a diet doctor or a weight loss doctor. I focus on understanding who people are, why they tend to gain (or re-gain) weight, and what we might be able to do about it.  I work together with patients to understand and address the specific drivers of their weight gain; build skills, knowledge, and […]

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