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JewishJournal.com

January 23, 2003

Obesity WeighsHeavily on Jews

"How we deal with food is a true test of spirituality"

http://www.jewishjournal.com/health/article/obesity_weighsheavily_on_jews_20030124

Lynn Kaufman admits that she comes from "big, hearty stock." But after 30 years of being overweight, the Westside resident decided to get control.

"I had gotten to a really scary number on the scale," said Kaufman, a veteran of numerous diets and 10 years with Overeaters Anonymous. At long last, Kaufman lost 42 pounds with Weight Watchers and has kept them off for two years.

Of course, she needs to stay slim to keep her job as a Weight Watchers group leader.Spirited and passionate about health consciousness, Kaufman even drastically curtailed her hours as a personal injury attorney in favor of a far less lucrative career with the weight-loss company.

In fact, Kaufman is one of the busiest  leaders in town, running 11 meetings weekly. Several are in the Beverly-La Brea area, where Kaufman estimated that close to 70 percent of the members are Jewish, including many who are Orthodox.

As the nation's obese population has increased since the 1980s, even Jews in image-conscious Los Angeles have followed suit.

"In my clinical expereince, obesity is just as prevalent in the Jewish community as in the general population," said Dr. David Medway, a Los Angeles physican specializing in obesity and weight control. "It's a problem that is pervasive throughout all economic groups: It's an epidemic," he said.

Up until the 1970s, the nation's obese population had remained fairly stable at about 13 percent. However, by the end of the 1980s, nearly 25 percent of the population was obese, and the numbers have continued to rise since then, according to National Center for Health Statistics. The number of overweight children has nearly tripled.

It's easy to see why. People are generally less physically active today, yet live high-stress lives. Less inclined to cook at home, sales of convenience or take-out meals have soared in recent years. In addition, U.S. restaurants serve portions dramatically larger than those in Europe -- often, far more than an individual should eat at a sitting.

For ritually observant Jews, who celebrate the holidays and Shabbat, managing their weight becomes even more of a challenge.

"People who eat OK during the week have a hard time keeping it together on Shabbat," Kaufman said. In fact, Kaufman's Sunday meetings are especially crowded with Orthodox Jews. One member confided that she likes Sunday weigh-ins because they keep her from overindulging on Shabbat.

"I tell people to eat whatever they want but just know what they're eating and how it will affect their goals," Kaufman said. "Don't expect to go out and eat a huge bowl of fettuccini Alfredo for dinner three nights in a row and lose any weight."

As Kaufman warms up before a meeting, Laura Weinman is often behind the desk, accepting payments from members. As the Orthodox mother of two young children, Weinman, who is also on the program, believes that many observant Jews need to "change the way they think about food. We come together as a community through food. You want to keep the traditions, but you also have to ask yourself, 'Do I really want to eat this?' It can be tremendously hard."

To keep her weight down, Weinman swears off all but homemade challah on Shabbat and exercises at least three times a week. An avid cook, she has also learned to retool her recipes, such as substituting applesauce for oil and low-fat Toffuti products for cream cheese. "I find ways to make a beautiful meal without sacrificing taste or volume," she said. "There's no recipe I can't alter."

But some people prefer other weight loss programs. Zvi Hollander, rabbi of Young Israel of Venice, battled his weight and struggled to control his diabetes for years. His exercise regimen of weekend mountain-biking and hiking -- he has climbed Mount Whitney twice -- didn't help.

Hollander finally found success through Compulsive Eaters Anonymous-Honesty, Open-mindedness and Willingness (CEA-HOW). The program is based on the 12-step philosophy of Alcoholics Anonymous and promotes abstinence --  not only from compulsive eating but also from foods considered particularly addictive: white sugar and flour.

Since joining CEA-HOW 16 months ago, Hollander has lost 44 pounds and is still losing at a rate of a half-pound to a pound each week. His goal is to lose another 20. However, Hollander is frustrated by what he sees as the denial of many in the observant Jewish community about the problem of obesity and its underlying issues.

"We eat for comfort, or because we're angry, or other reasons that have nothing to do with real hunger," he observed. He pointed out the irony of the Orthodox Union recently devoting a cover story in its magazine to eating disorders among Jews.

"You know what they focused on? Anorexia and bulimia," Hollander said. "Those are serious concerns, but they affect only a fraction of the number of people who are obese."

The rabbi is clearly relieved to have found a solution that works for him. "I can admit that I feel powerless over food," he said. "Only the Almighty can help me. And these 12-step ideas are also rooted in Torah."

Before he joined the program, Hollander consulted with Rabbi Abraham Twerski, a nationally known expert in issues of addiction. Twerski, the author of dozens of books on psychology and self-help, including "The Thin You Within You," endorsed the 12-step philosophy wholeheartedly, because it helps people recognize what Judaism calls the yetzer hara (the inclination to follow one's desires rather than one's better instincts).

"To the extent that I let go, food no longer controls me," Hollander said. "God can take away the obsession. How we deal with food is a true test of spirituality."

Hollander is thrilled with his weight loss but is even happier that as a result, he is now almost completely off insulin. A group leader for CEA-HOW, he is trying to encourage many of his heavy friends and colleagues to get serious about managing their own weight. Unfortunately, he has met a lot of resistance.

"Just because obesity is a slow killer doesn't mean it isn't a killer," noted Hollander, who lost an overweight friend only in his mid-40s to a heart attack last year. "People have no problem viewing alcohol as addictive, but they don't see food that way. I think we have desensitized ourselves to viewing obesity as a disease."

The Venice-based rabbi is proud that Ohr Eliyahu, the day school where he teaches, has stopped dangling the incentives of pizza or ice cream parties for children to learn or behave well. Now, they are rewarded with outings or new books.

That's the kind of change Kaufman would also like to see at the day school where her children go, where ice cream parties are the norm to celebrate in class. Kaufman is also disturbed when she sees very obese school staff, who she said provide a poor role model for children.

Yet, given a lifetime of reinforcement of the idea of food as reward, Kaufman admits that it's hard even for her not to reward her own children with food for good grades. But she is also determined to break the pattern.

Sometimes people have to experiment with many diet philosophies before they find the solution that works best for them. For Michel Mazouz, a Los Angeles internist in private practice, weight management became an almost accidental specialty in his practice.

"I had noticed a trend in the medical literature," Mazouz recalled. "It seemed that no matter what the main medical problem was, the physician also noted, 'Patient also needs to lose weight,' or 'Patient needs to control diabetes.' It seemed that being overweight was causing many additional health problems for more and more people."

After an orthopedist colleague sent Mazouz a patient for help with weight loss, both physicians realized that losing weight also cleared up the patient's knee problem. As word of his success with patients has grown, Mazouz's practice has grown from having almost no patients coming for weight loss help to nearly one-third.

"There are 1,001 reasons why people gain weight," Mazouz explained. "It's very time-consuming to treat these patients, because you have to know who you're dealing with. I explain the chain reactions of foods, because the more they know the more they'll do right."

Mazouz developed a weight-loss program that he describes as a "modified Atkins diet," referring to the no-carbohydrate diet that is back in vogue after 20 years of being ostracized by the medical practice. He allows more carbohydrates than Atkins, although they are still limited. Mazouz explains to his patients that quite simply, limiting carbohydrates promotes the burning of fat.

After weight loss is achieved, Mazouz emphasizes maintenance for his patients, which is, he acknowledges, the most important step. "Ultimately," he said, "I want my patients to become their own doctors."

Mazouz, who is Orthodox, believes in the importance of managing one's weight not only for health, but also because "the body is like the soul. Both are on loan from God. We need to take care of both."

Yet, even those who have succeeded in taming the beast of obesity know they must stay vigilant. As Weinman observed, "I'd love to have a day when I didn't have to think about food. Every day is a struggle."

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