The Washington Post Again Fails Miserably To Identify the Role of the Dietitian
Dietary patterns and the humans that possess them are not that simple, and no amount of conflation, oversimplification, or subject-matter incompetence by the WP is going to change that.
As my university’s spring break rolled along, and I found myself finally caught up on grading, I wondered aloud at what entertaining medium I might enjoy before class was back in session. No sooner had the thought exited my mind when a friend messaged me about a piece titled, As obesity rises, Big Food and dietitians push 'anti-diet' advice, brought to you by the usual players over at The Washington Post (WP) and The Examination.
This is the same group of people who think that dietitians have no business promoting… well, food. As I read through this new article, I was more amused than angered. It’s the same ploy as before, of pretending that the actions of a few represent the activity of the majority. Of not knowing the difference between food philosophy and evidence-based practice. Of failing to realize that a healthy diet is much more than the right governance, or policy, or sufficient amount of finger-wagging.
Dear reader, become ungovernable with me as I grab a slice of less-than-optimal carbs coupled with 43 grams of protein drink for my post workout snack, and let’s unpack this latest act of atomistic fallacy turned journalistic envoy.
Food companies are now, as the authors present it, jumping on board with anti-diet research (more on this later) and discouraging food shaming. The authors even cite how General Mills has “enlisted a team of lobbyists and pushed back against federal policies that would add health information to food labels.” To begin, anyone familiar at all with the food retail scene will know that food companies vying to promote legislation in their favor is neither a massive secret nor new trend unearthed by the WP. Don’t take my word for it, here’s the estimated amount that General Mills spent on lobbying back in 1998. So I experienced a sense of déjà vu as this article tried the same tactic, claiming that food companies using dietitians to promote their products was suddenly a hot new trend. It wasn’t, as I cynically stated in my post addressing the WP’s claim:
Food and nutrition experts promoting and discussing food products to their audience?! STOP. THE. PRESSES!
As the authors then cite the rise in obesity rates in the United States, here is where we have dietitians (again) dragged into the picture — an ambiguous assertion that dietitians are connected to or responsible for these obesity rates. How? What is their evidence of connection? Well you see, they looked at more than 6,000 social media posts from 68 registered dietitians, most of whom made repeated use of anti-diet language…
*Pause for effect*
112,000 active dietitians in the United States, and the WP is comfortable with running a story based on what amounts to 0.06% of them? From an “analysis” of social media posts tantamount to what I can basically scroll through on a Friday night after my family has gone to sleep?
What is the rationale being used here? Where else do we apply this sort of logic to professions and the professionals in their ranks? You have a fractious percentage of doctors who think that vaccines are unsafe. Do we see any articles titled, “Measles is making a comeback, and doctors are leading the charge”? Up to 100 firefighters are convicted of arson each year in the United States, but I don’t expect a corporate news outlet to run with “Are Firefighters actually Fire-assistants?”.
This is the table talk for most of the article; dietitians who fail to limit their content to posts about prime-grade beef, organically-produced lettuce, and carrots. As an aside, Cara Harbstreet really ought to write a thank you letter to the WP, what with all the free publicity they’re giving her in these articles.
The only interesting point mentioned — which would have made for a much better piece of data-driven journalism — is a discussion about the anti-diet movement and its effects:
While advocates say the anti-diet approach has brought a needed reprieve from the burdens of diet culture, others say the pendulum has swung too far, and the new anti-diet movement is hurting people at risk of health problems related to excess weight and a poor diet.
For disclosure, I am not an “anti-diet” or HAES-centric dietitian. The idea that mortality and disease in people with obesity is driven by stigma or cyclical dieting is nonsense. There is a mountain of rigorous and high-quality research which attests to the benefits of intentional weight-loss in those who suffer from obesity. Joint pain and back problems don’t go away with a sudden sense of body positivity. Sleep apnea and difficulty breathing are not constructs of stigma. Full. Stop.
Herein lies the critical detail I’m most annoyed by with this article, and while I am not a representative, I’m not a minority in respect to my views. The vast, vast majority of dietitians are evidence-based practitioners, who set aside personal food philosophies, and deliver patient-centered care. While the authors cited a few dietitians who offered push-back to anti-diet claims about obesity, as far as I can tell, they failed to mention that the perspective of managing obesity with weight loss is the norm, not the aberration.
But let me offer one more angle to this issue, one which I hope fairly characterizes the perspective of my sisters (and brothers) who take up anti-diet arms. If I were to draw a Venn diagram, where in one circle I wrote “Anti-diet dietitians”, and in the other circle I wrote “Dietitians who at some point struggled with an eating disorder”, the circles would almost perfectly overlap one another.
Let me make the same point, but in meme form.
Studies report that a small percentage of dietitians have received treatment for eating disorders at some point in their lives, or were at risk, past or present. I’m neither surprised nor alarmed by this fact, and you shouldn’t be either. How many people are in their professional careers because of something or someone personal who helped them with a problem they could not solve on their own? Children who became doctors after the efforts of a compassionate caregiver? Police officers who were themselves once rescued or protected by local law enforcement?
It is such with dietitians who overcame their health struggle, discovering newfound warmth and joy in the light of elevating food beyond mere nutrients. It is human nature to evangelize the good things that come along and make our lives better, and for the millions of people who suffer from either an eating disorder or disordered eating, those dietitians bring an empathy that enhances care.
There are, in fact, good and data-driven messages that are trumpeted by the anti-diet crowd. There are many people who have a terrible relationship with food, where something as innocuous as an offering of snacks or sweets send them into a near panic. People should not be mocked or belittled for their weight or appearance, and doing so actually decreases the likelihood they’ll be able to make meaningful changes. Not all dietary interventions should focus on or drive weight loss, as there are many noted benefits to dietary changes beyond the numbers on a scale.
This is the nuance of the discussion; there are people who need to lose weight and there are people who need to stop worrying about their weight. You won’t find this discussion in the article, but you will find plenty of food-shaming, food-snobbery, and finger-wagging:
"I think it is really reprehensible for the food industry to prey on the vulnerabilities of people who suffer from diabetes or obesity or diseases that are caused by excessive sugar, fat and perhaps other ingredients that do them harm,” Blumenthal said. “To tell people they should be proud of eating the wrong things [italics added], that's hardly doing them a service."
I’m sorry, wrong things? What exactly does that mean, and how would elitist and out-of-touch officials be poised to determine this? A brownie seems like the “wrong thing” until you consider that nothing else may have been eaten all day. A milkshake sounds like the “wrong thing” except to a chemo patient who can’t tolerate eating anything else. A kale salad may seem like the “right thing”, but what if my client hates kale?
No. I don’t take criticism from people who cannot tell me what diabetes even is, or what causes it, or why food deserves moral classification, or how their alleged expertise extends into my life to determine all my food choices. Dietary patterns and the humans that possess them are not that simple, and no amount of conflation, oversimplification, or subject-matter incompetence by the WP is going to change that.
Thanks for your post. You made some excellent points.
On a related note, I did my master's thesis on the factors influencing the choice of dietetics as a career. The incidence of disordered eating was surprisingly high, Unfortunately this was not published, but I'm seeing similar findings after all these years. I'm not an "anti-diet" myself, but I certainly support dietitians who choose to support brands that align with their values.
Excellent, Dustin, as always. Facts mixed with wry humor and the incredulousness of what now masquerades as journalism.