Are You Going to Eat the Rest of that Cheeseburger?
A study of 17,643 patients over 30 years found that “being overweight in mid-life substantially increased the risk of dying of heart disease later in life - even in people who began the study with healthy blood pressure and cholesterol levels.”
NO! Say is isn’t so! I’m shocked, shocked to find that obesity is associated with medical illness! Next thing you know we’ll all be told that gambling is associated with having less money, that alcohol ingestion is linked to intoxication, and (heaven forbid) cigarette smoking has been found to be a possible cause of yellow fingers and brown tongues! How do we cope with this latest attack on our brazen love affair with sultry vices?
A guilt-wracked thoughtful soul, especially one who has just ordered a hearty slice of peanut butter and chocolate cheesecake, might respond to the above news by eschewing the tempting plate of joy and declaring to his compatriots that he is “going on a diet.” The vast majority of the accused, however, will likely tut-tut over this new revelation and, vowing to watch what they eat, continue to shovel it in like a human garbage disposal. Is this a mistake, as the article suggests, or do we all have the right to smear as much fat on our bones as earth’s gravity will allow?
When I counsel overweight patients I like to ask them, “What do you like to eat?” The most common answer I get is a chuckle followed by “Everything!” It seems that many of us rationalize our addiction to fattening foods by indulging in a little self-centered teasing, as if having a sense of humor about our excessive calorie consumption legitimizes the habit. Hey, it’s great that you can laugh at yourself - in fact, if you listen carefully you can hear drug companies, cardiologists and funeral directors guffawing, too.
Again I ask- is this an abomination? Should we all feel guilty about our eating habits, and report to the monastery for a room and a small salad - with no dressing?
Hey, I’m not the guy with the answers, just the questions! I will say though that the first scientist to uncover the secret of why some of us eat until we waddle around like a walrus deserves the Nobel prize, if not a patent more valuable than King Midas’ warehouse. Until then the two debate teams will continue to scream at each other, one arguing that the government needs to arrest overeaters and shut down fast-food restaurants, and the other advocating our right to do whatever nasty things we want to do to our formerly pristine bodies, all in the spirit of truth, justice and the American way, or as their tee shirts say: Quam bene vivas refert, non quam diu!*
*How well you live is important, not how long. -Seneca
There’s a news release on the ASCO Web site about a survey of obese people in the U.K. Apparently many of them are in denial about their weight and don’t want to lose weight even if it would improve their health. Yikes, eh?
Maintaining a healthy weight takes discipline, no doubt about it. I’m still fighting off the 20 or so pounds I gained when my thyroid fizzled out after radiation therapy. Getting up early on these pitch-dark winter mornings so I can go on a long-distance walk is really, really hard some days… but I know I have to do it, and the reward has been in seeing the extra weight slowly come off.
I truly think, though, that it’s not enough to tell people to “just do it.” They need a lot of coaching and problem-solving and new skills. For instance, I am often shocked at the number of people who don’t know how to cook, even something as basic as steaming broccoli. And they don’t wanna learn either. I’m never quite sure if it’s a self-confidence thing or just inertia. I personally think psychology is going to be critical in turning the tide on obesity.
Comment by Kitty City — January 12, 2006 @ 12:16 am
I don’t know how somebody young would get to be obese. I can easily understand how a middle aged person can get to 20- or 30- or 40- pounds overweight.
It all comes down to a simple fact that gaining n pounds is easier than loosing n pounds. As you get older the former becomes easier and the latter more difficult.
So you get our of college all slim and pretty. When you were in college you run around between buildings to get to classes, maybe went to the gym or pool or parties where you danced. Loosing weight was easy. Then you get your sedentary job, you come home tired, turn on TV. It takes effort and time to go to the gym. Then, you may have deadlines and have to work until 10pm. You are at work and you are hungry and somebody brings pizza for everyone. Then somebody brings pastries for “special occasion”. It takes willpower to say “no, thanks”. It takes willpower to find time to go to the gym. Even if you try not to eat much at home, each “special occasion” adds a couple of pounds. Then there may be business trips when you work for the whole day only to go to the restaurant and eat lots in the evening (after all it is all paid for). Or vacations where you just want to try this French or whatever food. It takes a lot of walking around to burn just one pastry. A few pounds here and a few pounds there add up.
When I got out of college I weighted 114 (I am 5′2″). For the first few years after college I maintained it. Then, slowly weight started going up. And I wasn’t even eating too much - I mostly ate at home, only went out rarely. But every time I went on vacation I would gain a few pounds and never loose them; every time I had to work late I’d gain a few more pounds. I was even going to the gym regularly and swam with Master’s program but I still only managed to maintain. At some point, though, when my weight reached 140, I said to myself - I have to put a stop to it: I hate the fact that my blood pressure starts going up, I hate the fact that I can only wear loose-fitting clothes and not the tight ones I like and I hate how I look in the mirror. So I increased the number of times I went to the gym, eliminated sweets almost completely, eliminated most refined carbs, started to keep track of calories and to weight myself every day. I allowed myself a small piece of black chocolate a day (less than the “serving size”), and if I ever took a pastry I’d make sure to reduce calories accordingly the next day. Still, it took about 6 months to go from 140 to 122. Maybe if I had eaten lots of fast food and sweets previously, it would’ve been easier - just eliminate it; but since I had never eaten that much except for “special occasions” it took lots of work. So far I’ve managed to maintain, but it takes an effort. A lot of people just don’t have willpower. Also, I’d imagine for people who have more than 18 pounds to loose and who’s been obese for a long time it takes even more of an effort.
Comment by Kitty — January 14, 2006 @ 6:07 pm
I think there is a correlation between weight and depression, maybe ?
The paradigm that depression is associated with anorectic tendencies is not supported by strong evidence, to my knowledge.
Nonetheless, from my experience many people seem ignorant of the simple fact that weight loss is simply a matter of increased exercise and decreased caloric intake.
And I speak as someone who, despite working 70-80 hrs a week, managed to lose close to 30kg in 5 months.
Mind you, it’s bloody hard work. Better than dying, though.
Comment by dr dork — January 15, 2006 @ 10:53 am
Some people eat and eat and eat because their insulin metabolism is damaged. I know that if I splurge on refined carbs, I’m hungry all the time. If I limit my carbs/sweets, I do fine. I’ve been within 5 pounds of the same weight for the last 7 years, not counting gains and losses during and after pregnancy, and not counting my pre-cancer-diagnosis unexplained 10 lb drop. I’ve gained those back and look and feel a lot better now…
At any rate: I have no thyroid at all and have to manage carefully because I had thyroid cancer, but even so, the biggest factor for my weight maintenance is what I eat. I never restrict veggies and or fruit (well, I try to be moderate there), but I do limit other carbs because otherwise I’m just miserable.
It’s not as simple as “a calorie is a calorie is a calorie,” at least not for me. I’m glad I figured it out, too, because I was experiencing creeping weight gain for nearly 10 years before. Also, knowing that low-carb is good for me means I can cook things I love - low-carb - and not feel deprived.
Comment by Joan — January 16, 2006 @ 12:50 am
In my opinion, obesity is linked to the fact we think of eating all the time. And why not. We are constantly bombarded with advert on the best food, restaurants etc… on every imaginable media. To top it all, getting palatable food is so convenient, just put pop it into the oven. No energy expanded.
Comment by liling — January 16, 2006 @ 4:52 am
I want to die in my sleep, of heart disease or something similar problem. I just don’t want to live with heart disease or something similar.
Unfortunately, I don’t get to choose between the two.
Comment by Beverly — January 19, 2006 @ 5:56 pm
I am tired of the pious MD’s handwringing about obesity and their patient’s lack of discipline on the subject. Talk about job security! Just think of all those billable 15 minute intervals that the aging, obese boomers are going to be stacking up in the MD’s office! If I were an MD, I would get info on which diet programs work, and recruit the services of a good nutritionist or dietician, and then refer the patient if they express interest. If not, I would deal with the problems they present with.
I went to an MD’s office for a sinus infection, and he had his skinny, blonde, young nurse weigh me, then harangued me for 1/2 hour about my weight. I finally cautiously reminded him that I was there to get something for my genuine sinus infection. Of course he mentioned his skinny nurse, and wasn’t she the best, for being skinny…. Plus, he santimoniously let me know that he didn’t see patients for weight related visits as it was a waste of his time. Etc., Etc. Needless to say, I never went back to him again.
Comment by Carolyn — January 25, 2006 @ 7:04 pm