Wednesday, April 23, 2014

Eat, Pray, Love...Eat Some More

02/02/2012

curly fries Mary Annette Pember "Powwow food": Curly fries with cheese held by unidentified woman at a Plains powwow.

“Eat, Pray, Love, Eat Some More!”

That’s what I posted in the “About you” section of my Facebook profile.

It’s half a joke. As for the other half? I, like Oliver Twist, really do want more food, more of everything in general that makes me feel good in the short term. “Moderation” is a concept that I greatly admire but, despite great exertions of willpower, one that I have never been able to put into practice for very long.

I have battled obesity for a long time with a brief respite during my college and young adult years. For about the past 15 years, my excess weight has proved remarkably resistant to diets and exercise.

I take some consolation in the fact that I am not alone. According to the Centers for Disease Control, American Indian children have the highest obesity rate in the U.S., 20. 2%. A 2007 report by the U.S. Department of Health and Human Services found that the prevalence obesity among American Indian and Alaskan Native school aged children and adults is higher than the respective U. S. rates for all other races combined.

I know all of this data and information intimately because I have written  about obesity, type 2 diabetes and other health issues in Indian Country. I have spoken at length with health care professionals about the rates of diabetes, obesity, alcoholism, depression and suicide in our communities. All of these issues have affected me and/or my family directly.  In many ways, my choice of writing topics has been an effort to exorcise the pain and power of these ills from my life. I have operated under the illusion that knowledge alone would loosen their hold.

Despite all my efforts, knowledge and education, however, I have been unable to lose weight and found myself diagnosed with type 2 diabetes in November 2008.

I have finally concluded that will power alone is not the answer. Who would really choose to be overweight?  Who would choose to have diabetes? 

For me, there is a very real element of addiction in my relationship with food.  I suspect that I am not alone. Why else would obesity and diabetes have such a stubborn, strong hold on so many, Indians and non-Indians alike?

Mark Hyman, MD, notes in his article, “Food Addiction: Could It Explain Why 70 Percent of Americans are Obese?” “The ‘just say no’ approach to drug addiction hasn't fared too well, and it won't work for our industrial food addiction, either. Tell a cocaine or heroin addict or an alcoholic to ‘just say no’ after that first snort, shot, or drink. It's not that simple. There are specific biological mechanisms that drive addictive behavior. Nobody chooses to be a heroin addict, cokehead, or drunk. Nobody chooses to be fat, either. The behaviors arise out of primitive neurochemical reward centers in the brain that override normal willpower and overwhelm our ordinary biological signals that control hunger.”

In November 2011, I decided that I had had enough. Like so many addicts before me, I had hit bottom.  My collapse is expressed in physical pain in my hips, my knees and my back and nearly constant fatigue. I began to despair about surviving long enough to raise my kids, who are ages 7 and 13.  I surrendered to the fact that I can never have a normal relationship with food. Like an alcoholic, I must always be on guard against that first drink. Since then I have joined Weight Watchers, exercised regularly and so far have lost 25lbs.

I have found this admission of powerlessness over food to be remarkably sustaining as I work on changing my eating and exercise habits.  I feel better and have more energy, but most importantly I am examining the medicating role that food has played in my life.

Native people in general have a lot of reasons to medicate ourselves. Both Native and mainstream health care professionals are recognizing the psychological factors that affect addiction, health and other social problems in Indian Country. Maria Yellow Horse Braveheart, associate professor of social work at Columbia University, has helped identify historical trauma and grief as a factor in these problems.  She is describing the collective emotional and psychological injury over the life span and across generations, the inheritance of our history of colonialization. Add the day-to-day trauma of dealing with the fallout and personal losses from alcoholism, suicide and diabetes and you have a perfect recipe for despair.

And so, we have sought relief from our pain. Separated from our traditional spirituality and cultures, however, we chose the white man’s medicines. Alcohol, drugs and foods high in fat and sugar offered short-term relief but in the end, they have betrayed us.

harvesting wild rice Mary Annette Pember On the Bad River Reservation men harvest wild rice, manoonmin. Wild rice is only 4 "weight watchers power plus points" versus brown rice, which is 5. Manoomin is a traditional food high in complex carbohydrates. It also requires a big output of calories to harvest.
The shift from hunting, gathering and farming to a cash economy has resulted in Native peoples consuming far fewer wild and homegrown foods. Other factors affecting diet include poverty, unemployment and limited access to healthy foods as well as increased reliance on USDA commodities.

When I was very young, frybread was only a small part of our diet; my parents, like many other native families, kept a large garden, canning and preserving much of the harvest for later use. Now, however, I see white pasta, white flour, saturated fat, sugar as the mainstay diet in many homes.

After one or two short generations of this new diet, we have climbed to the top of the diabetic, obese, addicted heap. American Indians are more than twice as likely to be diabetic than white folks are.

The public narrative surrounding diabetes and obesity in Indian Country tends to blame Indians for these high rates. According to researchers Teresa Trumbly Lamsam of the Osage Nation and Rhonda LeValdo of Acoma Pueblo, media stories depict Indians as responsible for their diabetes because of eating habits and sedentary lifestyles.

But LeValdo, a journalism instructor at Haskell Indian Nations University, explains that blaming individuals will not improve outcomes for diabetics.

She and Lamsam, an associate professor at the University of Kansas, teamed up to research media stories, published between 1997 and 2011 about diabetes in Indian Country. They point out that negative portrayal in the media influences public policy and opinion.  This negativism, in turn, influences public funding for diabetes prevention and education programming.

They point to how the extensive media coverage about addictiveness of tobacco led to a more sympathetic public view of cigarette smokers’ inability to quit, as well as increased federal funding for nicotine treatment programming.

Science journalist Sally Lehrman, Santa Clara University professor in communications, agrees. She notes, “When journalists can show the social and institutional factors that help shape the choices that an individual or community are able to make, then we give the public more context and better tools for policy-making.”

native american garden Mary Annette Pember Many tribes like the Bad River Ojibwe in Wisconsin are encouraging members to return to raising some of their own food. This young woman tends her "hoop garden," a small plot over which plastic can be draped when needed.

So does this mean that since we have good excuses to be unhealthy that we no longer have to be personally responsible for our lives? Of course not! But understanding helps lead to healing and the willingness to reach out to our community and reconnect with our cultures.

Mainstream medicine is recognizing the importance that culture and spirituality play in healthy living for Native peoples. The National Library of Medicine recently unveiled an exhibition examining Native concepts of health and illness.

In his introduction of the exhibition, Director Donald A.B. Lindberg M.D. notes,  “The loss of pride and purpose can be serious obstacles to healthy living and recovery from illness.”

Last year, I observed some of the interviews for the Library’s exhibition, during which several native healers discussed their approaches to health and wellness.

They spoke of the importance of surrendering human power to the creator and acknowledging that human beings are essentially spiritual creatures forever tied to the spirits of the earth.  They encouraged a return to traditional ways and ceremonies as a means to combat diseases such as diabetes and obesity.

Overwhelmingly, however, the healers stressed personal responsibility for one’s health.  Ceremony alone will not heal us. We need to bring our hearts and our willingness to follow our ways and traditions throughout our daily lives.

So I am working to take responsibility for my health in a good way. Free of blame and shame, I put my tobacco down each morning with gratitude and prayer for strength to walk in the right path. 

I will keep Yonder readers updated on my progress and am officially changing my Facebook motto to “Eat, Pray, Love, Pray Some More!”