In many homes, food means comfort, love, and warm memories of family and friends. Sometimes, though, stress and negative thoughts can begin to rule, shifting our relationship with food from nourishment and feeling good, to something else. Magazines and media push us to go to extremes for diets, trying fad after fad, comparing ourselves as women (and men) to what we think we should look like.
As one of America’s leading cardiac surgeons, Dr. Ismael Nuño was intimately aware of the negative effects eating disorders could have on the heart. When his daughter lost her battle with anorexia nervosa at age 18, he felt tragedy hit home. In his new book, The Spirit of the Heart: Stories of Family, Hope, Loss, and Healing, Dr. Nuño shares a physician’s perspective on the physical effects of emotional and spiritual disconnection, as well as a negative view of oneself, and in contrast, how a positive outlook, self-acceptance, and support system within the home can create a healing environment for both mind and body.
We talked with Dr. Nuño about the concept of body image, tips on what parents can do if they suspect their son or daughter has an eating disorder, and what we as sisters, mothers, wives, and friends can do about to help each other to create positive self images.
CL: You’d had a great deal of experience with the connection between heart health and weight loss. Can you share some of your experience with us? What has worked for your patients?
Dr. Nuño: The enemy of heart health is obesity. In Los Angeles, 60% of our Latino population are overweight and 40% are obese. That is a terrible statistic. To be heart healthy what I recommend to my patients is to 1) carry a near normal weight. Something appropriate for their height and weight that makes the feel good and healthy—-not ultra skinny and not a number because the doctor said so. 2) Exercise as much as they can. The American Heart Association suggests 4x/week, but that is VERY hard to do because we all work. When I talk to people at the gym that have a great body sculpture about what it takes to get there they tell me they work at it 6 days a week, and do not have a job because they have to body build. Make it a priority, but be realistic. 3) Eat a healthy diet with lots of fresh leafy vegetables, fruits, nuts, water, fish and a little bit of wine. 4) Stay away from dead calories like eating lots of ice cream, chocolates, sugary drinks.
CL: What mistakes do you frequently see in the lifestyles of your patients? How can these decisions affect heart health, and what are the long term consequences of these choices?
Dr. Nuño: The two most frequent mistakes I see in my patients are 1) they smoke —- and will not stop smoking and either heart disease, stroke, or lung cancer will eventually kill them and 2) they do NOT follow doctors instructions. They do not take their medicines and they do not follow up with the doctor—this will also kill them.
Dr. Nuño: Extreme fad diets are okay for the first 3-7 days but that is it. I know that —especially young girls—-want to look beautiful and trim for special occasions, but at some point, you have to return to a normal diet with balanced nutrition. I once spoke with Miss Los Angeles. She was looking forward to going out with a boy, and went on a diet of water mixed in with her cereal and nothing else. She wound up in the hospital and she never made it out on her date. As these extreme diets progress, these girls develop Organic Brain Syndrome. They lose their judgment and continue in their extreme diet. Eventually 4% of them die of sudden cardiac death syndrome (like my daughter), or suicide. Not eating is a form of suicide.
CL: Young women have a lot of pressure on them to look ‘magazine skinny’. How do you think this is affecting them when it comes to diet and food choices?
Dr. Nuño: There is no question that social media, television, commercials, magazines and how skinny they show women in media is affecting these young girls. It resets their thermostat (way of thinking) when it comes to current standards of how they should look. There are some young women (and men) that end up with eating disorders without influence from social media and advertising, but this is rare. They go into extreme fasting. If you see even food commercials, the girls eating are very thin, and many times dressed as being trendy, or with minimal clothing. There is no escaping the message that success means being skinny.
CL: What kind of message do you feel the media needs to change or project differently in order to change this pressure to stay super thin?
Dr. Nuño: Commercial and social media need to re-set the standards. For example, a girl of normal weight gets the boy, gets the ring, wins at school. Right now, only skinny girls do the beer commercials, and hot car commercials. On the program Grey’s Anatomy, a heavy set BUT very bright black female surgeon bosses the rest of the girls around; this is closer to reality, and what needs to happen: brains over extremely thin beauty. Beer, spirits, automobile, food, clothes, hair and mascara commercials all employ very thin girls.
CL: How can we as older women, mothers, and friends help them to have a safe, healthy view of their bodies? Is there self talk that we need to change that may be teaching them the wrong message about how they look in the mirror?
Dr. Nuño: Self perception, correctness, and self value does start at home. All family members-mothers, fathers and siblings-need to help the child develop self worth. Unless that is done, self respect will not happen for these young women. Encouragement about academics is extremely important, as well, since that is where the standardization will come through.
CL: You lost your daughter to anorexia. This is often an illness that goes undetected until it is too late. How can parents encourage their children to have positive body images, and what are the signs that a parent can keep an eye out for if they suspect that their child or teen has an eating disorder?
Dr. Nuño: There are multiple red flags that go up in a young girl with anorexia. We did find out early enough, but fought it hard with her, and unfortunately it was too late. Any time you see a change in behavior, a change in eating habits, a change in academic performance or socialization, a red flag should go up in the parent’s mind because it is not normal. You may say, but in a young teenage girl this is often and not unusual. It is unusual for your daughter and that is why a red flag should go up.
CL: How can young teens help their friends if they suspect that they have an eating disorder?
Dr. Nuño: Young teens can help their friends by speaking one-on-one with their friend about how thin they look. Also, encourage other teens to talk to them as well. At some point, have a group meeting in school or outside of it to discuss eating disorders and what to do about them, how to get help. BUT, DO SOMETHING ABOUT IT. If nothing else is working, have a concerned teen talk to their own parents, and they can talk to the parents of the teen in question. In short, open up the means of communication such that the message goes through to somebody that a teen is in trouble.
CL: We’ve heard that looking at the scale every day can create serious body image issues, particularly as women, as our hormones and body weight may fluctuate more than men. What tips can you provide for women to monitor weight loss without obsessing over the scale?
Dr. Nuño: A body weight scale should be used once a month, but maximum once a week. Seeing it more often, like a daily basis, is really not healthy and can be part of the eating disorder syndrome. Discourage frequent scale checks. In particular, my daughter would specially weigh herself before going to see her endocrinologist and if she was lower in weight, she would force feed herself in the car as much as she could to increase weight an avoid being counseled by her doctors.
CL: What kinds of foods can you suggest to help maintain heart health, and a healthy weight?
Dr. Nuño: The American Heart Association recommends the Mediterranean Diet for Heart Health. This diet includes leafy vegetables, fruits, nuts, fish, chicken, rarely a piece of red meat, a little bit of wine.
About the Author: Dr. Ismael Nuño is author of the book The Spirit of the Heart: Stories of Family, Hope, Loss, and Healing. He is currently Medical Advisor for the Alfred Mann Institute of Bioengineering at USC, and was previously Medical Advisor for the St. Jude Medical Corporation for the Western United States, Chief of Cardiac Surgery and Chief of Staff Elect/President Elect of the Medical Association at the Los Angeles County + USC Medical Center, as well as Assistant Professor of Clinical Cardiothoracic Surgery at the Keck School of Medicine. You can learn more at NunoMD.com.
His new book, The Spirit of the Heart: Stories of Family, Hope, Loss, and Healing is available at Amazon.com and Barnes&Noble.com.
Model Photo: Kristjan Porm