Author Archives: Mary

About Mary

Mary has been a registered dietitian and leader in the nutrition field for decades. She has a B.S. in Food and Nutritional Science from the University of Rhode Island, a Masters of Public Health from the University of Minnesota, and completed a clinical dietetics internship at the New England Deaconess Hospital in Boston. Mary has logged more than 20,000 patient visits. When it comes to weight control, Mary is committed to a flexible, realistic and personal approach.

The Four-Star Diet is Not a Book for People Who are Attracted to Fad Diets

I would never guess by her images on Google that Laura Wellington used to struggle with her weight. But she uses diet-talk to describe her former mindset when she says, “I’m just in my self-destructive mode, but I can always go back on a diet.” Eventually, Laura does change her perspective in many small ways that add up to a critical mass when she becomes fundamentally changed. Exactly how she did it is not the point. Laura is simply writing about the lessons she learned for living a meaningful life along the way.

Somehow, Laura, a young widow, mother of four, owner of a TV show and brand, turned it all around. In trying to explain how she did it, she was inspired by a presentation, A Leadership Primer, on victory in business and life made by General Colin Powell. She applied Powell’s twenty principles for business to a weight-controlled life, and she sprinkled her new book, The Four Star Diet, with personal anecdotes and advice from inspirational leaders like Gandhi and Einstein. The book has only 136 pages and you don’t have to read it in order.

Laura Wellington believes that weight control is about taking personal responsibility for choices in less than optimum circumstances.  As a result, she asks you to “reflect daily,” “look below the surface,” and “live fearlessly!” When General Powell asserts, “Endeavors succeed and fail because of the people involved,” Laura interprets it as, “Birds of a feather flock together,” and then explains how positive role models provide invaluable visual lessons, while toxic people in your life must change or perish. She takes no prisoners, in the best possible way. (more…)

A Dietitian Reacts to “The Heavy: A Mother, A Daughter, A Diet”

Author Dara-Lynn Weiss’ airs her dirty linen in public in a controversial new memoir, “The Heavy: A Mother, A Daughter, A Diet.” She shines the light on a most important topic: How can we prevent our kids from becoming overweight? The Heavy chronicles the journey of a mother’s struggle to help her young daughter to get healthy. We first met Dara-Lynn and her daughter, Bea, last April in a Vogue essay from the overbearing mom’s point of view. Bea was deprived and publically shamed. It wasn’t pretty. The blogs condemned mom.

For sure, we need extensive interventions to curb the childhood obesity epidemic, but does the solution lie in a rescue by mom as the food police? The research does not agree. Dietitian Evelyn Tribole, co-author of the book Intuitive Eating, outlines the studies nicely in this video, Warning Dieting Causes Weight Gain.

She shows how the act of dieting, independent of genetics, is a cause of overweight. Deprivation diets can lead to food obsession, binge-eating, and more weight gain. Dieting is passed down from mothers to daughters. Dara-Lynn had strange practices of her own with frequent weigh-ins and juice cleanses to keep the numbers in line. Studies show that a mother’s over-concern about her own size is later expressed in her daughter’s negative body image and feelings of low self-worth. (more…)

Prediction: Fiscal Cliff and ObamaCare Mean More Obesity Discrimination Ahead

Talk of the fiscal cliff and ObamaCare makes me worry about my overweight friends. I fear it’s only a matter of time before they are blamed for dragging down the economy. Obesity is a huge expense, and unlike other costly health problems, obesity is in plain view.

Today, just over one third of Americans has a Body Mass Index of 30 or more, the obesity range. Per-capita medical spending for those individuals is 150 percent higher than for those who are not obese. The Institute of Medicine and other experts estimate the United States spends between $150 and $190 billion a year on obesity-related problems. Spending is driven by prescription drugs and medical procedures for heart disease, cancers, diabetes, and the other chronic diseases of obesity and by days missed from work and the long-term disability that commonly occurs. When public funds from Medicare and Medicaid pay the bill, everyone is impacted, but even when public funds are not involved, everyone pays higher insurance premiums to cover the cost.

Few of us realize that the U.S. health care reform law of 2010 (ObamaCare) allows employers to charge obese workers 30 to 50 percent more for health insurance if they decline to participate in a qualified wellness program. A growing number of companies have begun to make obese workers enroll in weight loss programs or pay higher insurance premiums. For instance, state workers in Alabama are subjected to at-work weigh-ins and body fat tests. Anyone with a BMI of 35 or more must attempt to lose weight or have $25 automatically deducted from their paychecks. To opt out of the weigh-ins, one can accept the $25 deduction. (more…)

The BMI Debate: Is it an Accurate Measure of Health?

As a registered dietitian, I don’t have a problem with the Body Mass Index (BMI.) This is probably because my expectations are entirely in line.

I understand that it is only one of several nutritional status assessment tools. It is an inexpensive and easy way to administer and uncover possible health problems. No screening tool is perfect, however. There are always false negatives and false positives. The BMI was actually designed for population studies, not for diagnosing individuals.

Body Mass Index is a proxy measure of a person’s “degree of adiposity,” or fatness. It is calculated as weight in kilograms divided by height in meters squared. The concept was devised by scientists in the 1800s, but it did not become an international standard for measuring obesity until the 1980s. In the late 1990s, it received popular attention when the government made it part of healthy eating and exercise initiatives.

For practical use, BMI is displayed as a “BMI chart” with weight on one axis and height on the other. A BMI of 18.5 to 25 corresponds to the “healthy weight” range; BMI less than 18.5 indicates underweight; BMI between 25 – 29.9 is the overweight range. Obesity starts when BMI is 30, and it is considered “extreme” when BMI is 40 or higher. (more…)

For Dr. Oz’s Green Coffee Bean, Conflicts of Interest and Flawed Studies Abound

Health Tips from Yahoo! Reluctantly Healthy

When Starbucks adds Green Coffee Bean Extract for a “boost of natural energy” in Starbucks Refreshers™, I understand it. But when Dr. Oz calls Green Coffee Bean Extract (GCBE) the “Miracle Pill to Burn Fat,” I don’t get it so much. During the last week of April, (aka bathing suit week), Dr. Oz featured GCBE on his show. From the looks of my inbox, I see another push for Labor Day, second only to January 1st as the best day to start a diet.

Dr. Oz laid it on thick for Green Coffee Bean Extract. “Breaking news: The coffee bean, in its purest raw form, may hold the secret to weight loss. Women and men who took GCBE lost an astounding amount of fat and weight – 17 pounds in 22 weeks – by doing absolutely nothing extra in their day.” It’s “the magic you’ve been waiting for.”

The segment reported one very small study of 16 healthy adults living in India. The subjects took two different doses of GCBE and a placebo, all in capsule form over four-week intervals for 22 weeks, which is when they lost the 17 pounds. The study wasn’t tight: the subjects weren’t blinded, diet and exercise information was gathered by recall, and side-effects weren’t measured, and so any safety claims are false. The analysis didn’t hold up because, regardless of dosage or even placebo, the subjects all lost weight in the beginning before leveling off just like every other diet. The website Science-based Medicine analyzed the study nicely in Dr. Oz and Green Coffee Beans – More Weight Loss Pseudoscience. (more…)

How Many Calories Do We Really Need?

By Mary Hartley, RD, with Dana Shultz

All of the diet and health advice we’re fed today can be confusing. But some have suggested that what it really all comes down to is eating the right amount of calories and staying active most days of the week. While this may sound like a simple solution, ‘how many calories we really need’ can be rather elusive.

There’s a whole slough of online tools that promise to accurately calculate the amount of calories we require. But how many of us really know if we’re ‘moderately active’ or ‘vigorously active?’ What’s the difference between the two. And are we also to assume that all women 5’5” tall and 130 pounds have the same resting metabolic rate?

To answer these sometimes baffling questions,’s Registered Dietitian, Mary Hartley, RD, weighs in to help us find the truth about what we really need to know when it comes to calorie requirements. (more…)

ObamaCare Approval Means Insurance Mandate for All Americans

Call it a tax, but there is no such thing as a free lunch.

ObamaCare (a.k.a. The Affordable Care Act or ACA) is a huge law with sections and subsections. It was introduced because 30 million Americans do not have health insurance, which is considered by many to be a basic right, and to mandate incentives to make the health care system more efficient, effective and safe. The law would force every American to carry health insurance and obligate insurance companies to cover everyone, even those with pre-existing medical conditions. But a few key provisions were challenged by states and parts of the federal government on the basis of constitutionality. The Supreme Court was brought in to decide the argument.

Two key provisions caused the most concern: (more…)

PCOS Treatment Relies Heavily on a Healthy Lifestyle

This week, we’re helping to raise understanding about infertility by recognizing National Infertility Awareness Week. One in eight couples of childbearing age is diagnosed with infertility, and for women, polycystic ovary syndrome (PCOS) is a leading cause. It is a hormonal imbalance accompanied by two of three characteristics: overproduction of androgens (male hormones); irregular menstrual cycles; and an ultrasound that shows ovaries with tiny follicles that look like cysts but are not. PCOS affects six to eight percent of women of childbearing age.

The signs of PCOS vary greatly among women. Some have excessive hair growth in a male pattern, as well as weight gain, acne, and scalp hair loss. Others have insulin resistance that may lead to diabetes, with lipid disorders and high blood pressure. The good news is that women with PCOS can and do get pregnant, but conception often means an unpleasant ordeal of tests, procedures, cycle tracking, and medications, not to mention cost.

Lifestyle interventions (i.e. healthy eating and activity) that help control weight are a cornerstone of PCOS treatment. Having too much body fat and eating too many carbohydrates aggravates insulin resistance and hormonal imbalance. The diet for PCOS should have only the number of calories that it takes to maintain a healthy weight and carbohydrates should not contribute more than 40 to 50 percent of total calories. (more…)

Potential Qnexa Users Better Off With a Salad Spinner and Walking Shoes

UPDATE 7/17/12: Qnexa was approved by the FDA on July 17, 2012. This marks the second weight loss drug approval in 2012; the first weight loss drugs approved since Alli in 1999. The prescription drug will be sold as Qsymia.

The inmates are running the asylum. Reversing an earlier decision, the medical experts on FDA’s Endocrinologic and Metabolic Drugs Panel cleared the way for approval of the new diet drug Qnexa. Qnexa (PHEN/TPM) is a combination of phentermine and topiramate (PHEN/TPM). Topiramate is used to treat seizures and prevent migraine headaches and phentermine is approved for the short-term treatment (i.e. a few weeks) of obesity. PHEN was half of PHEN/FEN, the discontinued diet drug that led to valvular heart disease and potentially fatal pulmonary hypertension, primarily in women. Qnexa is indicated for “BMI greater-than or equal to 27 kg/m2) with weight-related co-morbidities such as hypertension, type 2 diabetes, dyslipidemia, or central adiposity (abdominal obesity),” the group with the highest heart disease risk.

The panel decided that the complications of obesity outweighed the risk of heart problems. It’s hard to believe they were swayed by the research. The 2010 study published in the Lancet reported that people who took the highest dose of Qnexa (not the lower approved dose) lost at least 10% of their body weight and showed improvements in their risk cardiac factors. Clinical trials by the manufacturer showed 45% of subjects treated at the low dose lost > 5% of baseline body weight following one year of treatment. No one seems to care that we’re talking about a 10 to 15 pound weight loss on a 200 pound person. Do we need a drug for that, especially one that comes with heart disease risk? No matter because the results showed statistical significance in a placebo control study. (more…)

Intuitive Eating Shifts the Paradigm of Dieting

At any point in time, one in three women and one in five men in the United States are on some kind of diet. Most dieters opt for traditional programs that count nutrients or servings of food or actually specify which foods to eat. Those diets produce short-term weight loss, but two or three years later, 95 percent of traditional dieters regain the weight. But the diet industry manages to hold on because hope springs eternal in the human breast.

Research shows that starvation, whether from natural causes or intentional dieting, increases the risk of overeating and binge eating disorder (binge eating disorder is a distinct entity and not the same as overeating.) On-again, off-again dieters regain lost weight by over-eating in-between periods of restrictive dieting. The human body is simply programmed to respond to starvation by hoarding food when it becomes available.

On-again, off-again dieters develop a “dieting mindset.” They lose touch with their thresholds for taste and fullness. For example, when normal eaters eat sweets or a meal, they cross over a threshold and lose their desire for more sweets or food. Chronic dieters, on the other hand, learn to ignore those signals. They decide when, what, and how much to eat based on whether they are on or off a diet. That leaves them susceptible to eating in response to external cues, like TV commercials and food pushers, and to non-food cues such as boredom and unpleasant feelings. (more…)